Introduction:
Childhood obesity has been on the rise in recent years throughout the world. This further increases obesity among adults. Obesity is considered a complex disease characterized by increased adiposity. This can increase the risk of noncommunicable diseases. Childhood obesity is linked to early metabolic sequelae and long-term complications.
What Is Childhood Obesity?
Childhood obesity is a condition that affects both children and adolescents. Childhood obesity is on the rise in both developed and developing countries. The world is undergoing a rapid epidemiological and nutritional transition, leading to nutritional deficiency and an increased prevalence of stunting, anemia, iron, and zinc deficiencies. This further increased the prevalence of obesity, diabetes, and other nutritional-related chronic diseases (NRCD). NRCD includes obesity, diabetes, cardiac-related diseases, and some cancers. Females are more affected by obesity than males due to hormonal differences. Type 2 diabetes and cardiovascular diseases are emerging in childhood only due to childhood obesity serving as the main factor. Obesity is due to excess body fat. There are many methods to measure body fat. The common measurement techniques include body mass index (BMI), waist circumference, and skin-fold thickness. BMI is better for measuring body fat among adults and unsuitable for children as their body shape changes due to normal growth. Waist circumference can be used among children to measure body fat since it aims to measure central obesity.
What Are the Causes of Childhood Obesity?
Lifestyles like overeating and doing little activities may increase the calories in the body, resulting in childhood obesity. Genetics and hormones may also influence obesity. Many risk factors, alone or combined, may be responsible for childhood obesity. These include
- Diet: Consuming foods high in calories, like fast foods, baked items, and snacks, may lead to weight gain. Other items such as candy, desserts, surgery drinks, and fruit juices may lead to obesity.
- Lack of Exercise: Children who do not exercise regularly and those who practice sedentary lifestyles like watching television or playing video games may be affected by obesity.
- Psychological Factors: Personal, parental, or family stress may contribute to childhood obesity. To cope with the stress, children may tend to overeat.
- Socioeconomic Factors: Some may need access to supermarkets or have limited resources. Hence, they may buy frozen foods, cookies, etc., and some may need more space to practice regular exercises.
- Certain Medications: Some drugs prescribed to treat certain conditions may increase obesity. These include Prednisone, Lithium, and Gamma-aminobutyric acid (GABA), etc.
What Are the Endocrine Consequences of Childhood Obesity?
Endocrine causes of childhood obesity include Cushing's syndrome, growth hormone deficiency, or hypothyroidism. Endocrine and metabolic consequences lead to atherosclerotic cardiovascular disease later in life.
Endocrine aspects of childhood obesity include
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Prediabetes and type 2 diabetes.
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Dyslipidemia and metabolic syndrome (MS).
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Polycystic ovary syndrome (PCOS).
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Central precocious puberty (CPP).
Prediabetes and Type 2 Diabetes:
Diabetes mellitus is characterized by chronic hyperglycemia. This condition is caused by abnormal secretion of insulin or insulin resistance that may result in metabolic disturbances. Both prediabetes and diabetes are linked with cardiovascular diseases in adulthood. Childhood obesity is related to an increased risk of type 2 diabetes. Obesity is considered to cause insulin resistance in muscles, the liver, and adipose tissues. This further leads to prediabetes and type 2 diabetes. Excess fat accumulation in the muscles and liver increases peripheral insulin resistance. Recent data has found an increasing prevalence of pediatric prediabetes and type 2 diabetes, along with an increase in obesity.
Dyslipidemia:
An abnormal blood lipid level is known as dyslipidemia. This condition is caused by disordered lipoprotein metabolism. This is considered a risk factor for cardiovascular disease (CVD). Dyslipidemia, if not addressed properly, may lead to atherosclerosis. Hence, early detection of dyslipidemia may help prevent atherosclerosis and further prevent CVD in adulthood. Obesity is a risk factor for dyslipidemia. Insulin resistance, visceral adiposity, and proinflammatory state in obesity are linked with increased basal lipolysis in the adipose tissues, resulting in increased free fatty acid (FFA) levels in the circulation. A study conducted in the United States (U.S.) observed that the prevalence of dyslipidemia increased with an increase in childhood obesity and obesity among young adults.
Metabolic Syndrome (MS):
MS is considered a group of cardiometabolic risk factors. Cardiometabolic risk factors, along with insulin resistance, are termed MS. In this condition, about 3 to 5 components like abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and a low high-density lipoprotein cholesterol (HDL-C) level may be present. MS components are the same for pediatric obesity as for the adult population. Components of MS for childhood obesity include waist circumference, blood pressure, fasting glucose, fasting triglyceride, and fasting HDL-C. In the pathogenesis of MS, obesity, inflammation, insulin resistance, and their interplay are considered responsible. Apart from these, genetic and environmental factors do play a role. These include family history, female sex, smoking, sedentary lifestyle, etc.,. The long-term consequences of MS include CVD, type 2 diabetes, and other obesity-related diseases in adulthood.
Polycystic Ovary Syndrome (PCOS):
PCOS is an endocrine disorder in women of reproductive age. The prevalence of PCOS is around 5 percent to 10 percent. This condition is described as having hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphologic features. PCOS in adolescents is related to decreased quality of life, mental health problems, metabolic disturbances, and cardiovascular and reproductive problems in the long term. The pathophysiology of PCOS includes hyperandrogenism, insulin resistance, and imbalanced gonadotropin secretion as contributing factors. Most commonly, PCOS can be observed among women who are obese or overweight. It was also noticed that PCOS increases with increasing obesity. Recent studies have noticed that genetic and environmental factors are also responsible for the development of PCOS. The diagnosis of PCOS among adolescents is very challenging as the physiological anovulation is difficult to differentiate.
Central Precocious Puberty (CPP):
CPP is caused by premature activation of the hypothalamic-pituitary-gonadal (HPG) axis. This may lead to secondary sexual characteristics. Obesity is related to the early manifestation of secondary sexual characteristics. The increase in pediatric obesity has substantially increased since the earlier onset of puberty. Many studies have identified that pediatric obesity is associated with the early onset of puberty. Among obese children, insulin resistance, hyperinsulinemia, and hyperandrogenism are the factors that are responsible for the activation of the HPG axis. Adipokines may stimulate the initiation of puberty.
Conclusion:
Childhood obesity has been on the rise throughout the world in recent years. This may lead to many endocrine-related diseases, such as type 2 diabetes, PCOS, CPP, MS, and dyslipidemia. These may have effects in adulthood as well. Hence, it becomes important to know about childhood obesity and its endocrine consequences. Knowing helps in preventing the consequences of childhood obesity and obesity itself.
