The Impact of Overweight and Obesity on Plantar Pressure in Children and Adolescents: A Systematic Review

We aimed to synthesise the results of previous studies addressing the impact of overweight and obesity on plantar pressure in children and adolescents. An electronic search of scientific literature was conducted using PubMed, Cochrane and Scopus database, with keywords: “plantar pressure” AND “children” AND “obesity”; “plantar pressure” AND “adolescents” AND “obesity”, “plantar pressure” AND “children” AND “overweight”, “plantar pressure” AND “adolescents” AND “overweight”. Twenty-two articles were included in the review and the following data were recorded: authors, publication year, type of technology (systems, software) for the determination of plantar pressure, study characteristics. Most of the articles used dynamic plantar pressure determination with only four using static plantar pressure measurement. Using ultrasonography with static plantar pressure determination, the correlation between structural and functional changes in the feet of obese children. In overweight and obese children and adolescents, important findings were recorded: higher contact area, increased maximum force beneath the lateral and medial forefoot, increased pressure–time integral beneath the midfoot and 2nd–5th metatarsal regions. Significantly increased foot axis angle and significantly flatter feet were observed in obese subjects in comparison to their normal-weight counterparts. The obese children presented increased midfoot fat pad thickness, with decreased sensitivity of the whole foot and midfoot.

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Estimation of percentage of body fat in field studies – a method based on relative elbow breadth (Frame Index) and BMI

Human Biology and Public Health ◽

10.52905/hbph.v1.3 ◽

2021 ◽

Vol 1 ◽

Author(s):

Rebekka Mumm ◽

Anna Reimann ◽

Christiane Scheffler

Keyword(s):

Children And Adolescents ◽

Body Fat ◽

Field Studies ◽

Skinfold Thickness ◽

Public Health Research ◽

Normal Weight ◽

Overweight And Obesity ◽

Obese Children ◽

Cross Sectional ◽

Skeletal Robusticity

Background Over the last 20 years, a decreasing trend in external skeletal robusticity and an increasing trend in overweight and obesity was observed worldwide in adults and children as modern lifestyles in nutritional and activity behavior have changed. However, body mass index (BMI) as a measure for overweight is not an ideal predictor of % body fat (%BF) either in children and adolescents or in adults. On the contrary, it disguises a phenomenon called “hidden obesity”. Objectives We aim to approximate %BF by combining skeletal robusticity and BMI and develop an estimation-based tool to identify normal weight obese children and adolescents. Sample and Methods We analyzed cross-sectional data on height, weight, elbow breadth, and skinfold thickness (triceps and subscapular) of German children aged 6 to 18 years (N=15,034). We used modified Hattori charts and multiple linear regression to develop a tool, the “%BF estimator”, to estimate %BF by using BMI and skeletal robusticity measured as Frame Index. Results Independent of sex and age an increase in BMI is associated with an increase in %BF, an increase in Frame Index is associated with a decrease in %BF. The developed tool “%BF estimator” allows the estimation of %BF per sex and age group after calculation of BMI and Frame Index. Conclusion The “%BF estimator” is an easily applicable tool for the estimation of %BF in respect of body composition for clinical practice, screening, and public health research. It is non-invasive and has high accuracy. Further, it allows the identification of normal weight obese children and adolescents.

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Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-035676 ◽

2020 ◽

Vol 10 (10) ◽

pp. e035676

Author(s):

Taimoor Hasan ◽

Tom S Ainscough ◽

Jane West ◽

Lorna Katharine Fraser

Keyword(s):

