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Racial Differences in Childhood Obesity: Pathogenesis and Complications

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Race and ethnicity are terms used to categorize populations on the basis of shared characteristics. Race is traditionally used to categorize populations on the basis of shared biological characteristics such as skin color, other observable features, and the genetic determinants of such differences (1). Ethnicity is used to categorize individuals on the basis of cultural characteristics such as shared language, ancestry, religious traditions, dietary preferences, and history. Although ethnic groups can share a range of phenotypic characteristics due to shared ancestry, the term is typically used to highlight cultural and social characteristics instead of biological ones (1). Both race and ethnicity are frequently used interchangeably and are constantly evolving concepts, especially in the United States, making the task of comparing groups or following the same group over time quite challenging.

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References

  1. Caprio S, et al. Influence of race, ethnicity, and culture on childhood obesity: implications for prevention and treatment: a consensus statement of Shaping America’s Health and the Obesity Society. Diabetes Care. 2008;31(11):2211–21.

    Article  PubMed  Google Scholar 

  2. Nesbitt SD, et al. Overweight as a risk factor in children: a focus on ethnicity. Ethn Dis. 2004;14(1):94–110.

    PubMed  Google Scholar 

  3. Ogden CL, et al. Prevalence of overweight and obesity in the United States, 1999–2004. J Am Med Assoc. 2006;295(13):1549–55.

    Article  CAS  Google Scholar 

  4. Whitaker RC, Orzol SM. Obesity among US urban preschool children: relationships to race, ethnicity, and socioeconomic status. Arch Pediatr Adolesc Med. 2006;160(6):578–84.

    Article  PubMed  Google Scholar 

  5. Kimm SY, et al. Racial divergence in adiposity during adolescence: The NHLBI Growth and Health Study. Pediatrics. 2001;107(3):E34.

    Article  PubMed  CAS  Google Scholar 

  6. Troiano RP, et al. Energy and fat intakes of children and adolescents in the united states: data from the national health and nutrition examination surveys. Am J Clin Nutr. 2000;72(5 Suppl):1343S–53S.

    PubMed  CAS  Google Scholar 

  7. Kimm SY, et al. Decline in physical activity in black girls and white girls during adolescence. N Engl J Med. 2002;347(10):709–15.

    Article  PubMed  Google Scholar 

  8. Burke GL, et al. Differences in weight gain in relation to race, gender, age and education in young adults: the CARDIA Study. Coronary Artery Risk Development in Young Adults. Ethn Health. 1996;1(4):327–35.

    Article  PubMed  CAS  Google Scholar 

  9. Lee S, Arslanian SA. Fat oxidation in black and white youth: a metabolic phenotype potentially predisposing black girls to obesity. J Clin Endocrinol Metab. 2008;93(11):4547–51.

    Article  PubMed  CAS  Google Scholar 

  10. Egyud MR, et al. Use of weighted reference panels based on empirical estimates of ancestry for capturing untyped variation. Hum Genet. 2009;125(3):295–303.

    Article  PubMed  Google Scholar 

  11. Bacha F, Arslanian SA. Ghrelin and peptide YY in youth: are there race-related differences? J Clin Endocrinol Metab. 2006;91(8):3117–22.

    Article  PubMed  CAS  Google Scholar 

  12. Bressler J, et al. The INSIG2 rs7566605 genetic variant does not play a major role in obesity in a sample of 24,722 individuals from four cohorts. BMC Med Genet. 2009;10:56.

    Article  PubMed  CAS  Google Scholar 

  13. Grant SF, et al. Association analysis of the FTO gene with obesity in children of Caucasian and African ancestry reveals a common tagging SNP. PLoS ONE. 2008;3(3):e1746.

    Article  PubMed  CAS  Google Scholar 

  14. Grant SF, et al. Investigation of the Locus near MC4R with childhood obesity in Americans of European and African Ancestry. Obesity (Silver Spring). 2009;17(7):1461–65.

