Obesity in children linked to heart risk


NEW RESEARCH linking overweight children to greater risk of heart disease shows the importance of finding new ways to prevent childhood obesity, a leading Irish specialist has said.

Dr Donal O’Shea, consultant endocrinologist at St Columcille’s Hospital in Loughlinstown, Co Dublin, said the new Dutch research was “a slap in the face” that must drive policymakers to keep working to prevent obesity in children as well as looking at other ways to slow down the growing prevalence of overweight and obese children.

The research is published this morning in the Archives of Diseases in Children. Researchers from the department of public and occupational health at the VU University Medical Centre in Amsterdam found that two out of three severely obese children in the study already had at least one risk factor for heart disease.

Among these children exhibiting risk factors, more than half had high blood pressure. Fifty-four per cent of them had high levels of LDL or “bad” cholesterol.

One in seven severely obese children in the study had elevated fasting blood sugar levels.

The study, which involved all newly diagnosed cases of severe obesity in children aged between two and 18 across the Netherlands, looked at a range of cardiovascular risk factors. Of 500 children initially recruited, 307 were correctly classified as severely obese, which the researchers defined as a body mass index (BMI) of 20.5 for a two-year-old, a BMI of 31 for a 12-year-old and a BMI of 35 for an adolescent aged 18.

Because of rapid changes in height in children, it is not possible, as it is in adults, to have a uniform cut-off point for various levels of BMI. There are currently no internationally agreed criteria for the definition of severe obesity in children.

In a comparison between under-12s and over-12s, younger boys tended to be more severely obese while the opposite was true of girls. Cardiovascular risk factors were more frequently reported in over-12 boys than in under- 12s. This was especially significant for high levels of triglycerides.

Overall, some 62 per cent of the under-12 boys and girls had one or more cardiovascular risk factor, a finding described as remarkable by lead author Dr Joana Kist-van Holthe.

“The prevalence of impaired fasting glucose in [these children] is worrying, considering the increasing prevalence worldwide of type 2 diabetes in children and adolescents,” said the authors.

“Likewise, the high prevalence of hypertension and abnormal lipids may lead to cardiovascular disease in young adulthood,” they added.

This concern was echoed by Dr O’Shea, who said he and his colleagues were already seeing type 2 diabetes in adolescents and people in their 20s.

“There is almost no way back. In the last 30 years we have seen a sixfold increase in the prevalence of obesity for girls in Ireland and an eightfold rise in obesity prevalence for boys,” he said.

“This represents a tsunami for the healthcare system in terms of the numbers of people who will require medical treatment early in adult life,” he added.