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November 2006
News this month Overweight adolescents, especially those who are obese, may be at risk for heart disease, according to a study in the June 6, 2006 issue of the Journal of the American College of Cardiology. The Strong Heart Study (SHS) — a longitudinal study of cardiovascular risk factors and cardiovascular disease — examined heart dimensions and function in 460 adolescents age 14 to 20 from American Indian communities in Arizona, North Dakota, Oklahoma and South Dakota. Of the 460 participants, 113 were overweight and 223 were obese. In addition, 110 had high-normal blood pressure and 27 had high blood pressure. Ten were diagnosed with diabetes. The study revealed the left ventricles of the hearts of both overweight and obese teenagers were larger and heavier than those of normal-weight participants, but the obese teenagers also showed signs of impaired heart function. “The study revealed the left
ventricles of the hearts of
both overweight and obese
teenagers were larger and
heavier than those of
normal-weight participants.”
Childhood obesity is defined as a mass body index — a person’s body weight adjusted for height — at or above the 95th percentile for a child’s age and gender. “The main findings are that, when obesity is present, something happens in our hearts to increase their size and wall thickness, which cannot be understood by measurement of blood pressure,” said author Giovanni deSimone, M.D., FACC., from the NewYork-Presbyterian Hospital/Weill Medical College of Cornell University and Frederico II University School of Medicine in Naples, Italy "According to the American
Heart Association, 25
percent of obese children
age 5 to 10 already have the
early signs of heart disease,
including elevated blood
cholesterol or high blood
pressure."
While the analysis was performed in an American Indian population, similar analyses have documented that overweight and obese children and adolescents tend to have enlarged hearts and that enlarged hearts are a sign of increased risk of chronic heart failure. According to the American Heart Association, 25 percent of obese children age 5 to 10 already have the early signs of heart disease, including elevated blood cholesterol or high blood pressure. Other studies indicate that as many as 10 percent of adolescents may already have plaque buildup in their arteries. Dr. deSimone said the results underscore the need to fight excess weight in children, since the damaging effects are evident even before adulthood. “Heart damage starts very early in the natural history of obesity,” said Dr. deSimone. “We need to work on our young people, to prevent catastrophic effects later on.” According to the World Health Organization (WHO) an estimated 22 million children under age 5 are considered overweight worldwide. It projects that ailments related to obesity, such as heart disease, diabetes and stroke, could soon overwhelm health services everywhere. “According to the World
Health Organization (WHO)
an estimated 22 million
children under age 5 are
considered to be
overweight worldwide.”
“We truly have a global epidemic
appears to be affecting most
countries in the world,” said Philip
James, M.D., chairman of the WHO
international obesity task force. 
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The study shows the direct and early impact obesity has on the heart While this study looked at American Indians, I believe the results are relevant to the overall U.S. population. Previous studies of American Indians have been shown to be early markers of where we will be in 20 years. Obesity in children is now an epidemic in the United States. Overweight children tend to become overweight adults who are at a significantly increased risk of developing heart disease, high blood pressure, diabetes and stroke at a much earlier age. ““The onset of obesity in
children needs to be
addressed in early
childhood, and the success
of obesity treatment
programs relies on parent
participation.”.”
This study shows the direct and early impact obesity has on the heart and why we as a nation have to be concerned. While there are many causes of obesity, genetics being one of them, genetics does not account for the huge increase in obesity rates over the past few decades. The main culprits are the same as those for adult obesity: eating too much, having a diet of processed foods with empty calories and moving around too little. The onset of obesity in children needs to be addressed in early childhood, and the success of obesity treatment programs relies on parent participation. • Make diet health an activity for the whole family. Children form habits by watching parents and usually maintain them into adulthood. Become a role model for your children. If your child sees you reach for an apple instead of a cookie, he or she is likely to do the same. Involve the whole family in healthy eating habits and physical activities. It benefits everyone and doesn’t single out the overweight child. • Examine how much exercise you and your children get. Put on a pedometer. How many steps a day are you taking? For an average adult it should be at least 10,000 steps a day and for a child, even more. Aim for 30 minutes a day of consistent aerobic exercise. Keep a Frisbee or bat and ball in the car. Take your kids to the park. Ride bikes. Assign active chores such as making the beds, vacuuming or washing the car. • Aim for a balanced, natural diet. Focus on fruits, vegetables and whole grains. Eat fast foods rarely. When you visit a fast-food restaurant, opt for the healthier selections. Avoid products with sugary ingredients such as high-fructose corn syrup (the excess calories can put on weight) and sodium (it can increase blood pressure over time). Read labels. Avoid trans-fatty acids found in margarine, shortening and processed foods containing oil. Trans-fatty acids are not readily metabolized by your body and can still be found in fat cells one year later. Plan healthy meals and sit down to eat together as a family regularly. • Discourage inactive pastimes. A recent study found that children who watch more than three hours of television a day are 50 percent more likely to become obese than children who watch fewer than two hours a day. Set limits on how much time your family watches TV, plays video games or uses the Internet. Encourage your child to move during commercials and discourage snacking when the TV is on. Dr. Lee is an attending cardiologist at Yale-New Haven Hospital and the program director for Yale Cardiology at the Yale-New Haven Shoreline Medical Center. She is an assistant clinical professor of internal medicine and cardiology at the Yale University School of Medicine. |
