CHILDHOOD AND ADOLESCENT OBESITY: Prevalence and Significance

The prevalence of children and adolescents with body mass index (BMI) of greater than 95th percentile has doubled in the last 2 decades (present prevalence is 10.9%) and there is a 50% increase in the prevalence of those with a BMI greater than 85th percentile (present prevalence is 22.0%) in the US. There are substantial risks for morbidity in obese children even before they reach adulthood. Further, if obesity in childhood persists into the adult years, the morbidity and mortality is greater than if the obesity developed in the adult. Screening using appropriate historical and physical data will reveal those children most in need of modification of weight gain.

[1]  R. Martorell,et al.  Fatness and body mass index from birth to young adulthood in a rural Guatemalan population. , 1999, The American journal of clinical nutrition.

[2]  W. Tamborlane,et al.  Metabolic impact of obesity in childhood. , 1999, Endocrinology and metabolism clinics of North America.

[3]  J. Strong,et al.  Association of Coronary Heart Disease Risk Factors with microscopic qualities of coronary atherosclerosis in youth. , 2000, Circulation.

[4]  D. Williamson,et al.  Secular increases in relative weight and adiposity among children over two decades: the Bogalusa Heart Study. , 1997, Pediatrics.

[5]  E. Montaña,et al.  Exercise-Induced Bronchospasm in Nonasthmatic Obese Children , 1993, Clinical pediatrics.

[6]  H. Dean.  Diagnostic Criteria for Non-Insulin Dependent Diabetes in Youth (NIDDM-Y) , 1998, Clinical pediatrics.

[7]  M. Knip,et al.  Weight loss, body composition and risk factors for cardiovascular disease in obese children: long-term effects of two treatment strategies. , 1992, Journal of the American College of Nutrition.

[8]  Y. Manios,et al.  Obesity indices in a cohort of primary school children in Crete: a six year prospective study , 2000, International Journal of Obesity.

[9]  R J Prineas,et al.  Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults. The Minneapolis Children's Blood Pressure Study. , 1999, Circulation.

[10]  W. Dietz,et al.  The Relation of Overweight to Cardiovascular Risk Factors Among Children and Adolescents: The Bogalusa Heart Study , 1999, Pediatrics.

[11]  J. Cruz,et al.  Dietary habits and nutritional status in adolescents over Europe--Southern Europe. , 2000, European journal of clinical nutrition.

[12]  J. Frane,et al.  Body mass index (BMI) in Turner syndrome before and during growth hormone (GH) therapy , 2000, International Journal of Obesity.

[13]  W. Dietz,et al.  Introduction: the use of body mass index to assess obesity in children. , 1999, The American journal of clinical nutrition.

[14]  T. Cole,et al.  Body mass index and height from childhood to adulthood in the 1958 British born cohort. , 1997, The American journal of clinical nutrition.

[15]  S. Gidding.  Preventive pediatric cardiology: Tobacco, cholesterol, obesity, and physical activity , 1999 .

[16]  D Kromhout,et al.  Body Mass Index at the age of 18 and its effects on 32-year-mortality from coronary heart disease and cancer. A nested case-control study among the entire 1932 Dutch male birth cohort. , 1989, Journal of clinical epidemiology.

[17]  E. Crain,et al.  Do obese inner-city children with asthma have more symptoms than nonobese children with asthma? , 2000, Pediatrics.

[18]  A. Franzese,et al.  Lack of efficacy of ursodeoxycholic acid for the treatment of liver abnormalities in obese children. , 2000, The Journal of pediatrics.

[19]  B. Loukidi,et al.  Impaired Serum Lipids and Lipoproteins in Fetal Macrosomia Related to Maternal Obesity , 1999, Neonatology.

[20]  B. Falkner,et al.  Can cardiovascular risk be predicted by newborn, childhood, and adolescent body size? An examination of longitudinal data in urban African Americans. , 1998, The Journal of pediatrics.

[21]  B. Stoll.  Teenage obesity in relation to breast cancer risk , 1998, International Journal of Obesity.

[22]  D. Phillips,et al.  Birth weight, climate at birth and the risk of obesity in adult life , 2000, International Journal of Obesity.

[23]  C Osmond,et al.  Obesity at the age of 50 y in men and women exposed to famine prenatally. , 1999, The American journal of clinical nutrition.

[24]  A. Must,et al.  Risks and consequences of childhood and adolescent obesity , 1999, International Journal of Obesity.