    Google Scholar 

  15. Svec F, et al. Black-white contrasts in insulin levels during pubertal development. The Bogalusa Heart Study. Diabetes. 1992;41(3):313–17.

    Article  PubMed  CAS  Google Scholar 

  16. Gutin B, et al. Relation of percentage of body fat and maximal aerobic capacity to risk factors for atherosclerosis and diabetes in black and white seven- to eleven-year-old children. J Pediatr. 1994;125(6 Pt 1):847–52.

    PubMed  CAS  Google Scholar 

  17. Arslanian SA, et al. Hyperinsulinemia in African-American children: decreased insulin clearance and increased insulin secretion and its relationship to insulin sensitivity. Diabetes. 2002;51(10):3014–19.

    Article  PubMed  CAS  Google Scholar 

  18. Gower BA, et al. Using genetic admixture to explain racial differences in insulin-related phenotypes. Diabetes. 2003;52(4):1047–51.

    Article  PubMed  CAS  Google Scholar 

  19. Lee S, et al. Racial differences in adiponectin in youth: relationship to visceral fat and insulin sensitivity. Diabetes Care. 2006;29(1):51–56.

    Article  PubMed  CAS  Google Scholar 

  20. Lindquist CH, Gower BA, Goran MI. Role of dietary factors in ethnic differences in early risk of cardiovascular disease and type 2 diabetes. Am J Clin Nutr. 2000;71(3):725–32.

    PubMed  CAS  Google Scholar 

  21. Ku CY, et al. Racial differences in insulin secretion and sensitivity in prepubertal children: role of physical fitness and physical activity. Obes Res. 2000;8(7):506–15.

    Article  PubMed  CAS  Google Scholar 

  22. Hannon TS, et al. Hyperinsulinemia in African-American adolescents compared with their American white peers despite similar insulin sensitivity: a reflection of upregulated beta-cell function? Diabetes Care. 2008;31(7):1445–47.

    Article  PubMed  CAS  Google Scholar 

  23. Danadian K, et al. Lipolysis in African-American children: is it a metabolic risk factor predisposing to obesity? J Clin Endocrinol Metab. 2001;86(7):3022–26.

    Article  PubMed  CAS  Google Scholar 

  24. Neel JV. Diabetes mellitus: a “thrifty” genotype rendered detrimental by “progress”? Am J Hum Genet. 1962;14:353–62.

    PubMed  CAS  Google Scholar 

  25. Johnson MS, et al. Longitudinal changes in body fat in African American and Caucasian children: influence of fasting insulin and insulin sensitivity. J Clin Endocrinol Metab. 2001;86(7):3182–87.

    Article  PubMed  CAS  Google Scholar 

  26. Zurlo F, et al. Low ratio of fat to carbohydrate oxidation as predictor of weight gain: study of 24-h RQ. Am J Physiol. 1990;259(5 Pt 1):E650–7.

    PubMed  CAS  Google Scholar 

  27. DeLany JP, et al. Energy expenditure and substrate oxidation predict changes in body fat in children. Am J Clin Nutr. 2006;84(4):862–70.

    PubMed  CAS  Google Scholar 

  28. Schutz Y. Abnormalities of fuel utilization as predisposing to the development of obesity in humans. Obes Res. 1995;3(Suppl 2):173S–8S.

    Article  PubMed  Google Scholar 

  29. Gallagher D, et al. Small organs with a high metabolic rate explain lower resting energy expenditure in African American than in white adults. Am J Clin Nutr. 2006;83(5):1062–67.

    PubMed  CAS  Google Scholar 

  30. Andreacci JL, et al. Comparison of maximal oxygen consumption between obese black and white adolescents. Pediatr Res. 2005;58(3):478–82.

    Article  PubMed  Google Scholar 

  31. Turner N, Heilbronn LK. Is mitochondrial dysfunction a cause of insulin resistance? Trends Endocrinol Metab. 2008;19(9):324–30.

