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Obese Kids Show Signs of Artery Damage

French study finds indications of cardiovascular problems in severely overweight children and adolescents.

MONDAY, Oct. 29, 2001 (HealthDayNews) -- Even among school children still swinging lunch pails, signs of cardiovascular disease can be well on their way, a new study says.

Doctors in France say early signs of thick and stiffening arteries, as well as unhealthy changes in the way cells handle energy, are readily apparent in severely overweight children and adolescents.

The findings add to a growing body of evidence showing that childhood obesity is a health problem with serious long-range consequences and one that pediatricians and parents should take more seriously.

And the findings are by no means surprising, says Dr. Francine Kaufman, head of the division of endocrinology at Childrens Hospital in Los Angeles and president-elect of the American Diabetes Association.

Cardiovascular complications, osteoporosis and high blood pressure "have their antecedents in childhood," she says. "We start to see early evidence when we look young enough."

Kaufman currently is coordinating a large study, funded by the National Institutes of Health, that will examine the effectiveness of various school-based obesity prevention regimens. Testing should begin sometime next year and probably will include thousands of youth nationwide. "It's very exciting that there is a lot of interest in the research community to look at childhood obesity," she says.

U.S. health officials say obesity has reached epidemic proportions at home and in other westernized nations. At least 13 percent of children between the ages of 6 and 11 and 14 percent of those 12 to 19 are overweight, according to the Centers for Disease Control and Prevention. Overall, one in five Americans is too heavy, experts say, which can lead to risk of heart attacks, strokes, diabetes and a wide range of other ailments.

Researchers have shown that people who were overweight as teens suffer more cardiovascular ailments in middle age. The new work helps explain why.

Led by Dr. Patrick Tounian, a pediatric nutritionist at the Armand-Trousseau Teaching Hospital in Paris, the French team looked for vessel problems in 48 severely obese children and 27 of their normal-weight compatriots. The obese children had been overweight for between 2.7 and 15.2 years, and had a body mass index -- a ration of height to rate referred to as BMI -- about three times that of their normal-weight peers.

Using various tests, including ultrasound of the carotid artery (the neck's main tubing) and measures of how well their blood vessels responded to brief obstructions, the researchers found that the obese children had markedly stiffer piping than their more slender classmates. Their blood vessel walls showed more stress, were less elastic and had poorer function of their lining -- all risk factors for heart disease and stroke.

Seven of the obese children had impaired tolerance to glucose, or blood sugar, indicating resistance to the hormone insulin. Insulin resistance is a sign of Type I diabetes, a major and potentially life-threatening complication of being overweight, and has been shown to harm blood vessels. Details of the study appear this week in The Lancet.

The recent surge in childhood obesity "will translate into a rise in cardiovascular morbidity and mortality, unless we improve our management of obesity," the French researchers write. However, they add, weight loss "is very difficult to achieve."

What To Do

To learn more about the problems that accompany being overweight, check out the National Institutes of Health Web site.

For more on how to eat right, visit the American Dietetic Association or the American Heart Association online.

To calculate your Body Mass Index, visit Shape Up America! or the CDC. And for more about trends for America's waistline, check out reports from the National Center for Chronic Disease Prevention and Health Promotion.

SOURCES: Interviews with Francine Kaufman, M.D., head, Division of Endocrinology, Childrens Hospital Los Angeles, and professor of pediatrics, University of Southern California School of Medicine, Los Angeles; Oct. 27, 2001, The Lancet
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