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Obesity-Linked Woes Boost Kids' Lifetime Heart Risk

'Metabolic syndrome' includes higher blood pressure, cholesterol

FRIDAY, Aug. 10, 2007 (HealthDay News) -- Obese children diagnosed with health problems collectively known as the "metabolic syndrome" are at higher risk for developing heart disease as adults, new research reveals.

Compared to healthier youngsters, school-age children with the condition face a 14.5 times greater risk of cardiovascular disease when they reached their 30s and 40s, the study found.

Components of the syndrome include high blood pressure, high body mass, high blood pressure and high triglycerides (blood fats).

"I wasn't exactly shocked, but this is the first time we have shown that children who have this constellation of factors known as metabolic syndrome are at an increased risk for cardiovascular disease in their adult years," said study lead author John A. Morrison, a research professor of pediatrics who also works in the division of cardiology at Cincinnati Children's Hospital Medical Center in Ohio.

The findings are published in the August issue of Pediatrics.

According to the American Heart Association, more than 50 million Americans have the metabolic syndrome. The condition is typically diagnosed on the basis of having at least three of the following characteristics: abdominal obesity; high blood pressure; insulin resistance (in which the body can't process insulin or blood sugar properly); a high risk for arterial plaque build-up due to high levels of triglycerides, low HDL ("good") cholesterol and high LDL ("bad") cholesterol; and a high risk for clotting and inflammation as indicated by the elevated presence of certain blood proteins.

Researchers long ago established that, for adults, having the metabolic syndrome increases their risk for both heart disease and diabetes. Physicians now recommend that patients combating the condition embark on a weight-loss program geared toward developing healthier eating habits and increased physical activity.

To explore a possible link between pediatric metabolic syndrome and adult heart disease, Morrison and his team cross-referenced data for contributing syndrome characteristics collected from a pool of 771 children between 1973 and 1978, and then again between 2000 and 2004.

The participants were drawn from the Cincinnati region and were between the ages of 6 and 19 in the first study and 30 and 48 in the follow-up study. A little less than three-quarters of the pool were white and a little more than a quarter were black.

Patient blood samples were taken the time of study enrollment and then 25 years later. The researchers gauged blood pressure; body mass index (BMI); and cholesterol. Blood triglyceride and glucose levels were also assessed.

The participants also reported any history of heart attack or stroke, or procedures such as coronary bypass or angioplasty.

Four percent of the participants -- 31 boys and girls -- had metabolic syndrome as children, while more than 25 percent had the condition 25 years later, the researchers reported.

Among those with pediatric metabolic syndrome, almost 70 percent still had the condition as adults, and almost 20 percent had gone on to develop cardiac disease in the intervening years.

In contrast, only 1.5 percent of the children who did not have the syndrome as kids went on to experience heart trouble as adults.

Furthermore, any rise or fall in BMI over the 25 years was linked to a concurrent rise or fall in risk for developing the metabolic syndrome. In that time frame, every BMI bump or drop of 10 points translated into a 24 percent risk increase or decrease for the syndrome, the team reported.

Morrison and his colleagues said their findings should help doctors and parents identify young patients who are at an increased risk for serious adult illness. They could also point the way toward ways to reduce that risk.

"So, there's some good news here," said Morrison. "Pediatric weight is not destiny. If you're obese as a child, you can do something to lose the pounds. And you must do something to lose the pounds, if you want to reduce risk."

Dr. Brenda Kohn, an associate professor of pediatrics at the New York University School of Medicine, added that proactive parental and physician intervention is critical to help children avoid behaviors that keep the syndrome going.

"The treatment has to be started in childhood, in adolescence," she advised. "Eating patterns, activity patterns, all start in infancy. Good habits have to start early."

"So, it's very, very important that a child is raised in an environment where physical exercise is encouraged on a routine basis and eating patterns are geared to healthy eating decisions," added Kohn, who is also a medical advisory board member with the Juvenile Diabetes Foundation. "Children should be monitored at least once yearly by a physician in order to ensure that all these goals are being met," she said.

More information

For additional information on metabolic syndrome, visit the American Heart Association.

SOURCES: John A. Morrison, Ph.D., research professor, pediatrics and division of cardiology, Cincinnati Children's Hospital Medical Center, Ohio; Brenda Kohn, M.D., associate professor, pediatrics, New York University School of Medicine, New York City, and member, medical advisory board, Juvenile Diabetes Foundation; August 2007, Pediatrics
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