    Article  PubMed  CAS  Google Scholar 

  32. Suminski RR, et al. Peak oxygen consumption and skeletal muscle bioenergetics in African-American and Caucasian men. Med Sci Sports Exerc. 2000;32(12):2059–66.

    Article  PubMed  CAS  Google Scholar 

  33. Hoffman DJ, et al. Comparison of visceral adipose tissue mass in adult African Americans and whites. Obes Res. 2005;13(1):66–74.

    Article  PubMed  Google Scholar 

  34. Goran MI, et al. Visceral fat in white and African American prepubertal children. Am J Clin Nutr. 1997;65(6):1703–8.

    PubMed  CAS  Google Scholar 

  35. Huang TT, et al. Growth of visceral fat, subcutaneous abdominal fat, and total body fat in children. Obes Res. 2001;9(5):283–89.

    Article  PubMed  CAS  Google Scholar 

  36. Bacha F, et al. Obesity, regional fat distribution, and syndrome X in obese black versus white adolescents: race differential in diabetogenic and atherogenic risk factors. J Clin Endocrinol Metab. 2003;88(6):2534–40.

    Article  PubMed  CAS  Google Scholar 

  37. Lee S, et al. Race and gender differences in the relationships between anthropometrics and abdominal fat in youth. Obesity (Silver Spring). 2008;16(5):1066–71.

    Article  Google Scholar 

  38. Taksali SE, et al. High visceral and low abdominal subcutaneous fat stores in the obese adolescent: a determinant of an adverse metabolic phenotype. Diabetes. 2008;57(2):367–71.

    Article  PubMed  CAS  Google Scholar 

  39. Shrewsbury V, Wardle J. Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990–2005. Obesity (Silver Spring). 2008;16(2):275–84.

    Article  Google Scholar 

  40. Rosenkranz RR, Dzewaltowski DA. Model of the home food environment pertaining to childhood obesity. Nutr Rev. 2008;66(3):123–40.

    Article  PubMed  Google Scholar 

  41. Crawford PB, et al. Ethnic issues in the epidemiology of childhood obesity. Pediatr Clin North Am. 2001;48(4):855–78.

    Article  PubMed  CAS  Google Scholar 

  42. Mokdad AH, et al. Diabetes trends among American Indians and Alaska natives: 1990–1998. Diabetes Care. 2001;24(8):1508–9.

    Article  PubMed  CAS  Google Scholar 

  43. Mokdad AH, Bowman BA, Ford ES, Marks JS, Koplan JP. The continuing epidemic of obesity and diabetes in the United States. JAMA. 21 Sept 2001;286(10):1195–200. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (1185).

    Article  PubMed  CAS  Google Scholar 

  44. Dorsey RR, Eberhardt MS, Ogden CL. Racial/Ethnic differences in weight perception. Obesity (Silver Spring). 2009;17(4):790–95.

    Article  Google Scholar 

  45. Paeratakul S, et al. Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight. Obes Res. 2002;10(5):345–50.

    Article  PubMed  Google Scholar 

  46. Melnyk MG, Weinstein E. Preventing obesity in black women by targeting adolescents: a literature review. J Am Diet Assoc. 1994;94(5):536–40.

    Article  PubMed  CAS  Google Scholar 

  47. Arcan C, et al. Sociodemographic differences in selected eating practices among alternative high school students. J Am Diet Assoc. 2009;109(5):823–29.

    Article  PubMed  Google Scholar 

  48. Grier SA, Kumanyika SK. The context for choice: health implications of targeted food and beverage marketing to African Americans. Am J Public Health. 2008;98(9):1616–29.

    Article  PubMed  Google Scholar 

  49. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(3 Pt 2):518–25.

    PubMed  CAS  Google Scholar 

  50. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346(16):1221–31.

    Article  PubMed  CAS  Google Scholar 

  51. Barshop NJ, et al. Review article: epidemiology, pathogenesis and potential treatments of paediatric non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2008;28(1):13–24.

