Research Review By Kevin Neeld©

Date Posted:

January 2010

Study Title:

Oversized young athletes: a weighty concern


McHugh MP

Author's Affiliations:

Nicholas Institute of Sports Medicine and Athletic Trauma, New York, USA

Publication Information:

British Journal of Sports Medicine 2010; 44: 45-49.

Background Information:

the prevalence of overweight or obese children and adolescents (6-17 year olds) has increased from 15% to 35% from 1965 to 2005! This value is higher than the 30% reported by the European Union for 5-18 year olds. Concomitant with these increases, the percentage of high school students that regularly attend physical education class decreased from 42% to 32% in the U.S. from 1991 to 2001, and from 70.3% to 60.3% in Canada between 1999 and 2005.

Interestingly, this decrease in physical education participation coincided with a substantial increase in high school sports participation. The purpose of this paper was to investigate whether a relationship exists between obesity and sports injury risk in young athletes.

Pertinent Results:

  • Injury risk was 1.4-3.9 times higher for athletes considered overweight, obese, or in a high BMI group.
  • A low BMI in American football players was associated with an increased risk of injury in 9-10 year olds.
  • Compared to non-obese players, obese American football players (older age-group than above) were 2.3 times more likely to sustain an injury. Obese linemen were 2.7 times more likely to sustain an injury than non-obese linemen. Obese players were also 3.9 times more likely to experience a non-contact ankle injury.
  • Obese athletes appear to be at a greater risk of sustaining ankle and medial collateral ligament injuries compared to non-obese athletes.
  • Impaired postural control, lower relative strength, and poor fitness levels were the primary proposed mechanisms responsible for the increased risk of injury in obese athletes.
  • Obesity is also related to long term injury morbidity. 33% of overweight/obese children experience persistent swelling and pain following an acute ankle injury compared to only 15% of children with lower BMIs. Decreased activity resulting from prolonged symptoms could have further deleterious effects on the athletes fitness and health levels.
  • Lastly, obesity (and related injuries) are associated with markers of inflammation, which can interfere with the normal production of anabolic hormones necessary for growth and development.

Clinical Application & Conclusions:

In addition to the well-described negative effects of obesity on cardiorespiratory health and insulin responsiveness, it appears that being overweight or obese increases the risk of sustaining, and the degree of resulting damage from, sport-related injuries. With the decrease in physical education participation, it is difficult to interpret this research as meaning that overweight or obese children should avoid athletics.

After all, the multi-factorial benefits of physical activity are well-documented and the kids need to get it from somewhere. From a practical standpoint, these results may indicate that special precautions need to be taken for overweight/obese athletes and/or that ALL sports participation should include some component of resistance training and interval training, which are essential for fat loss and improving overall athleticism.

When discussing fat loss, it’s negligent to overlook the importance of proper dietary habits. To a large extent, obesity can be prevented through dietary strategies alone. It could be beneficial for sports coaches and/or schools to organize speaking engagements hosted by nutrition professionals to help educate parents and athletes alike on what types of foods to choose, and which types of foods to avoid.

Because many young athletes lack the wisdom and foresight to make the connection between short-term food choices and long-term health and body composition outcomes, it would probably be best for nutrition professionals to make their recommendations within a performance framework. As fitness professionals, we can facilitate this relationship or act as resources ourselves.

Study Methods:

The author performed a Medline search for non-review papers using the terms “obese”, “obesity”, “overweight”, and “BMI”, combined with “injury”, “risk”, “physical activity”, and “sport.” A narrative review was then performed.

Study Strengths / Weaknesses:

This study provided valuable insight into the relationship between children and adolescents with a high BMI and related sports-injury risk. More prospective, long-term studies including male and female participants will shed further light on this relationship.

Additional References:

  1. Malina R et al. Incidence and player risk factors for injury in youth football. Clin J Sport Med 2006; 16: 214-222.
  2. Brownson RC et al. Declining rates of physical activity in the United States: what are the contributors? Annu Rev Public Health 2005; 26: 421-443.
  3. Bazelmans C et al. Is obesity associated with injuries among young people? Eur J Epidemiol 2004; 19: 1037-1042.
  4. D’Hondt E et al. Childhood obesity affects fine motor skill performance under different postural constraints. Neurosci Lett 2008; 440: 72-75.