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Complications of obesity in children and adolescents

Abstract

The increasing prevalence and severity of obesity in children and adolescents has provided greater emphasis on the wide variety of comorbid conditions and complications that can be experienced as a consequence of obesity. These complications can occur both in the short term and in the long term. Some complications, earlier thought to be long-term issues, which would only occur in adulthood, have now been shown to occur in children and adolescents. These findings have raised concerns about the overall health experience of those who develop obesity early in life and have even raised questions about whether the obesity epidemic might shorten the life span of the current generation of children. In this paper, I will examine current knowledge regarding the different organ systems that may be impacted by childhood obesity.

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References

  1. Metropolitan Life Insurance Company. New weight standards for men and women. Stat Bull 1959; 40: 1–4.

    Google Scholar 

  2. Mokdad AH, Marks JS, Stoup DF, Gerberding JL . Actual causes of death in the United States, 2000. JAMA 2005; 293: 293–294.

    CAS  PubMed  Google Scholar 

  3. Flegal KM, Graubard BI, Williamson DF, Gail MH . Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 2007; 298: 2028–2037.

    Article  CAS  PubMed  Google Scholar 

  4. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352: 1138–1145.

    Article  CAS  PubMed  Google Scholar 

  5. Ingelsson E, Sullivan LM, Fox CS, Murabito JM, Benjamin EJ, Polak JF et al. Burden and prognostic importance of subclinical cardiovascular disease in overweight and obese individuals. Circulation 2007; 116: 375–384.

    Article  PubMed  Google Scholar 

  6. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990; 322: 882–889.

    Article  CAS  PubMed  Google Scholar 

  7. Berenson GS, Srinivasan SR, Bao W, Newman III WP, Tracy Re, Wattigney WA . Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998; 338: 1650–1656.

    Article  CAS  PubMed  Google Scholar 

  8. McGill Jr HC, McMahan CA, Zieske AW, Malcom GT, Tracy RE, Strong JP . Effects of nonlipid risk factors on atherosclerosis in youth with a favorable lipoprotein profile. Circulation 2001; 103: 1546–1550.

    Article  CAS  PubMed  Google Scholar 

  9. Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt JD, Rost CA et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996; 27: 277–284.

    Article  CAS  PubMed  Google Scholar 

  10. Gidding SS, Bookstein LC, Chomka EV . Usefulness of electron beam tomography in adolescents and young adults with heterozygous familial hypercholesterolemia. Circulation 1998; 98: 2580–2583.

    Article  CAS  PubMed  Google Scholar 

  11. Sorof J, Daniels S . Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002; 40: 441–4417.

    Article  CAS  PubMed  Google Scholar 

  12. Rosner B, Prineas R, Daniels SR, Loggie J . Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. Am J Epidemiol 2000; 151: 1007–1019.

    Article  CAS  PubMed  Google Scholar 

  13. Muntner P, He J, Cutler JA, Wildman RP, Whelton PK . Trends in blood pressure among children and adolescents. JAMA 2004; 291: 2107–2113.

    Article  CAS  PubMed  Google Scholar 

  14. Lauer RM, Clarke WR . Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics 1989; 84: 633–641.

    CAS  PubMed  Google Scholar 

  15. Din-Dzietham R, Liu Y, Bielo MV, Shamsa F . High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 2007; 116: 1488–1496.

    Article  PubMed  Google Scholar 

  16. de Simone G, Devereur RB, Daniels SR, Koren MJ, Meyer RA, Laragh JH . Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 1995; 25: 1056–1062.

    Article  CAS  PubMed  Google Scholar 

  17. Yoshinaga M, Yuasa Y, Hatano H, Kono Y, Nomure Y, Oku S et al. Effect of total adipose weight and systemic hypertension on left ventricular mass in children. Am J Cardiol 1995; 76: 785–787.

    Article  CAS  PubMed  Google Scholar 

  18. Daniels SR, Loggie JM, Khoury P, Kimball TR . Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 1998; 97: 1907–1911.

    Article  CAS  PubMed  Google Scholar 

  19. Flynn JT, Alderman MH . Characteristics of children with primary hypertension seen at a referral center. Pediatr Nephrol 2005; 20: 961–966.

    Article  PubMed  Google Scholar 

  20. Steinberger J, Moran A, Hong CP, Jacobs Jr DR, Sinaiko AR . Adiposity in childhood predicts obesity and insulin resistance in young adulthood. J Pediatr 2001; 138: 469–473.

    Article  CAS  PubMed  Google Scholar 

  21. Ball GD, Huang TT, Gower BA, Cruz ML, Shaibi GO, Weigensberg MJ et al. Longitudinal changes in insulin sensitivity, insulin secretion, and beta-cell function during puberty. J Pediatr 2006; 148: 16–22.

    Article  CAS  PubMed  Google Scholar 

  22. Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P . Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr 1996; 128: 608–615.

    Article  CAS  PubMed  Google Scholar 

  23. American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care 2000; 23: 381–389.

    Article  Google Scholar 

  24. Lauer RM, Lee J, Clarke WR . Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study. Pediatrics 1988; 82: 309–318.

