Childhood Obesity and Bones

kids asleep

Seems like every time you turn around, another distressing medical condition is being linked to childhood obesity. We haven’t caught up with them for a while.

The first entry is a piece with the depressing title, “Chronic pain is common child complaint, study finds.” Actually, this was a meta-study originating in Nova Scotia, which combined the results of 41 other studies. The full report can be purchased from the journal Pain, and its abstract begins with what the researchers set out to look into:

Chronic and recurrent pain not associated with a disease is very common in childhood and adolescence, but studies of pain prevalence have yielded inconsistent findings.

For the LA Times, Shari Roan reported on the results:

They found that chronic pain conditions are more common in girls than boys and that pain problems tend to increase with age. Headache is the most common type of chronic pain in kids… But abdominal, back and musculoskeletal pain were common, too… And, in two studies that looked at back pain, 21% of the children reported back pain for at least one month.

So, one child in five reports experiencing back pain that lasted a month? That doesn’t sound good at all. Inside everyone, there is a skeleton waiting to come out. Most of the time we don’t have to think about our inner skeletons. Extra weight does things to the bones and joints that can force us to have to pay attention to them every day.

Journalist Kristina Goel quoted Dr. Michael S. Sridhar of Emory University on the subject of obesity and knee arthritis among a group of patients who had bariatric surgery, lost an average of 51 pounds each, and were evaluated one year post-op:

For a long time people felt there was nothing they could do to mitigate the debilitating effects of knee arthritis, but now we know that surgically-assisted weight loss is a way that folks can help themselves. However, there is probably some element of irreparable damage from being morbidly obese that may constrain the improvement in knee pain despite significant weight loss.

Goel also describes a similar study, and the consensus is that knee pain can be alleviated and the function can be improved, but all the damage already done before the weight loss might never go away. Some authorities believe that arthritis can’t help but increase, and they see total knee replacement surgery in a lot of children’s futures.

Orthopediatrics.com offers pictures of the hardware involved in the surgical correction of Blount’s disease, along with a very disturbing and comprehensive description of the condition:

Toddlers or children who are large or overweight for their age and who walk early are most often affected. As the child walks, the repeated stress and compression of extra weight suppresses (slows) or stops growth of the developing bone… Juvenile or adolescent Blount’s disease is usually caused by obesity… The child may have trouble walking without tripping… For the obese child, weight loss is helpful but often difficult.

Bruce Jancin reports that one particular type of breakage has been on the rise as a direct result of the childhood obesity epidemic. This is the pediatric forearm fracture caused by a fall from a standing height — in other words, tripping, which can in turn be caused by the difficulty in walking that may result from Blount’s disease.

It’s important that optimal bone accumulation should not be interrupted by adverse conditions, because the body needs to reach peak bone mass before early adulthood. Otherwise, it could be a setup for osteoporosis and fractures.

Toni Baker tells us that there is some confusion and even some contradiction when the scientific literature is examined for the impact of fat on the bone health of children and teens. Here is one of the puzzling anomalies:

In fact, total body fat didn’t seem to impact bone mass: it was fat around the middle, or visceral fat, that seemed to increase the risk for bad bones just like it does the risk of diabetes and heart disease.

Kathleen Doheny tells us that while state laws have been requiring that children be strapped into specially designed seats until older ages, children of every age have been growing larger. Consequently, manufacturers have been redesigning their products to accommodate bigger and bigger kids. One company states that its safety seat can hold a child of up to 120 pounds! Hopefully, this will not only save additional lives, but prevent some broken bones, too.

Your responses and feedback are welcome!

Source: “Chronic pain is common child complaint, study finds,” LA Times, 12/08/12
Source: “The epidemiology of chronic pain in children and adolescents revisited: A systematic review,” Pain, December 2011
Source: “Obesity takes heavy toll on knee arthritis,” Health.am, 02/14/11
Source: “A Patient’s Guide to Blount’s Disease in Children and Adolescents,” Orthopediatrics.com
Source: “Pediatric Obesity Epidemic Means More Forearm Fractures,” ACEP.org, May 2011
Source: “Overweight adolescents may have weaker bones: study,” EurekAlert.org, 03/04/11
Source: “Overweight Kids Means Bigger Car Seats,” Edmunds.com, 10/14/11
Image by deovolenti, used under its Creative Commons license.

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