[25]  R J Rona,et al.  Trends in growth and obesity in ethnic groups in Britain , 1998, Archives of disease in childhood.

[26]  W. Pond,et al.  Accuracy of dual-energy x-ray absorptiometry for body-composition measurements in children. , 1994, The American journal of clinical nutrition.

[27]  S. Burke,et al.  Clinical basis for a mechanical etiology in adolescent Blount's disease. , 1986, Orthopedics.

[28]  G. Grugni,et al.  Liver steatosis in juvenile obesity: correlations with lipid profile, hepatic biochemical parameters and glycemic and insulinemic responses to an oral glucose tolerance test , 2000, International Journal of Obesity.

[29]  N. Glaser.  Non-insulin-dependent diabetes mellitus in childhood and adolescence. , 1997, Pediatric clinics of North America.

[30]  S. Bartosh,et al.  Childhood hypertension. An update on etiology, diagnosis, and treatment. , 1999, Pediatric clinics of North America.

[31]  W H Dietz,et al.  Social and economic consequences of overweight in adolescence and young adulthood. , 1993, The New England journal of medicine.

[32]  I. Okosun,et al.  Impact of birth weight on ethnic variations in subcutaneous and central adiposity in American children aged 5–11 years. A study from the Third National Health and Nutrition Examination Survey , 2000, International Journal of Obesity.

[33]  W. Dietz,et al.  Body fatness and bioelectrical impedance in non-obese pre-menarcheal girls: comparison to anthropometry and evaluation of predictive equations , 1997, European Journal of Clinical Nutrition.

[34]  M. Nagamani,et al.  Acanthosis Nigricans as a Risk Factor for Non-Insulin Dependent Diabetes Mellitus , 1998, Clinical pediatrics.

[35]  R. Lauer,et al.  Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study. , 1988, Pediatrics.

[36]  J. Corbett,et al.  The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. , 1988, Archives of neurology.

[37]  B. Metzger,et al.  Correlations between the intrauterine metabolic environment and blood pressure in adolescent offspring of diabetic mothers. , 2000, The Journal of pediatrics.

[38]  K. Christoffel,et al.  Childhood Obesity , 1990, Clinical pediatrics.

[39]  D. Barker.  Fetal origins of cardiovascular disease. , 1999, Annals of medicine.

[40]  M. Rodríguez-Moran,et al.  Low prevalence of non-insulin-dependent diabetes mellitus in indigenous communities of Durango, Mexico. , 1997, Archives of medical research.

[41]  S. Srinivasan,et al.  Association of fasting insulin with longitudinal changes in blood pressure in children and adolescents. The Bogalusa Heart Study. , 1993, American journal of hypertension.

[42]  L. Epstein,et al.  The relationship between asthma and obesity in urban minority children and adolescents. , 1998, Archives of pediatrics & adolescent medicine.

[43]  Sheila M. Williams,et al.  Overweight and obese children have low bone mass and area for their weight , 2000, International Journal of Obesity.

[44]  K. Resnicow,et al.  Body mass index as a predictor of systolic blood pressure in a multiracial sample of US schoolchildren. , 1993, Ethnicity & disease.

[45]  W H Dietz,et al.  Role of the prenatal environment in the development of obesity. , 1998, The Journal of pediatrics.

[46]  T. Cole,et al.  Child to adult body mass index in the 1958 British birth cohort: associations with parental obesity , 1997, Archives of disease in childhood.

[47]  R. Lauer,et al.  The relation between ponderosity and coronary risk factors in children and their relatives. The Muscatine Ponderosity Family Study. , 1989, American journal of epidemiology.

[48]  L. Honoré.  Cholesterol cholelithiasis in adolescent females: its connection with obestiy, parity, and oral contraceptive use--a retrospective study of 31 cases. , 1980, Archives of surgery.

[49]  J. Takala,et al.  Relative weight gain and obesity as a child predict metabolic syndrome as an adult , 1999, International Journal of Obesity.

[50]  M. Goran,et al.  Energy expenditure, body composition, and disease risk in children and adolescents , 1997, Proceedings of the Nutrition Society.

[51]  A. Roche,et al.  Grading body fatness from limited anthropometric data. , 1981, The American journal of clinical nutrition.

[52]  D. Ehrmann,et al.  Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion. , 1995, Endocrine reviews.

[53]  E. Demerath,et al.  Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study , 2000, International Journal of Obesity.

[54]  M. Knip,et al.  Serum insulin and other cardiovascular risk indicators in children, adolescents and young adults. , 1991, Annals of medicine.

