These results are particularly important in light of the deleterious consequences of childhood obesity and early changes in markers of inflammatory and oxidative stress. We suggest exploring the direct clinical application of zinc supplementation in childhood obesity in future studies.

OBJECTIVE: Zinc, an essential trace element and a component of many enzymes, is involved in the synthesis, storage and release of insulin. The aim of the present study was to assess the effect of zinc supplementation on insulin resistance and components of the metabolic syndrome in prepubertal obese children. DESIGN: This triple-masked, randomized, placebocontrolled cross-over trial was conducted among 60 obese Iranian children in 2008. Pertinent clinical findings, fasting serum glucose, insulin and lipid profile were assessed. Participants were randomly assigned to two groups of equal number; one group received 20mg elemental zinc and the other group received placebo on a regular daily basis for eight weeks. After a 4-week wash-out period, the groups were crossed over. RESULTS: The mean age of participants was 9.1 ± 1.1 years. After receiving zinc, the mean fasting plasma glucose (FPG), insulin and HOMA-IR decreased significantly, while body mass index (BMI), waist circumference (WC), LDL-C and triglycerides (TG) did not significantly change. After receiving placebo, the mean FPG, insulin and HOMA-IR increased significantly, while BMI, WC, LDL-C and TG showed a non-significant increase. CONCLUSION: Besides lifestyle modification, zinc supplementation might be considered as a useful and safe additional intervention treatment for improvement of cardiometabolic risk factors related to childhood obesity.

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Background: The increasing trend of both obesity and postural disorders in pediatric population. Objectives: We aimed to determine the prevalence of lower extremities' postural disorders among school children in Qom province, Iran. Methods: In this cross-sectional study, a representative sample of schoolchildren aged 6-7 years was selected by multi-stage clustering method from all urban and rural regions of Qom province. Presence of postural deformities of lower limbs, including genu valgum, genu varum and flat foot were evaluated and recorded. Prevalences of deformities in different categories of weight status (underweight, normal and overweight) were compared. Results: Out of 20000 school children 1450 students were randomly selected. Genu valgum, genu varum and flat foot was present in 256 (17.7%), 351 (24.2%) and 194 (13.38%) of studied population. 1021 (70.41%), 161 (11.1%) and 268 (18.48%) students were normal weight, underweight and overweight/obese, respectively. Prevalence of flat foot and genu valgum was significantly higher in obese/overweight students (P < 0.01). Mean of skin fold thickness was significantly higher in students with genu valgum (P < 0.001). A significant relation existed only between occurrence of lower limb postural deformities and body mass index [OR = 1.89, CI (95%) = 1.18-3.03]. Conclusions: The findings of this study indicate that prevalence of genu valgum and flat foot are higher in overweight/obese children. In addition to early diagnosis and timely treatment of the deformities, developing and validation of a multidisciplinary care for obese and overweight children to reduce the occurrence of obesity related musculoskeletal complications is of importance.

Context:Child abuse is a serious problem, and its physical manifestations can be mimicked by certain diseases and conditions. These conditions can include genetic, congenital and other disorders that may result in poor weight gain, bone fractures or skin lesions that look like bruises or burns.Case Report:This paper reports the case of a seven-year-old girl with Ehlers-Danlos Syndrome (EDS), which was misdiagnosed as child abuse. This child was referred to us for treatment of an unexplained facial scar that was alleged to be the result of child abuse.Conclusion:When unusual skin presentations are observed, dermatologists should consider the possibility of child abuse to protect the child. Furthermore, they should be aware of the cutaneous abnormalities that mimic injuries associated with abuse to avoid the unnecessary reporting of child abuse.