TUESDAY, March 12 (HealthDay News) -- Obese children
hospitalized for certain serious illnesses may have a higher risk
of dying than thinner patients, a new research review suggests.
Experts caution that the findings are just "suggestive" of a
link, and do not prove that critically ill children are more likely
to die if they're obese.
But the results, published online March 11 in
JAMA Pediatrics,add to the list of potential risks tied to
Past studies have found that obese children face higher rates of
some long-term health problems, such as type 2 diabetes, high blood
pressure and asthma. They also tend to become obese adults, with
all the potential health consequences that come with that,
including increased risks of heart disease and certain cancers.
"This (study) suggests there may be more to childhood obesity than the risks we already know of," said lead researcher Lori Bechard, a clinical nutrition specialist at Boston Children's Hospital. "There may also be some near-term risks."
Bechard stressed, however, that the studies in her team's review
had a number of limitations. They also varied widely in how they
were done, and even in how they defined obesity.
"We don't feel confident that we can say there is an association" between obesity and seriously ill children's risk of dying, Bechard said. "We need more research."
Given that roughly 17 percent of U.S. children and teens are
obese, this possible connection, if proven, could have significant
The findings are based on data from 28 past studies of children
ages 2 to 18 who were hospitalized for various reasons. Twenty-one
studies looked at kids' risk of dying, and half of them found that
for children with serious illnesses, obesity was linked to an
increased risk of death.
The studies that did find a link tended to be larger and better
done than the others. Still, Bechard said, "the evidence wasn't
Besides the higher death risk in some reports, a couple of
studies also found that obese children generally had a longer
hospital stay. No clear link was established between obesity and
the risk of contracting an infection in the hospital.
It's hard to know what to make of the results, said Dr. Patricia
Vuguin, a pediatric endocrinologist at Cohen Children's Medical
Center in New Hyde Park, N.Y.
"This is suggestive that there might be a relationship between obesity and higher mortality. But that doesn't tell us anything about causality," said Vuguin, who was not involved in the research.
The better-done studies tried to account for other factors --
such as the severity of a child's disease -- but there could be
other reasons that obese children tended to be at greater risk of
Thankfully, children rarely develop life-threatening illnesses,
Vuguin said. "It's not common," she stressed. "It's unusual."
The review found no evidence that obese kids who were presumably
in better health -- those having elective surgery -- had a
higher-than-normal death risk. But it is so rare for children to
die from elective surgery, Bechard said, it would be "very hard"
for a study to detect a link with obesity, if there is one.
Vuguin said a big limitation is that nearly all studies on this
issue have been retrospective, which means the researchers looked
back in time at patient records. And those records may lack a lot
of important information.
Bechard agreed. Prospective studies -- where researchers enroll
kids when they enter the hospital, then follow them over time --
would give stronger evidence. "It would be helpful to do
prospective studies, and have clearer definitions of obesity,"
According to Vuguin, it's plausible that obesity could have some
effect on how seriously ill children fare. It's thought that
obesity creates a state of chronic, low-level inflammation in the
body. And based on animal research, it's believed that can impair
immune system function.
But it's not possible to tell from the current findings whether
that explains the higher death risk seen in some obese
So for now, Bechard said, there are no practical implications
from the results -- only more questions. "We need to keep looking
at the effects of being obese in childhood," she said.
For information on helping overweight kids, visit the
U.S. National Institute of Diabetes and Digestive ... Kidney
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