Micronutrient Deficiency in Children and Adolescents with Obesity-A Narrative Review

Overview

Journal Children (Basel)

Specialty Health Services

Date 2023 May 16

PMID 37189944

Authors

Valeria Calcaterra

Elvira Verduci

Chiara Milanta

Marta Agostinelli

Carolina Federica Todisco

Federica Bona

Jonabel Dolor

Alice La Mendola

Martina Tosi

Gianvincenzo Zuccotti

Affiliations

Soon will be listed here.

Abstract

Childhood obesity represents a serious public health burden. Despite excessive dietary consumption, children with obesity present high rates of micronutrient deficiencies, such as deficiencies in minerals and specific vitamins; micronutrient deficiencies may have a pathogenic role in obesity-related metabolic comorbidities. In this narrative review, we analyzed the main deficiencies associated with obesity, their clinical consequences, and the evidence about a possible supplementation. Iron; vitamins A, B, C, D, and E; folic acid; zinc; and copper deficiencies represent the most common deficient microelements. The relationship between obesity and multiple micronutrient deficiencies remains unclear, and different mechanisms have been proposed. The medical care plan for pediatric obesity should include food choices with high nutritional content as part of a crucial approach to obesity-related complications. Unfortunately, only a few studies are available regarding the efficacy of oral supplementation or weight loss for treating them; thus, continuous nutritional monitoring is necessary.

Citing Articles

Worldwide prevalence of the double burden of malnutrition in children and adolescents at the individual level: systematic review and meta-regression.

Viana R, De Araujo-Moura K, Ferreira De Moraes A J Pediatr (Rio J). 2025; 101(2):158-166.

PMID: 39753201 PMC: 11889680. DOI: 10.1016/j.jped.2024.11.010.

Exploring the determinants of malnutrition in 2-5 year Iranian children using structural equation modeling: national food and nutrition surveillance.

Rabiei S, Ebrahimof S, Rasekhi H, Amini M, Ghodsi D, Yari Z BMC Public Health. 2024; 24(1):3406.

PMID: 39696079 PMC: 11654002. DOI: 10.1186/s12889-024-20931-w.

A retrospective study to assess adolescent nutritional deficiencies and the association with post-COVID-19 status.

Gupta A, Kumar P, Desu S, Aravindakshan R, Reddy B, Naidu N J Family Med Prim Care. 2024; 13(10):4201-4207.

PMID: 39629403 PMC: 11610838. DOI: 10.4103/jfmpc.jfmpc_14_24.

Is oxidative stress - antioxidants imbalance the physiopathogenic core in pediatric obesity?.

Lupu A, Fotea S, Jechel E, Starcea I, Ioniuc I, Knieling A Front Immunol. 2024; 15:1394869.

PMID: 39176098 PMC: 11338799. DOI: 10.3389/fimmu.2024.1394869.

Cuproptosis, the novel type of oxidation-induced cell death in thoracic cancers: can it enhance the success of immunotherapy?.

Zhao R, Sukocheva O, Tse E, Neganova M, Aleksandrova Y, Zheng Y Cell Commun Signal. 2024; 22(1):379.

PMID: 39068453 PMC: 11282696. DOI: 10.1186/s12964-024-01743-2.

References

Sharma A, Subramaniam P . Association of Salivary Zinc Levels to Dental Caries and Body Mass Index. A Comparative Study. J Clin Pediatr Dent. 2021; 45(4):265-268. DOI: 10.17796/1053-4625-45.4.8. View

Kiefer F, Orasanu G, Nallamshetty S, Brown J, Wang H, Luger P . Retinaldehyde dehydrogenase 1 coordinates hepatic gluconeogenesis and lipid metabolism. Endocrinology. 2012; 153(7):3089-99. PMC: 3380298. DOI: 10.1210/en.2011-2104. View

Koziol-Kozakowska A, Kozlowska M, Jagielski P . Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children. Pediatr Endocrinol Diabetes Metab. 2020; 26(1):27-38. DOI: 10.5114/pedm.2020.93250. View

Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E . Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr. 2018; 44(1):51. PMC: 5941617. DOI: 10.1186/s13052-018-0488-7. View

Decsi T, Molnar D, Koletzko B . Reduced plasma concentrations of alpha-tocopherol and beta-carotene in obese boys. J Pediatr. 1997; 130(4):653-5. DOI: 10.1016/s0022-3476(97)70253-1. View