[55]  H. Gökbel,et al.  Exercise-induced bronchospasm in nonasthmatic obese and nonobese boys. , 1999, The Journal of sports medicine and physical fitness.

[56]  Chris Landon,et al.  Early Presentation of Type 2 Diabetes in Mexican-American Youth , 1998, Diabetes Care.

[57]  J M Tanner,et al.  Variations in the Pattern of Pubertal Changes in Boys , 1970, Archives of disease in childhood.

[58]  G. Takada,et al.  Serum alanine aminotransferase activity in obese children , 1997, Acta paediatrica.

[59]  J. Reilly,et al.  Body composition of healthy 7- and 8-year-old children and a comparison with the ‘reference child’ , 1999, International Journal of Obesity.

[60]  D. Weiner,et al.  Maturation factors in slipped capital femoral epiphysis. , 1988, Journal of pediatric orthopedics.

[61]  T. Kamoda,et al.  The phosphorylation status of insulin-like growth factor-binding protein-1 in prepubertal obese children. , 1999, European journal of endocrinology.

[62]  J. Silverstein,et al.  Treatment of Type 2 Diabetes Mellitus in Children and Adolescents , 2000, Journal of pediatric endocrinology & metabolism : JPEM.

[63]  Troiano Rp,et al.  Overweight prevalence and trends for children and adolescents , 1996 .

[64]  G. Radetti,et al.  Growth hormone bioactivity, insulin-like growth factors (IGFs), and IGF binding proteins in obese children. , 1998, Metabolism: clinical and experimental.

[65]  P. Katzmarzyk,et al.  Validity of the body mass index as an indicator of the risk and presence of overweight in adolescents. , 1999, The American journal of clinical nutrition.

[66]  P. Emmett,et al.  Cholesterol and triglyceride concentrations, birthweight and central obesity in pre-school children , 2000, International Journal of Obesity.

[67]  L. Epstein,et al.  Asthma and maternal body mass index are related to pediatric body mass index and obesity: results from the Third National Health and Nutrition Examination Survey. , 2000, Obesity research.

[68]  D. Molnár,et al.  Presence of metabolic cardiovascular syndrome in obese children , 2000, European Journal of Pediatrics.

[69]  R. Eckel,et al.  Insulin-like growth factor binding protein-I levels are strongly associated with insulin sensitivity and obesity in early pubertal children. , 1998, The Journal of clinical endocrinology and metabolism.

[70]  B. Rosner,et al.  Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. , 2000, American journal of epidemiology.

[71]  J. Himes.  Agreement among anthropometric indicators identifying the fattest adolescents , 1999, International Journal of Obesity.

[72]  W. Dietz,et al.  Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. , 1994, The American journal of clinical nutrition.

[73]  Wei Chen,et al.  Age-related patterns of the clustering of cardiovascular risk variables of syndrome X from childhood to young adulthood in a population made up of black and white subjects: the Bogalusa Heart Study. , 2000, Diabetes.

[74]  R. Loder,et al.  The epidemiology of bilateral slipped capital femoral epiphysis. A study of children in Michigan. , 1993, The Journal of bone and joint surgery. American volume.

[75]  A. Fagot-Campagna.  Emergence of Type 2 Diabetes Mellitus in Children: Epidemiological Evidence , 2000, Journal of pediatric endocrinology & metabolism : JPEM.

[76]  J. Reilly,et al.  Identification of the obese child: adequacy of the body mass index for clinical practice and epidemiology , 2000, International Journal of Obesity.

[77]  D. Sartoris,et al.  Obesity and decreased femoral anteversion in adolescence , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[78]  K. Flegal,et al.  Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. , 1995, Archives of pediatrics & adolescent medicine.

[79]  J. Kelsey,et al.  The body build of patients with slipped capital femoral epiphysis. , 1972, American journal of diseases of children.

[80]  A. Stunkard,et al.  A 40-year history of overweight children in Stockholm: life-time overweight, morbidity, and mortality. , 1994, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[81]  T. Cole,et al.  Establishing a standard definition for child overweight and obesity worldwide: international survey , 2000, BMJ : British Medical Journal.

[82]  B. Metzger,et al.  Long-Term Prospective Evaluation of Offspring of Diabetic Mothers , 1991, Diabetes.

[83]  S. Lessell,et al.  Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). , 1992, Survey of ophthalmology.

[84]  W. Muntean,et al.  Determinants of haemostatic risk factors for coronary heart disease in obese children and adolescents , 2000, International Journal of Obesity.

