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      Prevalence of incorrect body posture in children and adolescents with overweight and obesity

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          Abstract

          The ever increasing epidemics of overweight and obesity in school children may be one of the reasons of the growing numbers of children with incorrect body posture. The purpose of the study was the assessment of the prevalence of incorrect body posture in children and adolescents with overweight and obesity in Poznań, Poland. The population subject to study consisted of 2732 boys and girls aged 3–18 with obesity, overweight, and standard body mass. The assessment of body mass was performed based on BMI, adopting Cole’s cutoff values. The evaluation of body posture was performed according to the postural error chart based on criteria complied by professor Dega. The prevalence rates of postural errors were significantly higher among children and adolescents with overweight and obesity than among the group with standard body mass. In the overweight group, it amounted to 69.2% and in the obese group to 78.6%.

          Conclusion: The most common postural deviations in obese children and adolescents were valgus knees and flat feet. Overweight and obesity in children and adolescents, predisposing to higher incidence of some types of postural errors, call for prevention programs addressing both health problems.

          What is Known:

          The increase in the prevalence of overweight and obesity among children and adolescents has drawn attention to additional health complications which may occur in this population such as occurrence of incorrect body posture .
          What is New:

          The modified chart of postural errors proved to be an effective tool in the assessment of incorrect body posture .

          This chart may be used in the assessment of posture during screening tests and prevention actions at school .

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          Most cited references32

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          Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia.

          Few studies have used the same references across countries to examine the trends of over- and underweight in older children and adolescents. Using international references, we examined the trends of overweight and underweight in young persons aged 6-18 y from 4 countries. Nationally representative data from Brazil (1975 and 1997), Russia (1992 and 1998), and the United States (1971-1974 and 1988-1994) and nationwide survey data from China (1991 and 1997) were used. To define overweight, we used the sex- and age-specific body mass index cutoffs recommended by the International Obesity Task Force. The sex- and age-specific body mass index fifth percentile from the first US National Health and Nutrition Examination Survey was used to define underweight. The prevalence of overweight increased during the study periods in Brazil (from 4.1 to 13.9), China (from 6.4 to 7.7), and the United States (from 15.4 to 25.6); underweight decreased in Brazil (from 14.8 to 8.6), China (from 14.5 to 13.1), and the United States (from 5.1 to 3.3). In Russia, overweight decreased (from 15.6 to 9.0) and underweight increased (from 6.9 to 8.1). The annual rates of increase in the prevalence of overweight were 0.5% (Brazil), 0.2% (China), -1.1% (Russia), and 0.6% (United States). The burden of nutritional problems is shifting from energy imbalance deficiency to excess among older children and adolescents in Brazil and China. The variations across countries may relate to changes and differences in key environmental factors.
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            The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study.

            Although overweight and obesity in childhood are related to dyslipidemia, hyperinsulinemia, and hypertension, most studies have examined levels of these risk factors individually or have used internal cutpoints (eg, quintiles) to classify overweight and risk factors. We used cutpoints derived from several national studies to examine the relation of overweight (Quetelet index, >95th percentile) to adverse risk factor levels and risk factor clustering. The sample consisted of 9167 5- to 17-year-olds examined in seven cross-sectional studies conducted by the Bogalusa Heart Study between 1973 and 1994. About 11% of examined schoolchildren were considered overweight. Although adverse lipid, insulin, and blood pressure levels did not vary substantially with the Quetelet index at levels <85th percentile, risk factor prevalences increased greatly at higher levels of the Quetelet index. Overweight schoolchildren were 2.4 times as likely as children with a Quetelet index <85th percentile to have an elevated level of total cholesterol. Odds ratios for other associations were 2.4 (diastolic blood pressure), 3.0 (low-density lipoprotein cholesterol), 3.4 (high-density lipoprotein cholesterol), 4.5 (systolic blood pressure), 7.1 (triglycerides), and 12.6 (fasting insulin). Several of these associations differed between whites and blacks, and by age. Of the 813 overweight schoolchildren, 475 (58%) were found to have at least one risk factor. Furthermore, the use of overweight as a screening tool could identify 50% of schoolchildren who had two or more risk factors. Because overweight is associated with various risk factors even among young children, it is possible that the successful prevention and treatment of obesity in childhood could reduce the adult incidence of cardiovascular disease.
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              Association of body fat distribution and cardiovascular risk factors in children and adolescents.

