Rates of childhood obesity have increased more than threefold in the last 30 years according to the American Medical Association (AMA). The AMA also states, obesity can have both immediate and long-term effects on children’s health, ranging from poor self-esteem, sleep apnea, and asthma, to increased risks for heart disease, high blood pressure, and cancer. Childhood obesity is also associated with Type II diabetes and an increase in the stress on weight-bearing joints.
The good news is that the most recent study from the Center for Disease Control (CDC) related that the prevalence of obesity among children aged 2 to 5 years decreased significantly from 13.9% in 2003-2004 to 8.4% in 2011-2012. However, in 2011-2012, 8.4% of 2- to 5-year-olds had obesity compared with 17.7% of 6- to 11-year-olds and 20.5% of 12- to 19-year-olds. This shows that as children have been aging into their teenage and young adult years, they have a higher tendency of being overweight.
According to the American Academy of Orthopaedic Surgeons, today approximately 32% of American children and adolescents, ages 2 to 19, are considered overweight or obese. Excess weight can cause vitamin deficiencies, hormonal imbalances, and increased stress and tension that can affect bone growth and overall musculoskeletal health, causing deformity, pain, and potentially a lifetime of limited mobility and diminished quality of life.
There were two studies performed that evaluated the prevalence of flatfoot in overweight children using body mass index. They were looking to see if these children had different function of their feet or just fatter arches that made them appear lower. The controlled studies showed that the children who were overweight had lower arches, not just fatter feet, as well as much higher forefoot pressures during walking. A more recent study performed in 2013 in Israel found there was a greater prevalence of flexible flatfoot among males compared with females in a general, healthy adolescent age group. Flexible flat foot was associated with increased body mass index and shorter body height for all grades of flexible flatfoot severity.
Another study, from the European Journal of Pediatrics published in January of 2013, concluded that excess weight affects the foot structure of children. The differences they found between age groups appear to indicate that the feet of children with overweight and obesity follow a different growth pattern that that of normal-weight children. In this study by Jimenez et al, they provided actual and normative date of the foot of schoolchildren by age and BMI. They studied 1,032 school children, 6-12 years old from different locations in Toledo, Spain. Their BMI was calculated using height and weight from a standing scale and used their sex to determine their BMI as well according to the classification system proposed by cole et al. In addition to these findings, the researchers also used 3D measures with a feet digitizer that included four laser projectors and four CCD cameras. When comparing the measures between overweight and obese children, significant differences were found in the widths, ball height, and arch height for both feet. Obese children showed larger dimensions of the foot.
Overweight and obese children were shown to have larger feet than their normal-weight counterparts throughout growth. Obese children and overweight children were shown to differ only in the width if their feet. Another interesting feature of this study was that they found among the age groups there were more significant differences in measures between children with normal-weight, followed by overweight and obese children. This shows that children with more weight tend to show less change in their feet or the changes are more gradual as they age. Could excess weight than be a factor in foot development in school-age children? Several studies, including this one, showed that the most significant change in foot type occurs between ages 7-8 as well as the highest incidence of obesity. The significance in foot measures between ages 10-12 was much less, showing the developmental structure of the foot stabilizes and there are less changes. Some researchers have found that the foot of school children from 12 to 13 years is structurally formed at this point and does not change throughout the length of primary school.
Children who are overweight or obese often have painful, flat feet that tire easily and prevent them from walking long distances. Many children with flat feet are treated with orthotics and stretching exercises focused on the Achilles tendon (heel cord). Because weight loss is effective enough to ease the pain of flat feet, low impact weight reduction exercises, such as swimming or cycling may be recommended.
Children who are overweight or obese must find ways to lose weight. With help from their parents, pediatricians and teachers school aged children can learn how to eat right and exercise regularly. Children must have good role models at home. Parents have to set an example by eating right and exercising. I have always believed actions speak louder than words. Just telling your kids to eat better and go exercise, just will not work. Cook at home with your kids. Take your kids food shopping and focus on the perimeters of the grocery store. This is where all the fruits, vegetables, fish and other fresh foods are. Avoid the aisles in the middle. If children participate in all aspects of their diet they are likely to continue to eat healthy and even find it fun! Family days out should include something outdoors or a physical activity such as a 30 minute walk around where you live, or taking a class at your local YMCA.
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Dr. Suzanne Fuchs has a passion for nutrition, health and fitness. She aims to connect the dots between our overall health and the substances that go into our bodies on a daily basis by using only evidence based medicine, science and expert advice.
Dr. Suzanne Fuchs currently practices concierge foot and ankle medicine and surgery in Palm Beach and Palm Beach Gardens, Florida at LuxePodiatry™
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