    CAS  PubMed  Google Scholar 

  25. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143–3421.

    Article  Google Scholar 

  26. American Heart Association; National Heart, Lung, and Blood Institute, Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. Cardiol Rev 2005; 13: 322–327.

    Google Scholar 

  27. Goodman E, Dolan LM, Morrison JA, Daniels SR . Factor analysis of clustered cardiovascular risks in adolescence: obesity is the predominant correlate of risk among youth. Circulation 2005; 111: 1970–1977.

    Article  PubMed  Google Scholar 

  28. Goodman E, Daniels SR, Meigs JB, Dolan LM . Instability in the diagnosis of metabolic syndrome in adolescents. Circulation 2007; 115: 2316–2322.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH . Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003; 157: 821–827.

    Article  PubMed  Google Scholar 

  30. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350: 2362–2374.

    Article  CAS  PubMed  Google Scholar 

  31. Moran JR, Ghishan FK, Halter SA, Green HL . Steatohepatitis in obese children: a cause of chronic liver dysfunction. Am J Gastroenterol 1983; 78: 372–377.

    Google Scholar 

  32. Schwimmer JB, Deutsch R, Rauch JB, Behling C, Newbury R, Lavine JE . Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr 2003; 143: 500–505.

    Article  PubMed  Google Scholar 

  33. Nadeau KJ, Klingensmith G, Zeitler P . Type 2 diabetes in children is frequently associated with elevated alanine aminotransferase. J Pediatr Gastroenterol Nutr 2005; 41: 94–98.

    Article  CAS  PubMed  Google Scholar 

  34. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C . Prevalence of fatty liver in children and adolescents. Pediatrics 2006; 118: 1388–1393.

    Article  PubMed  Google Scholar 

  35. Schwimmer JB, Behling C, Newbury R, Deutsch R, Nievergelt C, Schork NJ et al. Histopathology of pediatric nonalcoholic fatty liver disease. Hepatology 2005; 42: 641–649.

    Article  PubMed  Google Scholar 

  36. Schwimmer JB, McGreal N, Deutsch R, Finegold M, Lavine JE . The influence of gender, race, and ethnicity on suspected fatty liver in obese adolescents. Pediatrics 2005; 115: e561–e565.

    Article  PubMed  Google Scholar 

  37. Mallory Jr GB, Fiser DH, Jackson R . Sleep-associated breathing disorders in morbidly obese children and adolescents. J Pediatr 1989; 115: 892–897.

    Article  PubMed  Google Scholar 

  38. Rhodes SK, Shimoda KC, Waid LR, O'Neil PM, Oexmann MJ, Collop NA et al. Neurocognitive deficits in morbidly obese children with obstructive sleep apnea. J Pediatr 1995; 127: 741–744.

    Article  CAS  PubMed  Google Scholar 

  39. Amin RS, Kimball TR, Bean JA, Jeffries JL, Wilging JP, Cotton RT et al. Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 2002; 165: 1395–1399.

    Article  PubMed  Google Scholar 

  40. Amin RS, Kimball TR, Kalra M, Jeffries JL, Carroll JL, Bean JA et al. Left ventricular function in children with sleep-disordered breathing. Am J Cardiol 2005; 95: 801–804.

    Article  PubMed  Google Scholar 

  41. Rodriguez MA, Winkleby MA, Ahn D, Sundquist J, Kraemer HC . Identification of population subgroups of children and adolescents with high asthma prevalence: findings from the Third National Health and Nutrition Examination Survey. Arch Pediatr Adolesc Med 2002; 156: 269–275.

    Article  PubMed  Google Scholar 

  42. Stenius-Aarniala B, Poussa T, Kvarnstrom J, Gronlund EL, Ylikahri M, Mustajoki P . Immediate and long term effects of weight reduction in obese people with asthma: randomised controled study. BMJ 2000; 320: 827–832. Erratum in BMJ 2000; 320: 984.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Loder RT, Richards BS, Shapiro PS, Reznick LR, Aronson DD . Acute slipped capital femoral epiphysis: the importance of physical stability. J Bone Joint Surg Am 1993; 75: 1134–1140.

    Article  CAS  PubMed  Google Scholar 

  44. Britz B, Siegfried W, Ziegler A, Lamertz C, Herpertz-Dahlmann BM, Remschmidt H et al. Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes Relat Metab Disord 2000; 24: 1707–1714.

    Article  CAS  PubMed  Google Scholar 

  45. Pine DS, Goldstein RB, Wolk S, Weissman MM . The association between childhood depression and adulthood body mass index. Pediatrics 2001; 107: 1049–1056.

    Article  CAS  PubMed  Google Scholar 

  46. Schwimmer JS, Burwinkle TM, Varni JW . Health-related quality of life of severely obese children and adolescents. JAMA 2003; 289: 1813–1819.

    Article  PubMed  Google Scholar 

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Correspondence to S R Daniels.

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Daniels, S. Complications of obesity in children and adolescents. Int J Obes 33 (Suppl 1), S60–S65 (2009). https://doi.org/10.1038/ijo.2009.20

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