National Science Popularization Day | A dark neck may be caused by obesity

In the eyes of many parents, "little fat boy" is always synonymous with "cute". Many parents are even proud that their children are "little fat boys", thinking that it is a sign that their children are not picky about food and have "particularly good" nutrition. But is this really the case?

Case Introduction

Recently, 8-year-old Chenchen (pseudonym) came to the hospital for treatment because his neck was black and he couldn't wash it clean. After a nutritionist's examination, Chenchen, who is 125 cm tall, should weigh about 26 kg, but Chenchen weighed as much as 48 kg! The subsequent "body composition" test found that Chenchen's body fat was seriously overweight, and Chenchen's "black neck" happened to be one of the important complications of childhood obesity, called "pseudoacanthosis nigricans."

In fact, situations like Chenchen's are not uncommon nowadays. With the increasingly affluent living conditions in cities and the continuous "strengthening" of preschool education by many parents, it is easier to ignore the amount of physical exercise children need in their daily lives. Most parents like to give fast food and drinks as extra rewards for their children's hard work, not knowing that their children have long been overnourished and have become obese.

In addition to "pseudoacanthosis nigricans", childhood obesity can also cause other varying degrees of harm to the body and mind:

1. Insulin resistance and type 2 diabetes

Insulin is an important hormone that maintains normal blood sugar levels in the human body. Obese children generally like to eat all kinds of sweets, which leads to more insulin secretion to control the rise of blood sugar. However, due to the long-term overload of the pancreas, it will cause fatigue of the organ, eventually causing insulin resistance, and slowly and largely prematurely developing into type 2 diabetes.

How to understand it simply? It is similar to children doing homework. If they are given a lot of homework every day, so much that they cannot finish it at 12 o'clock in the evening, then will they also have "homework resistance" and become tired of studying? The same is true for the organs in the human body. They also need enough rest, so no organ can be overworked, otherwise it will not be worth the loss!

2. Fatty Liver

Fatty liver is caused by lipid metabolism disorder in the body, which leads to the accumulation of fat in liver cells, posing a serious threat to the patient's health. The prevalence of fatty liver in people with high body weight is higher than that in people with normal weight.

Studies in my country have shown that the detection rate of fatty liver in children of normal weight is 0.5%[1], while in overweight children, the detection rate of fatty liver is 23.2%, and in obese children, the detection rate of fatty liver is as high as 46.2%[2]. It is worth noting that in obese children with fatty liver, increases in waist circumference, hip circumference, and waist-to-hip ratio are all risk factors for fatty liver, especially increases in waist circumference have a greater impact[3].

Generally speaking, fatty liver caused by obesity is a reversible disease. Early diagnosis and timely intervention can restore the condition to normal. For example, under the guidance of doctors and nutritionists, patients can increase aerobic exercise such as swimming, skipping rope, and brisk walking, control the intake of high-oil, high-fat, and high-cholesterol foods, increase the intake of fruits and vegetables, and take medication if necessary. Of course, if fatty liver is not taken seriously, it may further develop into fatty liver hepatitis, liver fibrosis, and cirrhosis, and eventually lead to liver failure[4].

3. Precocious puberty

Some parents found that their children's chests had slightly bulged or armpit hair had appeared when they were helping them change clothes. The incidence of precocious puberty is increasing year by year, especially in obese children, and has become a major concern for many parents. Some scholars have found that adequate fat reserves are the basis for promoting sexual development. Increased fat can promote the secretion of hormones such as leptin and insulin, stimulate the maturation of gonads, and further aggravate fat accumulation, forming a vicious cycle and increasing the incidence of precocious puberty in obese children [5].

Premature sexual development will not only lead to premature closure of the epiphysis, causing the child to fail to reach his genetic height, but also cause problems such as alcoholism, smoking, and premature sexual behavior due to the mismatch between physical development and psychological state. This issue deserves attention.

4. Mental Health

In school, classmates often give obese children nicknames, such as "little fat boy" or "fat boy", which will have a serious impact on the self-esteem of children, and they are likely to become withdrawn, taciturn, and have strange personalities. Studies have shown that overweight and obese children generally have mental health problems, especially in learning disabilities and behavioral disorders.

Therefore, parents should pay attention to their children's weight and intervene actively. This is very important for the healthy growth of children!

In summary, are the hazards caused by obesity terrible? I hope that all parents will pay attention to the changes and fluctuations in their children's height and body mass index in time! If there is a "fat sister" or "fat brother" at home, you should go to the nutrition department for consultation in time, follow the advice of doctors and nutritionists, actively control weight, eat a reasonable diet, and correct bad living habits in time, so that the "flowers of the motherland" will not be burdened by weight and grow up healthily and happily.

References:
[1] Ma Jun, Zhang Shiwei, Wu Shengxin, Zhang Heng, Li Shanshan. Analysis of the detection of fatty liver in children with different nutritional status[J]. Chinese School Health, 2008(02): 109-110.

[2] Ben Xiuluan, Ji Fenghua. Correlation between simple obesity and non-alcoholic fatty liver disease in children[J]. Liver, 2016, 21(08): 705-707.

[3] Kang Rutong, Zhong Yan, Jiang Yaohui, Liu Kangxiang, You Cheng. Analysis of influencing factors of non-alcoholic fatty liver disease in obese children[J]. Practical Preventive Medicine, 2013, 20(03): 277-279.

[4] Li Hua, Xiao Yanfeng, Yin Chunyan, Chu Haiping. Analysis of risk factors related to fatty liver in children with simple obesity[J]. Chinese Journal of Maternal and Child Health Research, 2017, 28(04): 366-368.

[5] Suh J, Choi HS, Kwon A, Chae HW, Kim HS. Effect of agricultural pesticide on precocious puberty in urban children: an exploratory study. Clin Exp Pediatr. 2020 Apr; 63(4): 146-150.

Project source: Shanghai Science and Technology Commission Science Popularization Project Funding (Project No.: 21DZ2301800)

Author: Zhao Xuan Niu Yang | Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine