People who are obese in childhood but are of normal weight as adults have similar cardiovascular risks to an individual who has a normal weight both as a child and an adult, new
research shows.
The findings were based on four long-term cohort studies with a mean follow-up was 23 years. They included the Australian Childhood Determinants of Adult Health project, which contributed more than one-third of the 6,328 participants. A Finnish study of similar size and two smaller American studies made up the balance.
Compared to people who were consistently of normal weight, those who were obese both as children and adults had a significantly higher risk of type 1 diabetes (relative risk 5.4), hypertension (2.7), high LDL cholesterol (1.8), low HDL cholesterol (2.1), high triglycerides (3.0) and increased carotid intima-media thickness (1.7).
However, there were no significant increases in these risk factors among the minority of obese children who were of normal weight as adults.
“Primary care physicians should not take the pessimistic view that once childhood obesity is established, cardiovascular risk is also determined but should recognise that cardiovascular risk may be substantially reduced if childhood obesity is also treated,” the researchers said.
An editorial emphasised that only 15% of normal-weight children in the study became obese as adults during the follow-up period, but 82% of those who were obese as children remained obese as adults.
“If we want to reduce the incidence of adult heart disease and thereby start to control the continuing escalation in health care expenditures, now is the time to do whatever it takes to develop more effective methods for both the prevention and the treatment of childhood obesity,” it said.
Targeting interventions for prevention and treatment specifically to children at high risk might be more valuable and more cost-effective than targeting whole populations of children, it said.
New England Journal of Medicine2011; 365: 1876-1885.