Just a few years ago ailments such as type-2 diabetes, high blood pressure, worn joints, liver disease and gall stones occurred only in adults and mostly among the elderly. Now more and more children are being affected.
The implications are wide-ranging. A life of discomfort and pain lies ahead for the sufferer, there are huge costs for state health systems and the economy is affected.
Children, parents and pediatricians confront these challenges to an extent unknown before and face challenges that include recognizing these ailments early on and treating the young sufferer as best as possible.
"The causes of these lifestyle diseases lie in lack of physical exercise, poor nutrition and obesity," says Martin Wabitsch, professor of endocrinology, diabetes and overweight at the University of Ulm's pediatric clinic.
"Often these three factors occur in tandem. Overweight -- or obesity in its extreme form -- is caused by lack of exercise and poor nutrition," Wabitsch says.
The professor estimates that 15 percent to 20 percent of all German children are overweight or obese. They run a higher risk of suffering diseases once typical of the aged.
Pediatricians recommend that these children are specially screened to measure blood sugar, cholesterol, blood pressure and changes to blood vessels.
"Family history also provides valuable insights. If diabetes occurs frequently, the child is also sent to have the beta cells responsible for producing insulin screened," Wabitsch says.
Standard tests do not measure these indicators, so that these serious illnesses can lie hidden for years if this special screening is not undertaken.
"If the family doctor does not offer this screening to an overweight child, then the parents should definitely push for it," Wabitsch believes.
The first signs of illness are difficult for the untrained eye to recognize. Type-2 diabetes takes hold slowly without showing noticeable symptoms.
In Germany there are thought to be around 15,000 children with this ailment, although only 500 are currently undergoing treatment.
"Over the last 10 years the number of children who have become ill with type-2 diabetes has risen by several hundred percent," according to Wolfram Hartmann, the head of the German association of pediatricians.
Once the long-term consequences of the disease -- damage to the retina and the kidneys or circulation problems in the arms and legs -- are discovered, it is often too late.
In the same way, high blood pressure, metabolic and blood vessel problems, which can lead to arteriosclerosis, heart attacks and strokes in the longer term, remain undetected for far too long without special screening.
By contrast, orthopaedic problems like bad knees and signs of wear in the hip joints and back are often soon noticed as they cause pain.
These are in general indications of future arthritis.
"Every child or young person must be able to walk five to 10 kilometers. If they can't, the reason must be found," Hartmann says.
According to Wabitsch, some 2 percent of seriously overweight children suffer with gall stones. Uncovering this requires careful interpretation of symptoms.
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