Metabolic Syndrome and Obesity in Childhood and Adolescence

212 Pages·2015·2.58 MB·English

by  W. Kiess

Pediatric and Adolescent Medicine
Editor: W. Kiess
Vol. 19
Metabolic Syndrome
and Obesity in Childhood
and Adolescence
Editors
W. Kiess
M. Wabitsch
C. Maff eis
A.M. Sharma
Serum triglycerides
≥150 mg/dl
Fasting blood glucose
Blood pressure
≥100 mg/dl
≥130/85
HDL cholesterol
≤40 mg/dl (m)
≤50 mg/dl (f)
Metabolic Syndrome and Obesity in Childhood and Adolescence
Pediatric and Adolescent Medicine
Vol. 19
Series Editor
Wieland Kiess
Leipzig
Metabolic Syndrome and
Obesity in Childhood
and Adolescence
Volume Editors
Wieland Kiess
Leipzig
Martin Wabitsch
Ulm
Claudio Maffeis
Verona
Arya M. Sharma
Edmonton, Alta.
28 figures, 18 in color, 9 tables, 2015
Basel · Freiburg · Paris · London · New York · Chennai · New Delhi ·
Bangkok · Beijing · Shanghai · Tokyo · Kuala Lumpur · Singapore · Sydney
Pediatric and Adolescent Medicine
Founded 1991 by D. Branski, Jerusalem
Prof. Wieland Kiess, MD Prof. Martin Wabitsch, MD, PhD
Department of Women and Child Health Interdisciplinary Obesity Unit
Hospital for Children and Adolescents Division of Pediatric Endocrinology and Diabetes
University of Leipzig, Leipzig, Germany Department of Pediatrics and Adolescent
Medicine
Prof. Claudio Maffeis, MD University Medical Center Ulm
University of Ulm, Ulm, Germany
Pediatric Diabetes, Clinical Nutrition and
Obesity
Department of Life and Reproduction Science Prof. Arya M. Sharma, MD, PhD,
School of Medicine and Surgery DSc. (h.c.), FRCPC
University of Verona, Verona, Italy Obesity Research and Management
Division of Endocrinology
Department of Medicine
Faculty of Medicine and Dentistry
University of Alberta, Edmonton, Alta., Canada
Library of Congress Cataloging-in-Publication Data
Metabolic syndrome and obesity in childhood and adolescence /
volume editors, Wieland Kiess, Martin Wabitsch, Claudio Maffeis, Arya M. Sharma.
p. ; cm. -- (Pediatric and adolescent medicine, ISSN 1017-5989; vol. 19)
Includes bibliographical references and indexes.
ISBN 978-3-318-02798-3 (hard cover: alk. paper) -- ISBN 978-3-318-02799-0 (electronic version)
I. Kiess, W. (Wieland), editor. II. Wabitsch, Martin, editor. III. Maffeis, Claudio, editor.
IV. Sharma, Arya M., editor. V. Series: Pediatric and adolescent medicine; v. 19. 1017-5989
[DNLM: 1. Pediatric Obesity. 2. Adolescent. 3. Child. 4. Metabolic Syndrome X.
W1 PE163HL v. 19 2015 / WS 115]
RJ399.C6
618.92’39--dc23 2014044095
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Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck GmbH, Ettlingen
ISSN 1017–5989
e-ISSN 1662–3886
ISBN 978–3–318–02798–3
e-ISBN 978–3–318–02799–0
Contents
VII Preface
Kiess, W. (Leipzig); Wabitsch, M. (Ulm); Maffeis, C. (Verona);
Sharma, A.M. (Edmonton, Alta.)
Definitions and Clinical Aspects
1 Definitions
Wabitsch, M. (Ulm); Körner, A. (Leipzig)
13 Hypothalamic Obesity in Children
Bereket, A. (Istanbul); Kiess, W. (Leipzig); Lustig, R.H. (San Francisco, Calif.);
Muller, H.L. (Oldenburg); Goldstone, A.P. (London); Weiss, R. (Jerusalem);
Yavuz, Y. (Istanbul); Hochberg, Z. (Haifa)
Causes
31 Genetics of Obesity in Childhood and Adolescence
Böttcher, Y.; Kovacs, P. (Leipzig)
40 Nutrition
Kalhoff, H. (Dortmund); Kersting, M. (Bonn)
53 Sedentary Lifestyle
Raupp, A.; Jouret, B.; Tauber, M. (Toulouse)
68 Socio-Economic Aspects
Plachta-Danielzik, S.; Müller, M.J. (Kiel)
Consequences
75 Carbohydrate Metabolism
Wabitsch, M.; Denzer, C. (Ulm)
84 Orthopaedic Aspects of Obesity in Children and Adults
Thielemann, F.; Guenther, K.-P.; Stiehler, M. (Dresden)
99 Urogenital Complications: Renal Disease, Urolithiasis and Lower Urinary
Tract Symptoms
Morandi, A.; Maffeis, C. (Verona)
110 Influences of Childhood Obesity on Pubertal Development
Wagner, I.V. (Leipzig); Sabin, M. (Parkville, Vic.); Kiess, W. (Leipzig)
V
Societal Aspects and Prevention
126 Urban Living Conditions: The Relation between Neighborhood Characteristics
and Obesity in Children and Adolescents
Igel, U.; Grande, G. (Leipzig)
137 Metabolic Syndrome and the ‘Western Diet’: Science and Politics
Lustig, R.H. (San Francisco, Calif.)
