The State of the Summer: a Review of Child Summer Weight Gain and Efforts to Prevent It
Purpose of Review
Accumulating evidence shows that children in the USA gain weight more rapidly during the summer, when school is not in session. This narrative review spanning 2007 to 2017 summarizes efforts to characterize the problem, identify key determinants, and intervene to prevent excess summer weight gain.
Summer weight gain remains a concern for elementary-age youth. Few studies have examined its determinants, but unfavorable summertime shifts in diet, physical activity, sedentary time, screen media use, and sleep have been reported. Increased structure is thought to protect against summer weight gain. Interventions to support physical activity and nutrition during the summer show promise, though large-scale impact on weight outcomes remains to be seen.
Supporting health behaviors during the summer remains a priority for obesity prevention researchers, practitioners, and policymakers. Strategies to expand access to structured programs and reach beyond such programs to improve behaviors at home are of particular importance.
KeywordsChild obesity Summer weight gain Out of school time Seasonal weight gain
Compliance with Ethical Standards
Conflict of Interest
Lindsay A. Tanskey, Jeanne Goldberg, Kenneth Chui, Aviva Must, and Jennifer Sacheck declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
All reported studies/experiments with animal or human subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of outstanding importance
- 1.Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief. 2017;(288):1–8.Google Scholar
- 5.Institute of Medicine, The National Academy of Sciences. Accelerating progress in obesity prevention: solving the weight of the nation. Washington, DC, 2012.Google Scholar
- 6.Public Law 111-296: The healthy, hunger-free kids act of 2010.Google Scholar
- 7.Olsho LE, Klerman JA, Ritchie L, Wakimoto P, Webb KL, Bartlett S. Increasing child fruit and vegetable intake: findings from the US Department of Agriculture Fresh Fruit and Vegetable Program. J Acad Nutr Diet. 2015;115(8):1283–90. https://doi.org/10.1016/j.jand.2014.12.026.CrossRefPubMedGoogle Scholar
- 11.• Baranowski T, O'Connor T, Johnston C, Hughes S, Moreno J, Chen TA, et al. School year versus summer differences in child weight gain: a narrative review. Child Obes. 2014;10(1):18–24. https://doi.org/10.1089/chi.2013.0116. A narrative review of summer weight gain featuring a conceptual model of influences on seasonal differences in BMI CrossRefPubMedPubMedCentralGoogle Scholar
- 12.• Franckle R, Adler R, Davison K. Accelerated weight gain among children during summer versus school year and related racial/ethnic disparities: a systematic review. Prev Chronic Dis. 2014;11:E101. https://doi.org/10.5888/pcd11.130355. A systematic review of accelerated summer weight gain covering studies published between 2005 and 2013, with a focus on racial/ethnic disparities CrossRefPubMedPubMedCentralGoogle Scholar
- 16.• Moreno JP, Johnston CA, Chen TA, O'Connor TA, Hughes SO, Baranowski J, et al. Seasonal variability in weight change during elementary school. Obesity. 2015;23(2):422–8. https://doi.org/10.1002/oby.20977. A large longitudinal analysis of data from children in Southeast Texas illustrating a consistent pattern of summer weight gain that diminishes in magnitude over the elementary school years CrossRefPubMedGoogle Scholar
- 18.•• von Hippel PT, Workman J. From kindergarten through second grade, U.S. children’s obesity prevalence grows only during summer vacations. Obesity. 2016;24(11):2296–300. https://doi.org/10.1002/oby.21613. The most recent nationally representative analysis of summer weight gain, which followed over 18,000 children from kindergarten through second grade CrossRefGoogle Scholar
- 19.Daratha K, Power T, Steele M, Bindler R, Ullrich-French S. Changes in BMI between summer and school months among middle school students. Wash State J Public Health Pract. 2009;2(2):13–21.Google Scholar
- 22.Zhang J, Himes JH, Hannan PJ, Arcan C, Smyth M, Rock BH, et al. Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study. BMC Public Health. 2011;11:951. https://doi.org/10.1186/1471-2458-11-951.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Economos CD, Hyatt RR, Must A, Goldberg JP, Kuder J, Naumova EN, et al. Shape Up Somerville two-year results: a community-based environmental change intervention sustains weight reduction in children. Prev Med. 2013;57(4):322–7. https://doi.org/10.1016/j.ypmed.2013.06.001.CrossRefPubMedGoogle Scholar
- 26.Gutin B, Yin Z, Johnson M, Barbeau P. Preliminary findings of the effect of a 3-year after-school physical activity intervention on fitness and body fat: the Medical College of Georgia Fitkid Project. Int J Pediatr Obes. 2008;3(Suppl 1):3–9. https://doi.org/10.1080/17477160801896457.CrossRefPubMedGoogle Scholar
- 29.• Wang YC, Vine S, Hsiao A, Rundle A, Goldsmith J. Weight-related behaviors when children are in school versus on summer breaks: does income matter? J Sch Health. 2015;85(7):458–66. https://doi.org/10.1111/josh.12274. A cross-sectional analysis of nationally representative data to compare obesity-related behaviors in the school year and summer CrossRefPubMedGoogle Scholar
- 30.United States Department of Agriculture Economic Research Service. National school lunch program. 2015 http://www.ers.usda.gov/topics/food-nutrition-assistance/child-nutrition-programs/national-school-lunch-program.aspx. Accessed 1 May 2015.