Matsuoka L, Wortsman J, Haddad J, Kolm P, Hollis B . Racial pigmentation and the cutaneous synthesis of vitamin D. Arch Dermatol. 1991; 127(4):536-8. View

Mannino A, Sarapis K, Moschonis G . The Effect of Maternal Overweight and Obesity Pre-Pregnancy and During Childhood in the Development of Obesity in Children and Adolescents: A Systematic Literature Review. Nutrients. 2022; 14(23). PMC: 9739272. DOI: 10.3390/nu14235125. View

Kreusler P, Vogel M, Willenberg A, Baber R, Dietz Y, Korner A . Folate and Cobalamin Serum Levels in Healthy Children and Adolescents and Their Association with Age, Sex, BMI and Socioeconomic Status. Nutrients. 2021; 13(2). PMC: 7915137. DOI: 10.3390/nu13020546. View

Azab S, Saleh S, Elsaeed W, Elshafie M, Sherief L, Esh A . Serum trace elements in obese Egyptian children: a case-control study. Ital J Pediatr. 2014; 40:20. PMC: 3936780. DOI: 10.1186/1824-7288-40-20. View

10.

Garcia O, Ronquillo D, Caamano M, Camacho M, Long K, Rosado J . Zinc, vitamin A, and vitamin C status are associated with leptin concentrations and obesity in Mexican women: results from a cross-sectional study. Nutr Metab (Lond). 2012; 9(1):59. PMC: 3406981. DOI: 10.1186/1743-7075-9-59. View

11.

Garcia O, Long K, Rosado J . Impact of micronutrient deficiencies on obesity. Nutr Rev. 2009; 67(10):559-72. DOI: 10.1111/j.1753-4887.2009.00228.x. View

12.

Iamopas O, Ratanachu-Ek S, Chomtho S . Effect of folic acid supplementation on plasma homocysteine in obese children: a randomized, double-blind, placebo-controlled trial. J Med Assoc Thai. 2014; 97 Suppl 6:S195-204. View

13.

Ganguly S, Srivastava R, Agarwala S, Dwivedi S, Gupta Bansal P, Gonmei Z . Prevalence of micronutrient deficiency and its impact on the outcome of childhood cancer: A prospective cohort study. Clin Nutr. 2022; 41(7):1501-1511. DOI: 10.1016/j.clnu.2022.05.010. View

14.

Garcia O, Ronquillo D, Caamano M, Martinez G, Camacho M, Lopez V . Zinc, iron and vitamins A, C and e are associated with obesity, inflammation, lipid profile and insulin resistance in Mexican school-aged children. Nutrients. 2013; 5(12):5012-30. PMC: 3875915. DOI: 10.3390/nu5125012. View

15.

Carrelli A, Bucovsky M, Horst R, Cremers S, Zhang C, Bessler M . Vitamin D Storage in Adipose Tissue of Obese and Normal Weight Women. J Bone Miner Res. 2016; 32(2):237-242. PMC: 5577589. DOI: 10.1002/jbmr.2979. View

16.

Patel D, Stanford F . Safety and tolerability of new-generation anti-obesity medications: a narrative review. Postgrad Med. 2018; 130(2):173-182. PMC: 6261426. DOI: 10.1080/00325481.2018.1435129. View

17.

Rajjo T, Mohammed K, Alsawas M, Ahmed A, Farah W, Asi N . Treatment of Pediatric Obesity: An Umbrella Systematic Review. J Clin Endocrinol Metab. 2017; 102(3):763-775. DOI: 10.1210/jc.2016-2574. View

18.

Talsma E, Brouwer I, Verhoef H, Mbera G, Mwangi A, Demir A . Biofortified yellow cassava and vitamin A status of Kenyan children: a randomized controlled trial. Am J Clin Nutr. 2015; 103(1):258-67. DOI: 10.3945/ajcn.114.100164. View

19.

Daniels S . Complications of obesity in children and adolescents. Int J Obes (Lond). 2009; 33 Suppl 1:S60-5. DOI: 10.1038/ijo.2009.20. View

20.

Sommer A, Twig G . The Impact of Childhood and Adolescent Obesity on Cardiovascular Risk in Adulthood: a Systematic Review. Curr Diab Rep. 2018; 18(10):91. DOI: 10.1007/s11892-018-1062-9. View