148 An Economic Perspective on Childhood Obesity
Teuner, C.M.; John, J.; Wolfenstetter, S.B.; Holle, R. (Munich)
160 Prevention of Childhood and Adolescent Obesity and its Barriers
Markert, J. (Leipzig)
166 E-Health in Overweight and Obesity Prevention
Herget, S. (Leipzig)
Obesity Management
171 Obesity Treatment Programmes
Reinehr, T. (Datteln)
179 Adolescent Bariatric Surgery: Current Status in an Evolving Field
Luca, P. (Calgary, Alb.); Dettmer, E.; Langer, J.C.; Hamilton, J.K. (Toronto, Ont.)
187 Beyond Weight Loss: Experiences and Insights Related to Working
Effectively with Families and Operating within the Health Care System to
Manage Pediatric Obesity
Ball, G.D.C.; Avis, J.L.S. (Edmonton, Alta.); Buchholz, A. (Ottawa, Ont.);
Bridger, T. (St. John’s, Nfld.); Chanoine, J.-P. (Vancouver, B.C.);
Hadjiyannakis, S. (Ottawa, Ont.); Hamilton, J.K. (Toronto, Ont.);
Legault, L. (Montreal, Que.); Morrison, K.M. (Hamilton, Ont.);
Wareham, A. (St. John’s, Nfld.); Jetha, M.M. (Edmonton, Alta.)
194 Author Index
195 Subject Index
VI Contents
Preface
In this volume in our series ‘Pediatric and Adolescent Medicine,’ probably the most
common and most urgent clinical problem in pediatrics and adolescent medicine is
being covered by experts from around the world. The volume discusses pertinent and
prevalent topics such as the definition and clinical aspects of obesity. Additionally,
novel viewpoints and ideas for the future are presented; these will facilitate both in-
teraction with obese children and adolescents in a fair and appropriate way and col-
laboration with the individuals affected to seek appropriate and effective prevention
and treatment measures.
In section number one, definitions and clinical aspects are covered. Martin
Wabitsch from the University of Ulm, Germany, and Antje Körner from the Univer-
sity of Leipzig, Germany, discuss different definitions and the basic clinical aspects
of obesity in childhood and adolescence. They describe obesity as part of metabolic
syndrome and indeed as one of the causes leading to the full-blown clinical picture
of metabolic syndrome. Abdullah Bereket from Istanbul, Turkey, and his co-workers
report on the following in their chapter on the clinical entity of hypothalamic obe-
sity: obesity caused by injury or trauma to or surgery on the hypothalamus as well as
the fact that inborn genetic diseases affecting nuclei and regions of the hypothalamus
can cause obesity in a very severe and extreme way. Abdullah Bereket and his col-
leagues emphasize that hypothalamic obesity is still resistant to traditional therapeu-
tic measures, that prevention should be mandatory but is also difficult, and that new
clinical trials with new treatment protocols are urgently required.
In section two, Yvonne Böttcher and Peter Kovacs from the University of Leipzig,
Germany, first present a very nicely written chapter on the genetics of obesity in
childhood and adolescence. They focus on DNA and methylation and the biology of
the disease. Second, Hermann Kalhoff and Mathilde Kersting from Dortmund and
Bonn, Germany, outline all aspects of nutrition in relation to metabolic syndrome
and obesity in childhood and adolescence. Third, sedentary behavior has been identi-
fied as a public health issue for the last 10 years. This is being pointed out in the ex-
cellent chapter from France, in which Maïthé Tauber and her colleagues from Tou-
louse rightly argue that preventive interventions should focus on changing the seden-
tary lifestyle, even and especially at a young age. In this fine contribution they also
VII
report on why people adopt a sedentary lifestyle. Fourth, Sandra Plachta-Danielzik
and Manfred James Müller from the University of Kiel, Germany, review their own
data and perform a meta-analysis of all available information on socio-economic as-
pects as causes of metabolic syndrome and obesity. It is actually their contribution via
the ‘KOPS’ study in Kiel that has drawn our attention to the socio-economic aspects
of metabolic syndrome during the last decade.