- 31.Briefel RR, Wilson A, Gleason PM. Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants. J Am Diet Assoc. 2009;109(2 Suppl):S79–90. https://doi.org/10.1016/j.jada.2008.10.064.CrossRefPubMedGoogle Scholar
- 33.United States Department of Agriculture Food and Nutrition Service. National School Lunch Program and School Breakfast Program: nutrition standards for all foods sold in school as required by the Healthy, Hunger-Free Kids Act of 2010: interim final rule. Fed Regist 78(125) 2013 https://www.gpo.gov/fdsys/pkg/FR-2013-06-28/pdf/2013-15249.pdf. Accessed 2 Febr 2018.
- 35.United States Department of Agriculture, Economic research service. Summer Food Service Program 2017 https://www.ers.usda.gov/topics/food-nutrition-assistance/child-nutrition-programs/summer-food-service-program.aspx. Accessed 11 Dec 2017.
- 36.United States Department of Agriculture Economic research service. National School Lunch Program 2017 https://www.ers.usda.gov/topics/food-nutrition-assistance/child-nutrition-programs/national-school-lunch-program/. Accessed 11 Dec 2017.
- 37.United States Department of Agriculture. Food and nutrition service. Summer Food Service Program (SFSP). 2017. https://www.fns.usda.gov/sfsp/serving-summer-meals. Accessed 11 Dec 2017.
- 38.Hopkins LC, Gunther C. A historical review of changes in nutrition standards of USDA child meal programs relative to research findings on the nutritional adequacy of program meals and the diet and nutritional health of participants: implications for future research and the Summer Food Service Program. Nutrients. 2015;7(12):10145–67. https://doi.org/10.3390/nu7125523.CrossRefPubMedPubMedCentralGoogle Scholar
- 44.McCue M, Marlatt K, Sirard J. Examination of changes in youth diet and physical activity over the summer vacation period. Internet J Allied Health Sci Pract 2013; 11(1).Google Scholar
- 46.Katzmarzyk PT, Denstel KD, Beals K, Bolling C, Wright C, Crouter SE, et al. Results from the United States of America’s 2016 report card on physical activity for children and youth. J Phys Act Health. 2016;13(11 Suppl 2):S307–S13. https://doi.org/10.1123/jpah.2016-0321.CrossRefPubMedPubMedCentralGoogle Scholar
- 55.Sadeghirad B, Duhaney T, Motaghipisheh S, Campbell NR, Johnston BC. Influence of unhealthy food and beverage marketing on children’s dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obes Rev. 2016;17(10):945–59. https://doi.org/10.1111/obr.12445.CrossRefPubMedGoogle Scholar
- 59.• Brazendale K, Beets MW, Weaver RG, Pate RR, Turner-McGrievy GM, Kaczynski AT, et al. Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis. Int J Behav Nutr Phys Act. 2017;14(1):100. https://doi.org/10.1186/s12966-017-0555-2. A comparison of obesogenic behaviors on structured school days and unstructured weekend days to test the hypothesis that structure protects against summer weight gain CrossRefPubMedPubMedCentralGoogle Scholar
- 61.Hopkins LC, Fristad M, Goodway JD, Eneli I, Holloman C, Kennel JA, et al. Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months. BMC Public Health. 2016;16(1):1122. https://doi.org/10.1186/s12889-016-3765-7.CrossRefPubMedPubMedCentralGoogle Scholar
- 62.Weaver RG, Brazendale K, Chandler JL, Turner-McGrievy GM, Moore JB, Huberty JL, et al. First year physical activity findings from turn up the HEAT (Healthy Eating and Activity Time) in summer day camps. PLoS One. 2017;12(3):e0173791. https://doi.org/10.1371/journal.pone.0173791.CrossRefPubMedPubMedCentralGoogle Scholar
- 64.Bohnert AM, Ward AK, Burdette KA, Silton RL, Dugas LR. Active summers matter: evaluation of a community-based summertime program targeting obesogenic behaviors of low-income, ethnic minority girls. New Dir Youth Dev. 2014;2014(143):133–50. https://doi.org/10.1002/yd.20107. CrossRefPubMedGoogle Scholar
- 65.Weaver RG, Beets MW, Turner-McGrievy G, Webster CA, Moore J. Effects of a competency-based professional development training on children’s physical activity and staff physical activity promotion in summer day camps. New Dir Youth Dev 2014;2014(143):57–78. doi: https://doi.org/10.1002/yd.20104.
- 69.D'Haese S, Van Dyck D, De Bourdeaudhuij I, Deforche B, Cardon G. Organizing “Play Streets” during school vacations can increase physical activity and decrease sedentary time in children. Int J Behav Nutr Phys Act. 2015;12:14. https://doi.org/10.1186/s12966-015-0171-y.CrossRefPubMedPubMedCentralGoogle Scholar
- 72.• Moreno JP, Vezina-Im LA, Vaughan EM, Baranowski T. Impact of child summertime obesity interventions on body mass index, and weight-related behaviours: a systematic review and meta-analysis protocol. BMJ Open. 2017;7(10):e017144. https://doi.org/10.1136/bmjopen-2017-017144. A protocol describing what will be the first systematic review and meta-analysis of the impact of summertime obesity prevention and treatment interventions CrossRefPubMedPubMedCentralGoogle Scholar