Adiposity as a Risk Factor for Sport Injury in Youth: A Systematic Review

Abstract

Objective: To determine whether high or low adiposity is associated with youth sport-related injury. Data Sources: Ten electronic databases were searched to identify prospective studies examining the association between adiposity [body mass index (BMI) or body fat] and a future time-loss or medical attention sport-related musculoskeletal injury or concussion in youth aged 20 years and younger. Two independent raters assessed the quality (Downs and Black criteria) and risk of bias (Joanna Briggs Institute Critical Appraisal Tool). Random-effects meta-analyses were used to calculate pooled odds ratio [95% confidence interval (CI)] of injury. Main Results: Of 11 424 potentially relevant records, 38 articles were included with 17 eligible for meta-analyses. In qualitative synthesis, no clear association was identified between adiposity and any sport injury; however, 16/22 studies identified high adiposity as a significant risk factor for lower-extremity injury. Meta-analyses revealed higher BMI in youth with any sportrelated injury and lower BMI in youth who developed a bone stress injury (BSI) compared with noninjured controls. The pooled OR (95% CI) examining the association of BMI and injury risk (excluding bone injury) was 1.18 (95% CI: 1.03-1.34). A major source of bias in included articles was inconsistent adjustment for age, sex, and physical activity participation. Conclusions: Level 2b evidence suggests that high BMI is associated with greater risk of youth sport injury, particularly lower-extremity injury and excluding BSI or fracture. Although pooled mean differences were low, anthropometric risk of injury seems to be dependent on type and site of injury in youth sport.

Neuromusculoskeletal Health in Pediatric Obesity: Incorporating Evidence into Clinical Examination

“…Qualitative systematic/scoping reviews have explored common barriers to physical activity, indicating that children with obesity may be turned off activity by a range of ‘physical factors’ [ 12 , 30 ]. Injury has been identified as a barrier to activity [ 12 , 30 ] and a new meta-analysis of prospective evidence shows that youth with a higher BMI may be at a greater risk of injuring themselves during sport (OR 1.18) [ 31 ]. In addition, children with obesity have a higher risk of fractures [ 32 ].…”

Bone Health in Young Athletes: a Narrative Review of the Recent Literature

“…Considering other risk factors for BSI, a 2022 systematic review and meta-analysis of 17 prospective observational studies examined the relationship between adiposity and sports injury risk in young athletes, including BSIs [ 37 ]. Young athletes with a BSI were more likely to have a lower BMI than uninjured peers.…”

Maternal Pre-Pregnancy Nutritional Status and Physical Activity Levels and a Sports Injury Reported in Children: A Seven-Year Follow-Up Study

“…Moreover, impaired neuromuscular and postural control has been confirmed in obese children [25], often accompanied by altered biomechanical loadings of weight-bearing skeletal tissue and an increase in systemic inflammation caused by excess adipose [26]. In general, the most recent systematic review with a meta-analysis showed that of 38 articles studied, 16 identified high adiposity as a significant risk factor for lower-extremity injury [27]. Our results demonstrate that low maternal body mass index has a protective role for sports injuries, which is not in line with the findings in the literature [27,28].…”

“…In general, the most recent systematic review with a meta-analysis showed that of 38 articles studied, 16 identified high adiposity as a significant risk factor for lower-extremity injury [27]. Our results demonstrate that low maternal body mass index has a protective role for sports injuries, which is not in line with the findings in the literature [27,28]. A low body mass index may lead to a higher incidence of bone stress injuries among young female athletes who have a body mass index < 21 kg/m 2 , participate in physical activity ≥ 12 h/week, and have oligomenorrhea/amenorrhea [28].…”