Systematic Review ◽

Outcome Measures ◽

Meta Analysis ◽

Healthcare Utilisation ◽

Normal Weight ◽

Overweight And Obesity ◽

Obese Children ◽

Outpatient Visits ◽

Ed Visits ◽

The Impact

ObjectiveThis systematic review and meta-analysis aims to systematically analyse the association of overweight and obesity with health service utilisation during childhood.Data sourcesPubMed, MEDLINE, CINAHL, EMBASE and Web of Science.MethodsObservational studies published up to May 2020 that assessed the impact of overweight and obesity on healthcare utilisation in children and adolescents were included. Studies were eligible for inclusion if the included participants were ≤19 years of age. Findings from all included studies were summarised narratively. In addition, rate ratios (RRs) and 95% CIs were calculated in a meta-analysis on a subgroup of eligible studies.Outcome measuresIncluded studies reported association of weight status with healthcare utilisation measures of outpatient visits, emergency department (ED) visits, general practitioner visits, hospital admissions and hospital length of stay.ResultsThirty-three studies were included in the review. When synthesising the findings from all studies narratively, obesity and overweight were found to be positively associated with increased healthcare utilisation in children for all the outcome measures. Six studies reported sufficient data to meta-analyse association of weight with outpatient visits. Five studies were included in a separate meta-analysis for the outcome measure of ED visits. In comparison with normal-weight children, rates of ED (RR 1.34, 95% CI 1.07 to 1.68) and outpatient visits (RR 1.11, 95% CI 1.02 to 1.20) were significantly higher in obese children. The rates of ED and outpatient visits by overweight children were only slightly higher and non-significant compared with normal-weight children.ConclusionsObesity in children is associated with increased healthcare utilisation. Future research should assess the impact of ethnicity and obesity-associated health conditions on increased healthcare utilisation in children with overweight and obesity.PROSPERO registration numberCRD42018091752

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Prevalence of Overweight and Obesity in Children and Adolescents from the Age Range of 2 to 19 Years Old in Brazil

International Journal of Pediatrics ◽

10.1155/2014/583207 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 28

Author(s):

Janaina R. Niehues ◽

Ana Inês Gonzales ◽

Robson R. Lemos ◽

Poliana Penasso Bezerra ◽

Patrícia Haas

Keyword(s):

Public Health ◽

Children And Adolescents ◽

National Level ◽

Public Health Problem ◽

Overweight And Obesity ◽

Obese Children ◽

Cross Sectional ◽

Juvenile Obesity ◽

Age Range ◽

Obesity In Children

Introduction. Infant juvenile obesity is currently a worldwide public health problem and it is increasing at alarming rate in the Brazilian population, showing its relevance in terms of public health.Objectives. Determine the prevalence of overweight and obesity in children and adolescents between 2 and 19 years old in different regions of Brazil.Methods. The following electronic databases were searched (from September through November 2013): Medline (PubMed), LILACS, and SciELO, using the descriptors and Boolean operators (obesity) and (overweight) and (child) and (prevalence) and (Brazil). Prospective and/or cross-sectional designs studies were found regarding the prevalence of overweight and obese children and adolescents in the five regions of Brazil.Results. A total of 191 scientific articles were found of which 17 met all inclusion criteria. A higher prevalence of overweight was found in the south (25.7%) and north (28.8%) of the country, and obesity in the southeast (15.4%) and south (10.4%).Conclusions. The scope of the studies was mostly based on municipal coverage, which resulted in limitations for conclusive analysis, showing the need for further studies of prevalence at the national level, with emphasis on public health in obese children and adolescents throughout the Brazilian territory.

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Asthma prevalence and the impact of nutritional status on prescribed asthma medications in children

Medicinski pregled ◽

10.2298/mpns2010265p ◽

2020 ◽

Vol 73 (9-10) ◽

pp. 265-270

Author(s):

Vesna Petrovic ◽

Vesna Vujic-Aleksic ◽

Tanja Rozek-Mitrovic ◽

Aleksandra Hristov

Keyword(s):

