Consequences of overweight and obesity on the musculoskeletal system in children: a review of recent literature
DOI:
https://doi.org/10.12775/QS.2025.41.59988Keywords
obesity, musculoskeletal system, childhood overweight, chronic inflammation, vitamin D, injury riskAbstract
Childhood overweight and obesity are global health concerns, affecting millions of children and contributing to long-term musculoskeletal complications. This review examines the impact of excess body weight on bone health, posture, motor performance, and injury risk. Overweight and obesity increase mechanical stress on bones and joints, leading to pain, postural abnormalities, and higher fracture susceptibility. Despite increased bone mineral density (BMD), the obesity paradox highlights a paradoxical rise in fracture risk. Hormonal imbalances, chronic inflammation, vitamin D deficiencies, and reduced physical activity further exacerbate musculoskeletal challenges. Additionally, obesity-related postural changes and decreased motor function contribute to inactivity and worsening health.
This literature review was conducted using PubMed searches, selecting articles published in the last five years to ensure up-to-date findings. Keywords such as "obesity in children," "musculoskeletal system," "bone health," "posture," and "physical activity" were used. Original studies, meta-analyses, and systematic reviews were analyzed. Preventive measures, including dietary interventions, regular exercise, and early therapeutic strategies, are essential to mitigating the long-term effects of childhood obesity. Future research should focus on targeted interventions to improve musculoskeletal health and overall well-being in affected children.
References
1. World Health Organization. (2024, March 1). Obesity and overweight. WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. Shen, L., Wang, Y., Wang, C., Xu, D., Luo, T., & Wang, X. (2021). Association between vitamin D deficiency and pediatric obesity: A systematic review and meta-analysis. Nutrition Reviews, 80(3), 259–269. https://pubmed.ncbi.nlm.nih.gov/34948466/
3. Petry, N., Olofin, I., Hurrell, R., Boy, E., Wirth, J., & Woodruff, B. (2020). Micronutrient deficiencies, and child stunting in low- and middle-income countries: A meta-analysis. The American Journal of Clinical Nutrition, 112(3), 696–707. https://pubmed.ncbi.nlm.nih.gov/32390939/
4. Ying, D., & Ying, M. (2024). Causal link between childhood obesity and adult osteoporosis: An investigation through Mendelian randomization. Medicine, 103(36), e39548. https://doi.org/10.1097/MD.0000000000039548
5. López-Peralta, S., Romero-Velarde, E., Vásquez-Garibay, E. M., González-Hita, M., Robles-Robles, L. C., Ruiz-González, F. J., & Pérez-Romero, M. A. (2022). Bone mineral density and body composition in normal weight, overweight and obese children. BMC pediatrics, 22(1), 249. https://doi.org/10.1186/s12887-022-03317-y
6. McVey, M. K., Geraghty, A. A., O'Brien, E. C., McKenna, M. J., Kilbane, M. T., Crowley, R. K., Twomey, P. J., & McAuliffe, F. M. (2020). The impact of diet, body composition, and physical activity on child bone mineral density at five years of age-findings from the ROLO Kids Study. European journal of pediatrics, 179(1), 121–131. https://doi.org/10.1007/s00431-019-03465-x
7. Fiamenghi, V. I., & Mello, E. D. (2021). Vitamin D deficiency in children and adolescents with obesity: a meta-analysis. Jornal de pediatria, 97(3), 273–279. https://doi.org/10.1016/j.jped.2020.08.006
8. He, Q., & Ding, Z. (2022). Childhood obesity and the risk of cardiovascular diseases in adulthood: A systematic review and meta-analysis. European Heart Journal, 43(3), 206–214. https://pubmed.ncbi.nlm.nih.gov/35883220/
9. Lopes, K. G., Rodrigues, E. L., da Silva Lopes, M. R., do Nascimento, V. A., Pott, A., Guimarães, R. C. A., Pegolo, G. E., & Freitas, K. C. (2022). Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients, 14(16), 3260. https://doi.org/10.3390/nu14163260
10. Mazur, A., Zachurzok, A., Baran, J., Dereń, K., Łuszczki, E., Weres, A., Wyszyńska, J., Dylczyk, J., Szczudlik, E., Drożdż, D., Metelska, P., Brzeziński, M., Kozioł-Kozakowska, A., Matusik, P., Socha, P., Olszanecka-Gilianowicz, M., Jackowska, T., Walczak, M., Peregud-Pogorzelski, J., Tomiak, E., … Wójcik, M. (2022). Childhood Obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity. Składki odżywcze, 14(18), 3806. https://doi.org/10.3390/nu14183806
