Teen obesity alert, 'heart and sexuality at risk'

Obesity is growing among Italian adolescents, especially among males. "Obesity in adolescence is not just an aesthetic or temporary problem, but has direct consequences on metabolism, fertility, sexuality and is an important predictor of cardiovascular risk before adulthood. For this reason, prevention and early screening are needed". The alarm was raised by endocrinologist Carlo Foresta, promoter for twenty years of the 'Progetto Scuola' for andrological prevention.

According to the World Health Organization, the number of obese children and adolescents between the ages of 5 and 19 in the world has increased tenfold in the last 40 years. In Europe, 59% of adults and almost 1 in 3 children are overweight or obese, and in Italy the situation is no better: 43% of adults are overweight, with peaks of 49% in Puglia. And things are no better in the child population: according to the latest data from the Istituto Superiore di Sanità, over 22% of Italian adolescents are overweight. Among 17-year-old males, the percentage rises to almost 24%, with 3.9% classified as obese. The trend, which until a few years ago seemed to be slightly decreasing, is growing again, especially in the 11-14 age group. Furthermore, at a global level, a WHO report estimated that in 2022, childhood and adolescent obesity in Italy reached levels approximately 4 times higher than in 1990 (Epicentro Iss data). Even more worrying is the geographical distribution of the phenomenon: the highest prevalence of obesity among young people is observed in the regions of Southern Italy. National surveys indicate a clear North-South gradient: Southern regions such as Campania have rates of overweight/obese adolescents above 25-30%, with Puglia at 27%, while in some regions of the North (for example Trentino Alto Adige) these values ​​​​drop below 15%. In general, at least 1 in 4 adolescents in the South is overweight, compared to significantly lower rates in the Northern regions.

The Foresta Ets Foundation School Project, which started last October in Padua, involved almost 6,000 high school students. The data collected confirm a worrying picture, a note reports: young males are more frequently obese than their female peers (18% vs 12%), and this gap is increasingly wider than 8 years ago when the difference was only 2 percentage points. The consequences on health are not negligible and certainly include sexual dysfunction (20% of obese people declare having at least one sexual dysfunction already at 18, compared to less than 10% of their normal-weight peers), but also the typical cardiovascular risk factors of adults, such as hypertension, hyperglycemia and hypercholesterolemia.

That's not all. According to a study conducted by Foresta's team in collaboration with Andrea Di Nisio of Pegaso University, on over 100 Italian children between 11 and 14 years old, as part of a project for the prevention of obesity and andrological health and published in the international journal 'Endocrine', almost half of the sample was overweight or obese, the note continues. A key element that emerged is the widespread lack of vitamin D: 92% of obese children and 76% of normal weight children had insufficient levels. This deficiency has proven to be an independent indicator of the accumulation of cardiovascular risk factors, even in normal weight subjects. In conditions of hypovitaminosis D, that is, with levels lower than 30 ng/ml, the probability of presenting at least one risk factor increased by 31% in the total population and by 41% among overweight children. In cases of severe deficiency (lower than 20 ng/ml), the risk was even doubled.

"This study - says Foresta - demonstrates that adolescent obesity exposes children, already at a young age, to cardiometabolic risk factors that, if not corrected, can develop early into severe cardiovascular diseases in adults, not to mention the risk of hypogonadism and infertility, already confirmed by several studies that show how the testicular function of obese young people is already altered and remains so throughout the sexual development phase of adolescence".

The study will be illustrated in Lecce, at the Mercure Hotel President, on May 9-10 as part of the XVIII Conference on Endocrinology and Sexual Medicine on the topic 'Obesity, osteoporosis, infertility: a rampant syndromic complex': 3 frequently interconnected pathologies, especially in infertile males and independently of aging. Suffice it to say that almost 50% of infertile young people are obese, hypogonadal and have a reduced bone density prodromal to osteoporosis. The event - the promoters point out - has represented for 17 years now an important moment of cultural comparison and experimental clinical study on issues that, especially in this period, take on a character of extreme relevance.