    Article  PubMed  CAS  Google Scholar 

  52. Schwimmer JB, et al. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118(4):1388–93.

    Article  PubMed  Google Scholar 

  53. Schwimmer JB, et al. Histopathology of pediatric nonalcoholic fatty liver disease. Hepatology. 2005;42(3): 641–49.

    Article  PubMed  Google Scholar 

  54. Browning JD, et al. Ethnic differences in the prevalence of cryptogenic cirrhosis. Am J Gastroenterol. 2004;99(2): 292–98.

    Article  PubMed  Google Scholar 

  55. Poonawala A, Nair SP, Thuluvath PJ. Prevalence of obesity and diabetes in patients with cryptogenic cirrhosis: a case-control study. Hepatology. 2000;32(4 Pt 1):689–92.

    Article  PubMed  CAS  Google Scholar 

  56. Berenson GS, et al. Risk factors in early life as predictors of adult heart disease: the Bogalusa Heart Study. Am J Med Sci. 1989;298(3):141–51.

    Article  PubMed  CAS  Google Scholar 

  57. Zoratti R. A review on ethnic differences in plasma triglycerides and high-density-lipoprotein cholesterol: is the lipid pattern the key factor for the low coronary heart disease rate in people of African origin? Eur J Epidemiol. 1998;14(1): 9–21.

    Article  PubMed  CAS  Google Scholar 

  58. Jago R, et al. Prevalence of abnormal lipid and blood pressure values among an ethnically diverse population of eighth-grade adolescents and screening implications. Pediatrics. 2006;117(6):2065–73.

    Article  PubMed  Google Scholar 

  59. Duncan GE, Li SM, Zhou XH. Prevalence and trends of a metabolic syndrome phenotype among U.S. Adolescents, 1999–2000. Diabetes Care. 2004;27(10):2438–43.

    Article  PubMed  Google Scholar 

  60. Freedman DS, et al. Differences in the relation of obesity to serum triacylglycerol and VLDL subclass concentrations between black and white children: the Bogalusa Heart Study. Am J Clin Nutr. 2002;75(5):827–33.

    PubMed  CAS  Google Scholar 

  61. Freedman DS, et al. Levels and correlates of LDL and VLDL particle sizes among children: the Bogalusa heart study. Atherosclerosis. 2000;152(2):441–49.

    Article  PubMed  CAS  Google Scholar 

  62. Burns SF, Lee SJ, Arslanian SA. In vivo insulin sensitivity and lipoprotein particle size and concentration in black and white children. Diabetes Care. 2009;32(11):2087–93. Epub 12 Aug 2009.

    Article  PubMed  CAS  Google Scholar 

  63. Frontini MG, et al. Usefulness of childhood non-high density lipoprotein cholesterol levels versus other lipoprotein measures in predicting adult subclinical atherosclerosis: the Bogalusa Heart Study. Pediatrics. 2008;121(5):924–29.

    Article  PubMed  Google Scholar 

  64. Holman RL, et al. The natural history of atherosclerosis: the early aortic lesions as seen in New Orleans in the middle of the 20th century. Am J Pathol. 1958;34(2):209–35.

    PubMed  CAS  Google Scholar 

  65. Freedman DS, et al. Black-white differences in aortic fatty streaks in adolescence and early adulthood: the Bogalusa Heart Study. Circulation. 1988;77(4):856–64.

    Article  PubMed  CAS  Google Scholar 

  66. Tracy RE, et al. Histologic features of atherosclerosis and hypertension from autopsies of young individuals in a defined geographic population: the Bogalusa Heart Study. Atherosclerosis. 1995;116(2):163–79.

    Article  PubMed  CAS  Google Scholar 

  67. Gungor N, et al. Type 2 diabetes mellitus in youth: the complete picture to date. Pediatr Clin North Am. 2005;52(6):1579–609.