In section three, the consequences of obesity in childhood and adolescence are
discussed. Martin Wabitsch and Christian Denzer from the University of Ulm,
Germany, review the impact of obesity on carbohydrate metabolism. They especially
refer to insulin resistance, glucose intolerance, and the long-term development of type
2 diabetes early in life. Falk Thielemann, Klaus-Peter Guenther, and Maik Stiehler
from the University of Dresden, Germany, discuss the orthopedic aspects of obesity
in children and adults. In fact, back pain, hip and knee pain, and a vast array of or-
thopedic complications that are typical of severe obesity are already present in child-
hood. A very often neglected aspect of obesity at all ages, namely, urogenital compli-
cations, is summarized in the chapter by Anita Morandi and Claudio Maffeis from
the University of Verona in Italy. In fact, renal disease, even including terminal renal
failure as well as urolithiasis in the long term, and lower urinary tract symptoms such
as itching, painful urination, and cystitis are already related to obesity in childhood
and adolescence. The last chapter in this section deals with the putative consequenc-
es of obesity in childhood on pubertal development; it is still unclear whether obesity
has led to an earlier onset of puberty in affected populations or whether the phenom-
ena of the prevalence of obesity and an earlier age at menarche and puberty are mere-
ly coincidental. Our groups from the University of Leipzig in Germany and the Uni-
versity of Melbourne in Australia (authors Isabel V. Wagner, Matthew Sabin, and
Wieland Kiess) summarize the available data.
In section four, the societal aspects and prevention of obesity are discussed. In-
deed, during the last couple of years, it has become clear that societal aspects and in-
deed the social sciences have to be addressed much more when one wants to speak
about obesity in childhood and adolescence. In fact, Ulrike Igel and Gesine Grande
(University of Applied Sciences (HTWK), Leipzig, Germany) discuss the relationship
between neighborhood characteristics and obesity in children and adolescents. This
topic is very new, very pressing, and indeed innovative. Robert H. Lustig from the
University of California, San Francisco, USA, writes about the role of food industries
and the role of a ‘Western’ diet as causative factors in the development of obesity. He
sets science and politics, as sometimes conflicting and sometimes counterproductive
entities, as the focus of this chapter. Currently, the most talked about societal aspect
in our lives seems to be economics; it is therefore understandable that an economic
perspective on childhood obesity is also presented in this section. Rolf Holle and his
colleagues from the University of Munich, Germany, do this in a very comprehensive,
innovative, and diligent way. Finally, two chapters on new ways to think about
prevention are presented by two young investigators from the University of Leipzig,
VIII Kiess · Wabitsch · Maffeis · Sharma
Germany. Jana Markert identifies barriers that are obstacles to families’ participation
in childhood obesity prevention programs. She draws from a large body of data that
she and her co-workers have assembled and already partially published on this mat-
ter. Since electronic data usage and electronic communication means are now so prev-
alent in our lives, it is important to investigate e-health approaches and their effects
on obesity prevention. Can electronic communication means and social networks be
used for obesity prevention and even treatment (chapter by Sabine Herget, University
of Leipzig)?
In section five, new obesity treatments are presented. Thomas Reinehr from Dat-
teln, Germany, who has developed his own Obeldicks obesity treatment program and
has successfully evaluated and institutionalized it, reviews available obesity pro-
grams, their efficacy, and their routine clinical use. Next, in one chapter, bariatric
surgery in adolescents is reviewed: Paola Luca, Elizabeth Dettmer, Jakob C. Langer,
and Jill K. Hamilton from Calgary and Toronto, Canada, report on the current status
of adolescent bariatric surgery as an evolving field. Lastly, Geoff D.C. Ball and co-
workers from several Canadian Universities describe their vast experience and in-
sights related to working effectively with families and operating within the health-
care system to manage pediatric obesity. It is important that in this last contribution
in our volume, Geoff D.C. Ball and co-authors in fact go far beyond mere ‘weight loss’
and describe the many aspects of metabolic syndrome and obesity in childhood and
adolescence once more in a comprehensive and interdisciplinary manner.
Wieland Kiess, Leipzig
Martin Wabitsch, Ulm
Claudio Maffeis, Verona
Arya M. Sharma, Edmonton, Alta.
Preface IX