Nutritional Status ◽

Normal Weight ◽

Asthma Prevalence ◽

Obese Children ◽

Primary Health Center ◽

Cross Sectional ◽

Asthma Symptoms ◽

Children With Asthma ◽

Nutritional Status Of Children ◽

The Impact

Introduction. Asthma and obesity are the most common chronic health disorders in children. Although heredity plays a significant role in their development, environmental factors and early exposure have contributed to the increasing incidence of both disorders in recent decades. The aim of the study was to estimate asthma prevalence in schoolchildren in Indjija, Srem District, Serbia, and to investigate differences in nutritional status of children with asthma as well as differences between their nutritional status and prescribed asthma medications. Material and Methods. A cross-sectional retrospective cohort study was conducted at the Primary Health Center in Indjija. Of all the medical records of children aged 6 - 14 years, a cohort of children with asthma was formed. The retrospective study evaluated their nutritional status and the prescribed asthma medications. Results. The prevalence of asthma in children aged 6 - 14 was 6.9%. Children with asthma were significantly more overweight and obese (40.5%) than children without asthma. Boys accounted for 63.7% of children with asthma, with a statistically significant gender difference. Abnormal nutritional status was found in 44.3% of children with asthma and boys with asthma were significantly more obese (23%) compared to girls (7.8%). Overweight and obese children with asthma were not prescribed significantly more medications to relieve asthma symptoms than normal-weight children. Conclusion. The prevalence of asthma among schoolchildren in Indjija was 6.9%. Children with asthma were more likely to be overweight and obese than children without asthma, whereas boys with asthma were significantly more obese than girls. No significant differences were found between their nutritional status and prescribed asthma medications.

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Positive Association Between Body Mass Index and Hematologic Parameters, Including RBC, WBC and Platelet Count, in Korean Children and Adolescent

10.21203/rs.3.rs-576071/v1 ◽

2021 ◽

Author(s):

Hwal Rim Jeong ◽

Young Seok Shim

Keyword(s):

Body Mass Index ◽

Children And Adolescents ◽

Body Mass ◽

Linear Regression Analysis ◽

Positive Association ◽

Multiple Linear Regression Analysis ◽

Normal Weight ◽

Overweight And Obesity ◽

Korean Children ◽

Children And Adolescent

Abstract Objective: To investigate the associations between hematologic parameters and obesity in children and adolescents.Methods: A total of 7,997 subjects (4,259 boys, 3,738 girls) aged 10–18 years was enrolled and hematologic parameters, including WBC, RBC, Hb, Hct, and platelet levels, were recorded and compared against body mass index (BMI) classified into normal-weight, overweight, and obesity groups.Results : The obesity group had significantly higher mean levels of WBC (7.16 vs. 6.16 (x103/mm3), p<0.001), RBC (4.90 vs. 4.82 (x106/mm3), p<0.001), Hb (14.07 vs. 13.99 (g/dL), p<0.05), Hct (42.31 vs. 41.91 (%), p<0.001) and platelets (311.87 vs. 282.66 (x103/mm3), p<0.001) than the normal-weight group after adjusting for obesity and sex. BMI SDS was significantly positively associated with WBC (β=0.275, p<0.001), RBC (β=0.028, p<0.001), Hb (β=0.034, p<0.001), Hct (β=0.152, p<0.001), and platelets (β=8.372, p<0.001) after adjusting for age, sex, and possible socioeconomic confounders in a multiple linear regression analysis.Conclusion: Higher BMI is associated with elevated WBC, RBC, Hb, Hct and platelet counts in children and adolescents. Because higher hematologic parameters are potential risk factors for obesity-related morbidity, more attention should be paid to evaluating and interpreting hematologic parameters in children and adolescents with obesity

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Abstract MP25: Expression Of Urinary Somatic And Soluble N-domain Isoforms Of Angiotensin Converting Enzyme And Association With Different Nutritional Status And Cardiovascular Risk Profile

Hypertension ◽

10.1161/hyp.76.suppl_1.mp25 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Nayara A Cruz ◽

Lilian C Oliveira ◽

Fernanda B Fernandes ◽

Dulce E Casarini

Keyword(s):

