Children, Adolescents and Obesity
May 2007
Children, obesity and cardiovascular disease
- Obesity, a significant risk factor for cardiovascular disease (CVD), is on the rise among children.1
- The worldwide rise in childhood obesity is so great that it might lead to an epidemic of premature CVD.2
Risk factors
- Obesity leads to the metabolic syndrome, a precursor for CVD, even in childhood.3
- The metabolic syndrome is a cluster of traits that include problems in using insulin, obesity, high blood pressure, and abnormal levels of fat in the blood.4
- Normal weight children and adolescents rarely, if ever, have metabolic syndrome.3
- Overweight children run the risk of developing type 2 diabetes, a risk factor for CVD.5
- Developing nations, especially India, China and countries where traditional lifestyles have been abandoned, are seeing sharp rises in the number of children with type 2 diabetes.5
- Obesity is linked to stiffening and clogging of the arteries, known as atherosclerosis, which is an important risk factor for the development of heart disease and stroke.6
- The link between obesity and atherosclerosis is independent of other CVD risk factors.6
- Obese children are at a 3-fold higher risk for raised blood pressure, than non-obese children.7 High blood pressure is a CVD risk factor.
- Obstructive sleep apnea, where people experience episodes of stopped breathing during sleep, is associated with obesity in children and is emerging as a significant risk factor in CVD.8
Epidemiology
- Worldwide one in 10 children, aged 5-17 year old, is overweight, a total of 155 million, of which around 30-45 million are obese.9
- The prevalence rate of overweight in children under 5 years of age in developing countries is 3.3% or 17.6 million.10
- Countries with the highest prevalence of overweight are located mainly in the Middle East, North Africa, and Latin America.11
- In the United States, the prevalence of childhood overweight tripled between 1980 and 2000.12
- In Australia, the prevalence of childhood overweight almost doubled between 1985 and 1995.13
- In Europe there are 14 million children who are overweight and 3 million of them are obese.9
- In 2002 nearly a quarter of children within the European Union were overweight, higher than the predicted peak for 2010.14
Obesogenic environment
- Many factors have combined to fuel the obesity epidemic in children such as increased consumption of energy-dense food, decreasing physical activity and the increasingly easy accessibility of food.15
- Worldwide the urbanization of society is reducing children’s physical activity opportunities.5
- Increasing calorie consumption is not matched by increased levels of physical activity in children; in fact, children globally are becoming more physically inactive.16
- Schools are becoming a less and less healthy environment where children are not protected from bad diets or encouraged into physically active lifestyles.17
- Because of the link between food advertising and childhood obesity authorities in the UK have banned the advertising of high fat, salt and sugar products in or around programmes made for children or that are likely to appeal to children.18
1 Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH; American Heart Association; Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 113(6):898-918
2 McCrindle BW. Will childhood obesity lead to an epidemic of premature cardiovascular disease? Evid Based Cardiovasc Med. 2006;10(2):71-4.
3 Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, Robinson TN, Scott BJ, St Jeor S, Williams CL. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005 Apr 19;111(15):1999-2012.
4 DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care. 1991;14:173–194.
5 Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world--a growing challenge. N Engl J Med. 2007;356(3):213-5.
6
7 Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension. 2002;40(4):441-7.
8 Amin RS, Kimball TR, Kalra M, Jeffries JL, Carroll JL, Bean JA, Witt SA, Glascock BJ, Daniels SR.Left ventricular function in children with sleep-disordered breathing. Am J Cardiol. 2005;95(6):801-4.
9 Lobstein, T, Baur, L, Uauy R. IASO International Obesity TaskForce. Obesity in children and young people: a crisis in public health Obesity Reviews 2004; 5:4-104
10 Executive Board Eb109/11 109th Session 11 Provisional agenda item 3.8. Report by the Secretariat. Childhood nutrition and progress in implementing the International Code of Marketing of Breast-milk Substitutes. World Health Organization. Geneva, 2001.
11 de Onis M, Blossner M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr. 2000;72:1032-9.
12 Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics. 2002;109:45– 60.
13 Magarey AM, Daniels LA, Boulton TJ. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust. 2001;174:561–564.
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15 Anderson PM, Butcher KE. Childhood obesity: trends and potential causes. Future Child. 2006;16(1):19-45
16 St-Onge MP, Keller KL and Steven B Heymsfield SB. Changes in childhood food consumption patterns: a cause for concern in light of increasing body weights. Am J Clin Nutr 2003;78:1068–73.
17 Story M, Kaphingst KM, French S. The role of schools in obesity prevention. Future Child. 2006 Spring;16(1):109-42.