Childhood obesity and its physical and psychological co-morbidities: a systematic review of Australian children and adolescents

Abstract

Australia is predicted to have the highest overweight/obesity rate in the world by 2022 outranking the USA and UK. The purpose of this systematic review was to evaluate the associations between childhood obesity and physical and psychological health co-morbidities. Therefore, a systematic literature search was conducted from six databases (2004–2014). Studies were included if they investigated obesity-related co-morbidities with participants residing in Australia aged 0–18 years. Forty-seven studies fulfilled selection criteria. Evidence suggests that overweight/obese Australian children and adolescents, compared to normal-weight peers, had more cardio-metabolic risk factors and higher risk factors of non-alcohol fatty liver disease and were experiencing more negative psychological outcomes (depression, low self-esteem and lower scores of health-related quality of life). Many other health consequences have either not been investigated in Australia, or as frequently as in other countries.

Conclusions: Given Australia’s current overweight/obesity prevalence and trajectory, Australia-based studies are needed to identify the suspected co-morbidities, understand the range of individual, social and environmental mechanisms driving obesity, and help identify policies, interventions and strategies that will change the future trajectory and ‘disease burden’ both in Australia and internationally.

What is Known:
•Trend analyses have shown that obesity prevalence in Australia is increasing and will outrank UK and the USA by 2022.
•Every third Australian child/adolescent between 5 and 19 years old is predicted to be classified as overweight or obese by 2025.
•Childhood obesity is associated with multiple immediate physical and psychological health co-morbidities as well as co-morbidities in adulthood. These have often been identified and examined individually.
What is New:
•This paper presents a holistic picture of childhood obesity and the associated multiple co-morbidities in Australia.
•The extensive health-related outcomes from childhood obesity and those requiring further research are identified.
•The findings of this paper will influence the development of local/regional, state and national strategies to change Australia’s future trajectory.

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Fig. 1

Abbreviations

ADHD:

Attention deficit hyperactivity disorder

ALT:

Alanine transaminase

AN:

Acanthosis nigricans

AST:

Aspartate transaminase

BMI:

Body mass index

DBP:

Diastolic blood pressure

GGT:

Gamma glutamyltransferase

HDL:

High-density lipoprotein

HRQoL:

Health-related quality of life

hs-CRP:

High-sensitivity C-reactive protein

LDL:

Low-density lipoprotein

NAFLD:

Non-alcohol fatty liver disease

OECD:

Organisation for Economic Co-operation and Development

OSAS:

Obstructive sleep apnoea syndrome

SBP:

Systolic blood pressure

WC:

Waist circumference

WHO:

The World Health Organization

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Conflict of interest

There was no funding or sponsorship of this research. The authors declare that they have no conflict of interest.

Author contributions

This research was conceived and directed by RS and SC as part of a series of studies on adolescent obesity at The University of Sydney. AH conducted a comprehensive systematic literature search, study selection and data extraction. All authors contributed to writing and reviewing the document at all stages, reviewed and approved the manuscript prior to submission. Each of our authors meets the standard criteria for authorship.

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Correspondence to Ross H. Sanders.

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Communicated by Beat Steinmann

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Sanders, R.H., Han, A., Baker, J.S. et al. Childhood obesity and its physical and psychological co-morbidities: a systematic review of Australian children and adolescents. Eur J Pediatr 174, 715–746 (2015). https://doi.org/10.1007/s00431-015-2551-3

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Keywords

  • Obesity
  • Overweight
  • Co-morbidity
  • Systematic review
  • Childhood
  • Adolescents
  • Australia