Blount disease (tibia vara): Another skeletal disorder associated with childhood obesity

Dietz, William H.; Gross, Wendy L.; Kirkpatrick, John A.

doi:10.1016/s0022-3476(82)80305-3

Cited by 170 publications

(71 citation statements)

References 9 publications

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“…75 Often painless, Blount disease presents as visible bowing of the lower extremity and is diagnosed with anteroposterior radiographic views of the affected knee obtained while the patient is standing. An orthopedic surgeon can determine how to treat this condition, to correct bowing and to prevent progression.…”

Section: Orthopedic Disordersmentioning

confidence: 99%

Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

2007

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To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child's obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient's age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.www.pediatrics.org/cgi

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Section: Orthopedic Disordersmentioning

confidence: 99%

Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

2007

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“…Immediate psychosocial effects include social discrimination in childhood and self esteem problems in adolescents, 1,2 while physical health problems include poorer pulmonary function, 3 advanced growth, hyperlipidaemia, glucose intolerance, hepatic steatosis and cholelithiasis, and a wide range of less common pathologic conditions. 2,4 Perhaps even more importantly, obesity in the school years is an important independent risk factor for adult obesity. 5 In turn, adult obesity is strongly associated with a range of common chronic diseases including non-insulin dependent diabetes mellitus and coronary heart disease; 6 even moderately elevated levels of body mass index (BMI) are associated with increased risk of mortality.…”

Section: Introductionmentioning

confidence: 99%

Change in body mass index in Australian primary school children, 1985–1997

et al. 2000

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BACKGROUND: Childhood obesity is an important, potentially modi®able risk factor for a range of concurrent and later morbidities. Despite concerns about recent increases in children's body mass index (BMI), supporting data in Australia (as elsewhere) are scant. OBJECTIVE: To seek anthropometric evidence of a recent secular increase in BMI in primary school children in Victoria, Australia. DESIGN: Data from two cross-sectional population-based surveys of primary school children (the Victorian subsample of the 1985 Australian Health and Fitness Survey and the 1997 Health of Young Victorians Study) were compared. Similar strati®ed random sampling and standardized measurement methods were employed in the two studies. Subjects were all children aged 7 ± 12 y with complete height and weight data. Body mass index (BMI (weightaheight 2 )) was used as the index of relative adiposity. Non-parametric and parametric methods were used to examine the pattern and magnitude of change in BMI over the 12 y interval. RESULTS: Data for 1421 children (50% male, 68% response) from the 1985 survey and 2277 children (51% male, 75% response) from the 1997 survey were analysed. At all ages, mean height and median weight were greater in 1997 than 1985 for both boys and girls. Median BMI was signi®cantly higher in the 1997 sample for all but 12 y-old girls and for boys aged 7, 8 and 10 y (Mann ± Whitney U test). The magnitude of the overall increase in BMI was estimated using analysis of covariance for log-transformed BMI adjusted for exact age, which indicated an increase of 1.03 kgam 2 for boys and 1.04 kgam 2 for girls (both P`0.001). Plots of BMI against BMI percentile clearly showed a pattern of higher BMI at any given percentile, especially at the upper percentiles, for all ages and both genders. CONCLUSIONS: Primary school children in Victoria have become more obese over the last decade. Increases in BMI are most marked at the heavier end of the distribution. Lesser increases in median and mean BMI (con®rmed by both parametric and non-parametric statistical models) may also have major public health implications.

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“…Depression of the medial aspect of the proximal tibial epiphysis requiring medial plateau elevation has not been reported in patients with late-onset tibia vara 4 . Although late-onset tibia vara occasionally may occur in thin or normal-sized patients, the majority of patients are obese 2,6,[16][17][18][19][20][21] . These patients typically are in the ninetieth percentile of weight for both age and height 17,18,[20][21][22] .…”

mentioning

confidence: 99%