Cardiovascular Risk ◽

Nutritional Status ◽

Angiotensin Converting Enzyme ◽

Children And Adolescents ◽

Risk Profile ◽

Normal Weight ◽

Converting Enzyme ◽

Cardiovascular Risk Profile ◽

Obese Children ◽

High Cardiovascular Risk

Angiotensin converting enzyme (ACE) plays a dominant role in renal and cardiovascular diseases, obesity and diabetes. The somatic ACE (130-190 kDa) is composed of two homologous N- and C- domains. Two soluble N-domain isoforms have been described in human urine with 65 and 90KDa. Studies have supported that N-domain ACE with 90KDa is a biomarker for hypertension, pre-eclampsia and inflammation. We analyzed the expression of somatic and soluble N-domain ACE isoforms in urine of children and adolescents with different nutritional status and cardiovascular risk profile. The volunteers aged from 6 to 19 years were classified into four groups according to their BMI percentile; underweight (n=51), normal weight (n = 53), overweight (n=53) and obese (n=49). Waist-height-ratio (WHtR) was used to assess cardiovascular risk profile dividing the participants into normal risk (n=105) and high risk (n=101). The urines were concentrated 10-fold and dialyzed with Tris-HCl pH 8 and pure water. Then, we performed western blot analysis using 50μg of lyophilized urinary protein, using the ACE polyclonal antibody Y1. Protein detection was performed by chemiluminescent and analysis in Image Lab software utilizing total protein stain for normalization. ACE expression is augmented in obese children when compared with normal weight children ( 0.09 vs 0.53 arbitrary units, p=0,04 ). The higher cardiovascular risk group also presented increased expression of ACE ( 0.27 vs 0.09 arbitrary units, p=0.046 ). The 90KDa N-domain isoform is frequently found in the high cardiovascular risk children ( p= 0.02 ). According to Spearman correlation test, the expression of 90 kDa N-domain ACE correlates positively with waist circumference, WHtR, BMI percentile and Z-score of BMI. Increased ACE expression in obese children contributes to higher cardiovascular risk once this enzyme biosynthesizes Angiotensin II which promotes blood pressure increase, sympathetic nervous system activation and release of glucocorticoids from adrenal gland. ACE expression is also augmented in children with high cardiovascular risk. Presence of 90 KDa N-domain ACE in urine of children and adolescents is a biomarker of poor prognostic for cardiovascular disease in childhood obesity.

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Laboratory screening in overweight/obese adolescents: do the results change the management?

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-0102 ◽

2016 ◽

Vol 29 (5) ◽

Author(s):

Reshmi Morris ◽

Ronald Feinstein ◽

Martin Fisher

Keyword(s):

Children And Adolescents ◽

Laboratory Testing ◽

Liver Enzymes ◽

Thyroid Stimulating Hormone ◽

Management Program ◽

Overweight And Obesity ◽

Professional Organizations ◽

Obese Children ◽

Short Term

Abstract Due to the growth of the epidemic of obesity and the association of obesity with both short-term and long-term medical complications, many professional organizations have recommended performing laboratory testing as part of the initial evaluation of overweight and obese children and adolescents. We report on the results of laboratory testing performed on 110 patients (mean age 14.0 years, range 8–20 years) referred to our weight management program between 2011 and 2013. Our results showed mild abnormalities in levels of cholesterol, glucose, liver enzymes, and thyroid stimulating hormone (TSH) in fewer than 5% of patients for each test and no changes in management based on these results for any of the patients. We call for re-consideration of the recommendations for laboratory testing in children and adolescents being evaluated and treated for overweight and obesity.

