Disparities in the Prevalence of Childhood Obesity-Related Comorbidities: A Systematic Review

Abstract

BackgroundNon-communicable diseases among children are serious consequences of childhood obesity. However, less is known about the disparities in childhood obesity comorbidities burden. This review describes the salient pattern of disparities in the prevalence of childhood obesity-related non-communicable diseases and relevant inequalities in both high- and low/medium-income countries.MethodA systematic literature search was performed in MEDLINE, Embase, CINAHL, PsycInfo, Scopus, and Web of Science databases by two independent reviewers. Inclusion criteria were as follows: age 2–18 years; the prevalence or incidence of childhood obesity comorbidities reported; and studies published in English from January 2010 to date. No restrictions on the setting. The prevalence data were analyzed using range and median for subgroups based on the country's development status, gender, and geographical region.ResultsOur search identified 6,837 articles, out of which we examined 145 full-text articles and included 54 articles in the analysis. The median prevalence of childhood obesity-related hypertension was 35.6 vs. 12.7% among middle- and low-income countries compared with high-income countries; 37.7 vs. 32.9% among boys compared with girls; and 38.6, 25.3, and 20.1% in Asia, South America, and Europe, respectively. For metabolic syndrome, the median prevalence was 26.9 vs. 5.5% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared with girls; and 40.3, 25.8, and 7.7% in South America, Asia, and Europe, respectively. The prevalence of childhood obesity-related non-alcoholic fatty liver disease was 47.5 vs. 23% among middle- and low-income countries compared with high-income countries; and 52.1, 39.7, and 23.0% in Asia, South America, and Europe, respectively. The median prevalence of dyslipidemia was 43.5 vs. 63% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared to girls; and 73.7 and 49.2% in Australia and Europe, respectively.ConclusionThere are disparities in the prevalence of childhood obesity-related hypertension, metabolic syndrome, and non-alcoholic fatty liver disease, with middle- and low-income countries, boys, and Asian region having higher prevalence. Implementing targeted interventions for childhood obesity comorbidities should consider socioeconomic disparities and strengthening of research surveillance methods for a better understanding of non-communicable disease burden in the pediatric population.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021288607.

Criteria in the Diagnosis of Metabolic Syndrome in Children: A Scoping Review

“…In this review, a higher prevalence of MetS was found in girls than in boys, differing from that reported in the systematic review by Friend et al 53 with data from 2003 to 2010 and by Obita et al 54 who used information from 2010 to 2018; however, both include children and adolescents aged 2 to 18 years. However, these prevalences of MetS between boys and girls can vary due to the variable prevalence of obesity present in different countries.…”

Alanine aminotransferase elevation varies by ethnicity among Asian and Pacific Islander children with overweight or obesity

“…A MASLD prevalence ranging from 45.0% to 52.1% has been estimated among children with obesity in Asia based on a systematic review of 27 articles. 33 Overall MASLD prevalence among youth under 21 years of age is estimated at 7% in Asia, regardless of diagnostic method, from a meta-analysis encompassing 74 studies worldwide. 34 In Korea, a study using 2009-2018 data from the Korea National Health and Nutrition Examination Survey (KNHANES) found that 9.6% of 6327 children aged 10-18 years had suspected MASLD based on the biological ALT threshold.…”

“…In addition to a few US studies exploring the epidemiology of suspected MASLD among Asian/PI children and global reviews, the majority of findings on Asian/PI children come from individual countries in Asia where the estimated prevalence appears to be increasing. A MASLD prevalence ranging from 45.0% to 52.1% has been estimated among children with obesity in Asia based on a systematic review of 27 articles 33 . Overall MASLD prevalence among youth under 21 years of age is estimated at 7% in Asia, regardless of diagnostic method, from a meta‐analysis encompassing 74 studies worldwide 34 .…”

“It Takes a Village”: Reflections from participants after a Hispanic community-based health promotion program

“…Some parents commented on the di culty of engaging their children in activities without the formality of a structured commitment with mentors and facilitators outside the family unit, reinforcing a common experience. Existing literature supports the bene cial effect on weight management of culturally tailored programs that program leaders directly supervise for the duration of the program [28,29]. Even though the group consensus favored the reimplementation of the FIT4YES program, multiple ideals instilled by the program remained intact, inspiring the continuation of healthy substitutions into meal-time recipes, activities around the neighborhood, and choosing to become more health-aware throughout daily life.…”