[85]  W. Waz,et al.  Special topics in pediatric hypertension. , 1998, Seminars in nephrology.

[86]  A. Rosenbloom,et al.  Emerging epidemic of type 2 diabetes in youth. , 1999, Diabetes care.

[87]  C. Friesen,et al.  Clinical Characteristics in Children , 1989 .

[88]  R. Lauer,et al.  Increased familial cardiovascular mortality in obese schoolchildren: the Muscatine Ponderosity Family Study. , 1992, Pediatrics.

[89]  J. Steele,et al.  Does obesity influence foot structure in prepubescent children? , 2000, International Journal of Obesity.

[90]  V. Alvarez,et al.  The impact of obesity and body fat distribution on ambulatory blood pressure in children and adolescents. , 1998, American journal of hypertension.

[91]  R. Martorell,et al.  Overweight and obesity in preschool children from developing countries , 2000, International Journal of Obesity.

[92]  A. Slyper,et al.  Childhood Obesity, Adipose Tissue Distribution, and the Pediatric Practitioner , 1998, Pediatrics.

[93]  A. Galatzer,et al.  Early polycystic ovary-like syndrome in girls with central precocious puberty and exaggerated adrenal response. , 1995, European journal of endocrinology.

[94]  G. Mallory,et al.  Sleep-associated breathing disorders in morbidly obese children and adolescents. , 1989, The Journal of pediatrics.

[95]  T. Peters,et al.  Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. , 1998, The American journal of clinical nutrition.

[96]  Clive Osmond,et al.  The Fetal and Childhood Growth of Persons Who Develop Type 2 Diabetes , 2000, Annals of Internal Medicine.

[97]  R. Woolson,et al.  Changes in ponderosity and blood pressure in childhood: the Muscatine Study. , 1986, American journal of epidemiology.

[98]  K. Fox,et al.  Assessment of abdominal fat development in young adolescents using magnetic resonance imaging , 2000, International Journal of Obesity.

[99]  H. Mossberg.  40-YEAR FOLLOW-UP OF OVERWEIGHT CHILDREN , 1989, The Lancet.

[100]  W R Clarke,et al.  Predicting adult cholesterol levels from measurements in childhood and adolescence: the Muscatine Study. , 1989, Bulletin of the New York Academy of Medicine.

[101]  Shelly Y. Lensing,et al.  Non-Insulin Dependent Diabetes Mellitus in African-American Youths of Arkansas , 1998, Clinical pediatrics.

[102]  H. Dean.  NIDDM-Y in First Nation Children in Canada , 1998, Clinical pediatrics.

[103]  S. Arslanian.  Type 2 Diabetes Mellitus in Children: Pathophysiology and Risk Factors , 2000, Journal of pediatric endocrinology & metabolism : JPEM.

[104]  B. Gower,et al.  Prediction of intra-abdominal and subcutaneous abdominal adipose tissue in healthy pre-pubertal children , 1998, International Journal of Obesity.

[105]  W. Dietz,et al.  Blount disease (tibia vara): another skeletal disorder associated with childhood obesity. , 1982, The Journal of pediatrics.

[106]  M. Szklo,et al.  Childhood weight and growth rate as predictors of adult mortality. , 1992, American journal of epidemiology.

[107]  K. Jones,et al.  Non-insulin dependent diabetes mellitus in Mexican-American children. , 1998, The Western journal of medicine.

[108]  L. Robison,et al.  Changes in body mass index and prevalence of overweight in survivors of childhood acute lymphoblastic leukemia: role of cranial irradiation. , 2000, Medical and pediatric oncology.

[109]  J. Lewis,et al.  Changing spectrum of cholelithiasis and cholecystitis in infants and children. , 1989, American journal of surgery.

[110]  P. Bennett,et al.  Development of lithogenic bile during puberty in Pima indians. , 1979, The New England journal of medicine.

[111]  A. Rosenbloom,et al.  Non-Insulin Dependent Diabetes Mellitus (NIDDM) in Minority Youth: Research Priorities and Needs , 1998, Clinical pediatrics.

[112]  R. Troiano,et al.  Overweight prevalence among youth in the United States: Why so many different numbers? , 1999, International Journal of Obesity.

[113]  R. Troiano,et al.  Changes in the distribution of body mass index of adults and children in the US population , 2000, International Journal of Obesity.

[114]  James M. Tanner,et al.  Variations in pattern of pubertal changes in girls. , 1969 .

