Pandemic-Associated Disruption and Regional Divergence in Childhood Obesity Trajectories in Brazil, 2008-2025
5 affiliations
- 1Department of Medicine, Centro Universitário Cesumar, Maringá, BRA
- 2Department of Agronomy, Universidade Estadual de Maringá, Maringá, BRA
- 3Department of Medicine, Universidade Estadual de Londrina, Londrina, BRA
- 4Department of Internal Medicine, Universidade Nove de Julho, Maringá, BRA
- 5Department of Medicine, Centro Universitário Ingá, Maringá, BRA
Abstract
Background: National averages may conceal whether Brazilian regions experienced different departures from, and returns to, their projected pre-pandemic childhood obesity trajectories. We evaluated long-term trends, pandemic-associated deviations, and changes in regional inequality among children aged 5-10 years monitored by the Brazilian Food and Nutrition Surveillance System (SISVAN) from 2008 through 2025.
Methods: We conducted a nationwide ecological interrupted time-series study using publicly available surveillance data. Joinpoint regression estimated annual percent changes. Segmented regression estimated the 2020 level change and subsequent slope change nationally and in each region. From these coefficients, we calculated annual and cumulative fitted deviations from continuation of the pre-pandemic trajectory. Regional absolute and relative gaps were assessed at prespecified years.
Results: Prevalence increased from 10.45% in 2008 to 15.41% in 2025 and peaked at 17.84% in 2021. The national model showed a 2.54-percentage-point level increase in 2020 (P=0.001) and a -0.646-percentage-point annual slope change thereafter (P=0.002). The fitted deviation from the projected pre-pandemic trajectory decreased from +2.54 points in 2020 to approximately zero in 2024 and -0.69 in 2025. Regional recovery diverged: the South and Southeast crossed their projected trajectories in 2023, the Northeast and Center-West in 2025, whereas the North remained 1.28 points above projection in 2025. The maximum regional prevalence gap widened from 3.18 points in 2008 to 10.78 in 2021, then narrowed to 6.66 in 2025.
Conclusions: The pandemic period was associated with a transient national departure from the pre-pandemic trajectory, but recovery was regionally asynchronous. Persistent excess relative to projection in the North contrasted with faster reversal in the South and Southeast, while regional inequality remained wider in 2025 than in 2008. Interpretation must account for changes in surveillance coverage.
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BibTeX
@article{nanni2026pandemicassociated,
title = {{Pandemic-Associated Disruption and Regional Divergence in Childhood Obesity Trajectories in Brazil, 2008-2025}},
author = {Carolina O Nanni and Marcos R Nanni and Isadora O Nanni and Cintia Motta and Ricardo Fava and Kézia de Oliveira and Ana Carolina Santana da Silva Mangialardo and Nádia Sogabe and Jácomo Manzotti and Eduardo Moreschi},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117593},
url = {https://doi.org/10.7759/cureus.117593},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Pandemic-Associated Disruption and Regional Divergence in Childhood Obesity Trajectories in Brazil, 2008-2025
AU - Carolina O Nanni
AU - Marcos R Nanni
AU - Isadora O Nanni
AU - Cintia Motta
AU - Ricardo Fava
AU - Kézia de Oliveira
AU - Ana Carolina Santana da Silva Mangialardo
AU - Nádia Sogabe
AU - Jácomo Manzotti
AU - Eduardo Moreschi
PY - 2026
DA - 2026/10/07
JO - Cureus
DO - 10.7759/cureus.117593
UR - https://doi.org/10.7759/cureus.117593
AB - Background: National averages may conceal whether Brazilian regions experienced different departures from, and returns to, their projected pre-pandemic childhood obesity trajectories. We evaluated long-term trends, pandemic-associated deviations, and changes in regional inequality among children aged 5-10 years monitored by the Brazilian Food and Nutrition Surveillance System (SISVAN) from 2008 through 2025. Methods: We conducted a nationwide ecological interrupted time-series study using publicly available surveillance data. Joinpoint regression estimated annual percent changes. Segmented regression estimated the 2020 level change and subsequent slope change nationally and in each region. From these coefficients, we calculated annual and cumulative fitted deviations from continuation of the pre-pandemic trajectory. Regional absolute and relative gaps were assessed at prespecified years. Results: Prevalence increased from 10.45% in 2008 to 15.41% in 2025 and peaked at 17.84% in 2021. The national model showed a 2.54-percentage-point level increase in 2020 (P=0.001) and a -0.646-percentage-point annual slope change thereafter (P=0.002). The fitted deviation from the projected pre-pandemic trajectory decreased from +2.54 points in 2020 to approximately zero in 2024 and -0.69 in 2025. Regional recovery diverged: the South and Southeast crossed their projected trajectories in 2023, the Northeast and Center-West in 2025, whereas the North remained 1.28 points above projection in 2025. The maximum regional prevalence gap widened from 3.18 points in 2008 to 10.78 in 2021, then narrowed to 6.66 in 2025. Conclusions: The pandemic period was associated with a transient national departure from the pre-pandemic trajectory, but recovery was regionally asynchronous. Persistent excess relative to projection in the North contrasted with faster reversal in the South and Southeast, while regional inequality remained wider in 2025 than in 2008. Interpretation must account for changes in surveillance coverage.
SN - 2168-8184
ER -