11. McCann, M. R., & Ratneswaran, A. (2019). The role of PPARγ in childhood obesity-induced fractures. Genes & nutrition, 14, 31. https://doi.org/10.1186/s12263-019-0653-7
12. Reilly, J. J., & Kelly, J. (2021). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: A systematic review. International Journal of Obesity, 35(7), 891–898. https://pubmed.ncbi.nlm.nih.gov/33542317/
13. Barros, W. M. A., da Silva, K. G., Silva, R. K. P., Souza, A. P. D. S., da Silva, A. B. J., Silva, M. R. M., Fernandes, M. S. S., de Souza, S. L., & Souza, V. O. N. (2022). Effects of Overweight/Obesity on Motor Performance in Children: A Systematic Review. Frontiers in endocrinology, 12, 759165. https://doi.org/10.3389/fendo.2021.759165
14. González-Álvarez, M. A., Lázaro-Alquézar, A., & Simón-Fernández, M. B. (2020). Global Trends in Child Obesity: Are Figures Converging?. International journal of environmental research and public health, 17(24), 9252. https://doi.org/10.3390/ijerph17249252
15. Malden, S., Gillespie, J., Hughes, A., Gibson, A. M., Farooq, A., Martin, A., Summerbell, C., & Reilly, J. J. (2021). Obesity in young children and its relationship with diagnosis of asthma, vitamin D deficiency, iron deficiency, specific allergies and flat-footedness: A systematic review and meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity, 22(3), e13129. https://doi.org/10.1111/obr.13129
16. Bayartai, M. E., Schaer, C. E., Luomajoki, H., Tringali, G., De Micheli, R., & Sartorio, A. (2022). Differences in spinal posture and mobility between children/adolescents with obesity and age-matched normal-weight individuals. Scientific reports, 12(1), 15570. https://doi.org/10.1038/s41598-022-19823-z
17. Calcaterra, V., Marin, L., Vandoni, M., Rossi, V., Pirazzi, A., Grazi, R., Patané, P., Silvestro, G. S., Carnevale Pellino, V., Albanese, I., Fabiano, V., Febbi, M., Silvestri, D., & Zuccotti, G. (2022). Childhood Obesity and Incorrect Body Posture: Impact on Physical Activity and the Therapeutic Role of Exercise. International journal of environmental research and public health, 19(24), 16728. https://doi.org/10.3390/ijerph192416728
18. O'Malley, G. C., Shultz, S. P., Thivel, D., & Tsiros, M. D. (2021). Neuromusculoskeletal Health in Pediatric Obesity: Incorporating Evidence into Clinical Examination. Current obesity reports, 10(4), 467–477. https://doi.org/10.1007/s13679-021-00463-9
19. Vandoni, M., Marin, L., Cavallo, C., Gatti, A., Grazi, R., Albanese, I., Taranto, S., Silvestri, D., Di Carlo, E., Patanè, P., Carnevale Pellino, V., Zuccotti, G., & Calcaterra, V. (2024). Poor Motor Competence Affects Functional Capacities and Healthcare in Children and Adolescents with Obesity. Sports (Basel, Switzerland), 12(2), 44. https://doi.org/10.3390/sports12020044
20. Liang, Y., Deng, M.-G., Jian, Q., Zhang, M., & Chen, S. (2022). The causal impact of childhood obesity on bone mineral density and fracture in adulthood: A two-sample Mendelian randomization study. Frontiers in Nutrition, 9, 945125. https://doi.org/10.3389/fnut.2022.945125
21. Whitlock, E. P., Williams, S. B., Gold, R., Smith, P. R., & Shipman, S. A. (2022). Screening and interventions for childhood overweight: A systematic review for the U.S. Preventive Services Task Force. Pediatrics, 125(2), e396–e417. https://pubmed.ncbi.nlm.nih.gov/35049002/
22. McGregor, P. C., Lyons, M. M., Wozniak, A., Linko, K., Fishman, F., & Cappello, T. (2022). The Effect of Obesity on Pediatric Tibia Fractures. The Iowa orthopaedic journal, 42(1), 41–46.
23. Nhan, D. T., Leet, A. I., & Lee, R. J. (2021). Associations of childhood overweight and obesity with upper-extremity fracture characteristics. Medicine, 100(18), e25302. https://doi.org/10.1097/MD.0000000000025302
24. Nader, P. R., Huang, T. T., Gahagan, S., Kumanyika, S., Hammond, R. A., & Christoffel, K. K. (2012). Next steps in obesity prevention: Altering early life systems to support healthy parents and children. Childhood Obesity, 8(3), 195–204. https://pubmed.ncbi.nlm.nih.gov/23085797/
25. Ubago-Guisado, E., Jürimäe, J., & Gracia-Marco, L. (2023). Editorial: Physical activity and fitness for the prevention and management of bone diseases. Frontiers in physiology, 14, 1185201. https://doi.org/10.3389/fphys.2023.1185201
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jakub Mikszta, Natalia Mikszta, Maciej Michalik, Krzysztof Marcinkowski, Julia Marcinkowska, Mateusz Muras, Tomasz Lorenc
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 146
Number of citations: 0