    Article  PubMed  Google Scholar 

  68. Type 2 diabetes in children and adolescents. American diabetes association. Diabetes Care. 2000;23(3):381–89.

    Google Scholar 

  69. Scott CR, et al. Characteristics of youth-onset noninsulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus at diagnosis. Pediatrics. 1997;100(1):84–91.

    Article  PubMed  CAS  Google Scholar 

  70. Fagot-Campagna A, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr. 2000;136(5):664–72.

    Article  PubMed  CAS  Google Scholar 

  71. Dabelea D, et al. Type 2 diabetes mellitus in minority children and adolescents. An emerging problem. Endocrinol Metab Clin North Am. 1999;28(4):709–29.

    Article  PubMed  CAS  Google Scholar 

  72. Pinhas-Hamiel O, et al. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr. 1996;128(5 Pt 1):608–15.

    PubMed  CAS  Google Scholar 

  73. Pihoker C, et al. Non-insulin dependent diabetes mellitus in African-American youths of Arkansas. Clin Pediatr (Phila). 1998;37(2):97–102.

    Article  CAS  Google Scholar 

  74. Liese AD, et al. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics. 2006;118(4):1510–18.

    Article  PubMed  Google Scholar 

  75. White N, et al. Clinical characteristics and co-morbidities in a large cohort of youth with Type-2 Diabetes Mellitus (T2DM) screened for the treatment options for Type-2 Diabetes in adolescents and youth (TODAY) study. Diabetes. 2009;58:A70.

    Google Scholar 

  76. Li C, et al. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005–2006. Diabetes Care. 2009;32(2):342–47.

    Article  PubMed  Google Scholar 

  77. Williams DE, et al. Prevalence of impaired fasting glucose and its relationship with cardiovascular disease risk factors in US adolescents, 1999–2000. Pediatrics. 2005;116(5):1122–26.

    Article  PubMed  Google Scholar 

  78. Baranowski T, et al. Presence of diabetes risk factors in a large U.S. eighth-grade cohort. Diabetes Care. 2006;29(2): 212–17.

    Article  PubMed  CAS  Google Scholar 

  79. Dolan LM, et al. Frequency of abnormal carbohydrate metabolism and diabetes in a population-based screening of adolescents. J Pediatr. 2005;146(6):751–58.

    Article  PubMed  CAS  Google Scholar 

  80. Lee S, et al. Comparison of different definitions of pediatric metabolic syndrome: relation to abdominal adiposity, insulin resistance, adiponectin, and inflammatory biomarkers. J Pediatr. 2008;152(2):177–84.

    Article  PubMed  CAS  Google Scholar 

  81. Cruz ML, et al. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab. 2004;89(1):108–13.

    Article  PubMed  CAS  Google Scholar 

  82. Chen W, Srinivasan SR, Berenson GS. Path analysis of metabolic syndrome components in black versus white children, adolescents, and adults: the Bogalusa Heart Study. Ann Epidemiol. 2008;18(2):85–91.

    Article  PubMed  Google Scholar 

  83. Lee S, et al. Insulin resistance: link to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth. Diabetes Care. 2007;30(8):2091–97.

    Article  PubMed  CAS  Google Scholar 

  84. Lee S, et al. Waist circumference, blood pressure, and lipid components of the metabolic syndrome. J Pediatr. 2006;149:809–16.

    Article  PubMed  CAS  Google Scholar 

  85. Weiss R, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362–74.

    Article  PubMed  CAS  Google Scholar 

  86. Spear BA, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007;120(Suppl 4):S254–88.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the United States Public Health Service grant RO1 HD27503 (SA), K24 HD01357 (SA), MO1 RR00084 (GCRC) and UL1 RR024153 (CTSA), T32 DK063686 (CD), and T32 DK007729 (JH).

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Haidet, J., Demirci, C., Arslanian, S.A. (2010). Racial Differences in Childhood Obesity: Pathogenesis and Complications. In: Freemark, M. (eds) Pediatric Obesity. Contemporary Endocrinology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-60327-874-4_6

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