Conference ProceedingsChildhood Obesity Case Statement
Section snippets
International scope of the problem
Obesity is now recognized as a worldwide problem. Wang in 2006 demonstrated that with the exception of Russia and Poland in the 1990s, the prevalence of overweight and obesity has increased in almost all the countries studied. This finding is most profound in economically developed countries and in urbanized populations [9]. Kosli also showed significant prevalence of obesity not only in the US but also in the European Union and throughout the world [10].
No area of the world is immune to this
Scope of the problem: Pain
Obesity in adults has long been linked to musculoskeletal pain and post operative complications. Somewhat surprisingly, there is a lack of evidence to prove a relationship between obesity and back pain in adults, at least in one large epidemiologic study [14]. Obesity has more recently also been reported to be associated with pain in children. The most common sites of discomfort in one study of obese children (obesity defined as having a body mass index [BMI] in the 95th percentile for age- and
Alignment/gait abnormalities
Concern over the long-term impact on joints of altered gait, secondary to obesity has led to recommendation for further study [20]. There is no significant information as to the long-term effect this alteration will have as these children become adults. It is of great concern that obese children and adolescents are already presenting with significant pain and malalignments at a very young age and that this may be a precursor to early degenerative arthritis as an adult [21]. Further research
Slipped capital femoral epiphysis
The etiology of slipped capital femoral epiphysis is thought to be multifactorial. The association of this diagnosis with overweight conditions has been found in several countries, including the United States [28]. Manoff in 2005 evaluated the correlation between BMI and the incidence of SCFE, utilizing the Center for Disease Control and Prevention BMI for age percentile growth charts. For those with slipped capital femoral epiphysis, 81.1% of the individuals had a BMI above the 95th percentile
Fractures
There have been reports of an increasing incidence of distal radial fractures and forearm fractures in children over the past few decades. This increase has occurred at the same time as the increase in obesity and could be related to changing patterns of physical activity, decreased bone acquisition due to poor calcium and vitamin D intake, or other factors [38]. Complications of treating fractures, at least of the femur, have been reported to be higher in children with obesity. However, these
Vitamin D and mineral supplementation
The role of vitamin D and mineral supplementation in a healthy diet to maximize bone health is also not clear in children, as it requires further areas of emphasis and research, and is beyond the scope of this review. This obviously has long-termimplications not only for musculoskeletal health, but also for many other potential medical conditions. For example, very low levels of vitamin D increased the likelihood of Blount disease 7.33 times, but did not increase the likelihood of slipped
Summary and conclusions
The impact of obesity (typically defined as a body mass index over the 95th percentile matched for age and sex) in children, as it relates to metabolic diseases such as diabetes and heart disease, cannot be emphasized enough. Unfortunately, limited literature exists examining the associated musculoskeletal problems. However, clinicians are recognizing that obese children and adolescents are presenting with significant musculoskeletal abnormalities, especially pain and developmental issues of
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(2009) - Presidential memorandum: First lady Michelle Obama launches lets move: America's move to raise a healthier generation...
- Obama M. Lets move. Edited, 〈http://www.letsmove.gov/〉; letsmove.gov,...
- Hellmich N. Michelle Obama to launch initiative fighting child obesity. In: USA Today,...