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Double Burden of Malnutrition among Chinese Women of Reproductive Age and Their Social Determinants

Nutrients ◽

10.3390/nu12103102 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3102

Author(s):

Jingqi Song ◽

Ji Zhang ◽

Wafaie Fawzi ◽

Yangmu Huang

Keyword(s):

Normal Weight ◽

Overweight And Obesity ◽

Living Environment ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Double Burden ◽

Community Factors ◽

Wide Range ◽

Double Burden Of Malnutrition ◽

The Impact

This study aimed to examine the impact of a wide range of demographic, socioeconomic, and community factors on the double burden of malnutrition among women of reproductive age using longitudinal data. We used data about 11,348 women of reproductive age who participated in the China Health and Nutrition Survey (CHNS), a longitudinal survey, between 1989 and 2015. Nutritional outcomes were categorized into four groups, namely underweight, normal weight, overweight, and obesity, with normal weight as reference. A multinomial logit model was fitted due to geographic clustering and repeated observations of individuals. The prevalence of underweight decreased over time from 1991 but has tended to rise again since 2004, while the prevalence of overweight/obesity continued to rise between 1991 and 2015. Improved individual factors, socioeconomic status, and community urbanization reduced the risk of underweight but elevated the risk of overweight and obesity. The medium levels, rather than the highest levels, of household income and community urbanization are associated with a higher risk of overweight and obesity. The notable increase in underweight prevalence is a cause for concern to be addressed along with efforts to curb the rising tide of overweight. In order to enhance the nutritional status of women of reproductive age, it is essential to improving the community environment, levels of education, and living environment from a wider context. Long-term and targeted plans are urgently needed for nutrition improvements among the different populations.

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Health-related quality of life in children and adolescents with overweight and obesity: results from the German KIGGS survey

BMC Public Health ◽

10.1186/s12889-020-09834-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lara Meixner ◽

Caroline Cohrdes ◽

Anja Schienkiewitz ◽

Gert B. M. Mensink

Keyword(s):

Quality Of Life ◽

Children And Adolescents ◽

Well Being ◽

Normal Weight ◽

Overweight And Obesity ◽

Media Consumption ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background The well-being of persons with overweight and obesity, in particular of children and adolescents, may be impaired. The present study investigates the health-related quality of life (HRQoL) of girls and boys with overweight and obesity living in Germany as compared to those of normal-weight, while taking a selection of relevant determinants of HRQoL into account. Methods The sample comprises 1771 children and adolescents aged 11 to 17 years that took part in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KIGGS Wave 2, 2014–2017). Sex-and age-specific BMI (kg/m2) percentiles were utilized to classify overweight and obesity. HRQoL was measured with the KIDSCREEN-27 questionnaire, which gathers detailed information about the five dimensions physical and psychological well-being, well-being regarding peers (i.e., social acceptance), parents (i.e., autonomy) and within the school environment. Multiple regression analyses were performed with HRQoL dimensions as outcomes to test for differences between children and adolescents with normal-weight vs. those with overweight and vs. those with obesity, separately for girls and boys. In a next step, age, physical activity, media consumption, social support and self-efficacy were considered as potential confounders in the analyses. Results 18.7% of the children and adolescents under study were affected by overweight and among them 8.0% by obesity. After adjusting for potential confounders, overweight and obesity were associated with lower physical well-being as compared to normal weight in both sexes (boys with overweight: standardized beta [β] = −.14, standard error [SE] = .03, p < .001, and obesity: β = −.16, SE = .03, p < .001; girls with overweight: β = −.09, SE = .04, p = .011, and obesity: β = −.11, SE = .03, p = .003). Results moreover suggest lower levels of psychological (β = −.10, SE = .04, p = .002) and parent-related well-being (β = −.08, SE = .04, p = .036) of boys with obesity as compared to normal-weight peers. Conclusion HRQoL of German children and adolescents with overweight and obesity is impaired according to physical well-being in general, while psychological and parent-related well-being is particularly affected in boys. Public health approaches should therefore promote children and adolescents with overweight and obesity by improving diverse facets of HRQoL as well as relevant associated factors (i.e., media consumption, self-efficacy) in general and in boys in particular.

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