WEDNESDAY, Oct. 26, 2005 (HealthDay News) -- The seeds for heart disease may be sown in childhood, a new study suggests.
Researchers say they've identified a pattern of growth in the early years of life that greatly raises the risk of cardiovascular trouble decades later.
The discovery was made possible because of meticulous records kept by the Finnish health system, which followed more than 8,700 people born in Helsinki between 1934 and 1944, explained Dr. David J. P. Barker, lead author of a report published in the Oct. 27 issue of the New England Journal of Medicine.
A review of the histories of 357 men and 87 women who went on to develop coronary heart disease as adults by 2003 showed a clear pattern, Barker said.
"The people who developed coronary heart disease were born small and did not thrive in the first two years after birth for one reason or another," he said. "Then, after the first two years, they put on weight more rapidly, putting on fat rather than muscle between [ages] 2 and 13."
Children who displayed that pattern also were likely to develop insulin resistance, a known risk factor for heart disease. They were also at nearly three times the risk of developing heart disease as adults compared to those with a more normal growth pattern.
Children at highest risk were those who weighed less than 3 kilograms (6.6 pounds) at birth, had body mass indices (BMIs) below 16 at age 2 and BMIs above 17.5 at age 11. (For reference, a 5-foot 2-inch child weighing 95 pounds has a BMI of 17.5.)
Barker led the study while at the University of Southampton in the U.K. He is now a professor of medicine at the Oregon Health and Science University Heart Research Center in Portland.
The finding differs from those of other studies focused on links between childhood growth and adult heart risk. Some studies have shown that low birth weight increases coronary risk later in life. Others have shown a link between youthful obesity and adult coronary disease. But the pattern observed in this study suggests that youngsters who are not obese may still be at increased risk.
"In terms of targeting, you can't manage the obesity problem simply by saying that 'obese children are at risk,'" Barker said. "They are a target, of course. But this group of children at risk is identified by their current stage [of growth] in comparison to where they were earlier."
While the study singled out children of low birth weight, the finding "potentially applies to anyone, even if they were born big," Barker said. "If they don't grow normally in the first two years after birth for whatever reason, then put on fat rather than muscle, they end with a body high in fat and low in muscle."
Such children "are vulnerable, but they are not doomed," he said. Their risk can be reduced by emphasis on the known risk factors for heart disease, such as diet and exercise.
"Our latest advice is that children should enjoy plenty of physical activity and eat a nutritious diet to help prevent coronary heart disease in adulthood," said Kent Thornburg, director of the Heart Research Center.
The finding does require a new attitude toward heart risk by parents and doctors, Barker said. "It requires monitoring children in relation to where they were, rather than in relation to all other children," he said.
More information
For tips on keeping kids heart-healthy, head to the National Heart, Lung, and Blood Institute.