[115]  E. Smith,et al.  Obesity, acanthosis nigricans, insulin resistance, and hyperandrogenemia: pediatric perspective and natural history. , 1985, The Journal of pediatrics.

[116]  Robert C. Whitaker,et al.  Early Adiposity Rebound and the Risk of Adult Obesity , 1998, Pediatrics.

[117]  M. Brodsky,et al.  Idiopathic intracranial hypertension in children and adolescents. , 1997, American journal of ophthalmology.

[118]  V. Katch,et al.  Blood pressure in obese adolescents: effect of weight loss. , 1988, Pediatrics.

[119]  J. Viikari,et al.  Cardiovascular Risk in Young Finns Study: general outline and recent developments. , 1999, Annals of medicine.

[120]  R. Lauer,et al.  Lipoproteins in the progeny of young men with coronary artery disease: children with increased risk. , 1986, Pediatrics.

[121]  M. Goran,et al.  Intra-abdominal adipose tissue in young children. , 1995, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[122]  S. Srinivasan,et al.  Persistent elevation of plasma insulin levels is associated with increased cardiovascular risk in children and young adults. The Bogalusa Heart Study. , 1996, Circulation.

[123]  R. Lauer,et al.  Childhood Predictors of Future Blood Pressure , 1991, Hypertension.

[124]  J. Reilly,et al.  Factors Associated With Early Adiposity Rebound , 2000 .

[125]  J. Lightdale,et al.  Updates in pediatric nutrition. , 2000, Current opinion in pediatrics.

[126]  S. Gidding,et al.  Association of fasting blood sugar level, insulin level, and obesity with left ventricular mass in healthy children and adolescents: The Bogalusa Heart Study. , 1999, American heart journal.

[127]  W. Kidson.  Polycystic ovary syndrome: a new direction in treatment , 1998, The Medical journal of Australia.

[128]  G. Van Vliet,et al.  Evidence against growth hormone-releasing factor deficiency in children with idiopathic obesity. , 1986, Acta endocrinologica. Supplementum.

[129]  G. Thompson,et al.  Late-onset tibia vara (Blount's disease). Current concepts. , 1990, Clinical orthopaedics and related research.

[130]  C. L. Williams,et al.  Guidelines for screening, evaluating, and treating children with hypercholesterolemia. , 1995, Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners.

[131]  D. Kromhout,et al.  The impact of body mass index of 78,612 18-year old Dutch men on 32-year mortality from all causes. , 1988, Journal of clinical epidemiology.

[132]  W. Dietz,et al.  Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. , 1992, The New England journal of medicine.

[133]  B. Gutin,et al.  Visceral adipose tissue and cardiovascular risk factors in obese children. , 1998, The Journal of pediatrics.

[134]  T. Kitagawa,et al.  Increased Incidence of Non-Insulin Dependent Diabetes Mellitus Among Japanese Schoolchildren Correlates with an Increased Intake of Animal Protein and Fat , 1998, Clinical pediatrics.

[135]  E. Fliers,et al.  Long term survivors of childhood brain cancer have an increased risk for cardiovascular disease , 2000, Cancer.

[136]  M. Guillaume.  Defining obesity in childhood: current practice2. , 1999, The American journal of clinical nutrition.

[137]  G. Holcomb,et al.  Cholecystitis, Cholelithiasis and Common Duct Stenosis in Children and Adolescents , 1980, Annals of surgery.

[138]  W. Wallace,et al.  OBESITY IN LEUKEMIA SURVIVORS: The Familial Contribution , 2000, Pediatric hematology and oncology.

[139]  W. Dietz,et al.  Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. , 2000, The Journal of pediatrics.

[140]  M. Goran,et al.  Measurement issues related to studies of childhood obesity: assessment of body composition, body fat distribution, physical activity, and food intake. , 1998, Pediatrics.

[141]  B. Falkner,et al.  Dietary nutrients and blood pressure in urban minority adolescents at risk for hypertension. , 2000, Archives of pediatrics & adolescent medicine.

[142]  A. Perez-Atayde,et al.  Idiopathic steatohepatitis in childhood: a multicenter retrospective study. , 1995, The Journal of pediatrics.

[143]  P. Södersten,et al.  Exercise and the regulation of energy intake , 1999, International Journal of Obesity.

[144]  W. Dietz.  Health consequences of obesity in youth: childhood predictors of adult disease. , 1998, Pediatrics.

[145]  M. Jacobson,et al.  Adolescent Obesity and Cardiovascular Risk: A Rational Approach to Management a , 1993, Annals of the New York Academy of Sciences.