              Obesity is associated with increased risk of cardiovascular disease in adults and less favorable cardiovascular risk factor status in children and adolescents. In adults, fat distribution has been shown to be related to lipid and lipoprotein concentrations, blood pressure levels, and left ventricular mass. These relationships have not been extensively studied in young subjects. This was a cross-sectional study of 127 children and adolescents 9 to 17 years of age. Dual-energy x-ray absorptiometry was used to measure total and regional fat mass. The dependent variables were fasting lipid and lipoprotein concentrations, systolic and diastolic blood pressures, and left ventricular mass. There were significant (P<0.05) univariate correlations between fat distribution and log triglycerides (r=0.27), log HDL cholesterol (r=-0.23), systolic blood pressure (r=0.26), and left ventricular mass (r=0.37). Multiple regression analysis showed that the significant independent correlates for triglycerides and HDL cholesterol were age and fat distribution; for systolic blood pressure, height and fat distribution; and for left ventricular mass, height, race, sex, and fat distribution. These results demonstrate that fat distribution is a more important independent correlate of cardiovascular risk factors than percent body fat in children and adolescents. Greater deposition of central fat (an android fat pattern) is associated with less favorable plasma lipid and lipoprotein concentrations, blood pressure, and left ventricular mass.
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                Author and article information

                Contributors
                paprocka@ump.edu.pl
                0048 61 854 6822 , bwitoszynska@hoga.pl
                kotwicki@ump.edu.pl
                0048 61 854 6808
                0048 61 854 6822 , epidemiologia@ump.edu.pl
                jarwalk@ump.edu.pl
                0048 61 854 6822 , mwiewior@ump.edu.pl
                Journal
                Eur J Pediatr
                Eur. J. Pediatr
                European Journal of Pediatrics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0340-6199
                1432-1076
                22 February 2017
                22 February 2017
                2017
                : 176
                : 5
                : 563-572
                Affiliations
                [1 ]ISNI 0000 0001 2205 0971, GRID grid.22254.33, Physical Education and Sports Department, , Poznań University of Medical Sciences, ; Marcelińska 25, 60-802 Poznań, Poland
                [2 ]ISNI 0000 0001 2205 0971, GRID grid.22254.33, Department of Epidemiology Chair of Social Medicine, , Poznań University of Medical Sciences, ; Dąbrowskiego 79, 60-529 Poznań, Poland
                [3 ]ISNI 0000 0001 2205 0971, GRID grid.22254.33, Department of Pediatric Orthopedics and Traumatology, , Poznań University of Medical Sciences, ; Poznań, Poland
                [4 ]ISNI 0000 0001 2205 0971, GRID grid.22254.33, Department of Computer Science and Medical Statistics, , Poznań University of Medical Sciences, ; Poznań, Poland
                [5 ]ISNI 0000 0001 2205 0971, GRID grid.22254.33, Department of Pediatric Gastroenterology and Metabolic Diseases, 1st Chair of Pediatrics, , Poznań University of Medical Sciences, ; Poznań, Poland
                Author notes

                Communicated by Mario Bianchetti

                Article
                2873
                10.1007/s00431-017-2873-4
                5415578
                28229267
                f4f3413c-be57-43d0-b118-0188966680cb
                © The Author(s) 2017

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 1 March 2016
                : 5 February 2017
                : 7 February 2017
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag Berlin Heidelberg 2017

                Pediatrics
                prevalence,posture,overweight,obesity,child,adolescents
                Pediatrics
                prevalence, posture, overweight, obesity, child, adolescents

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