Greater adiposity in childhood, at ages 9 to 12 years, is associated with increased cardiovascular risk factors in adolescence, ages 15 to 16 years, although the risks can be decreased in obese children by achieving normal weight by adolescence, a new study has found.
Debbie A. Lawlor, PhD, professor of epidemiology at the University of Bristol, Bristol, United Kingdom, and colleagues reported their findings online November 25 in the BMJ.
“BMI has been criticised as an inadequate measure of adiposity, particularly in children, in whom annual increases in BMI can reflect increases in lean mass more so than fat mass,” Dr. Lawlor and colleagues note. However, the study found that BMI is just as suitable as waist circumference or fat mass in children for identifying adverse cardiovascular profiles.
The study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and included 2747 girls and 2488 boys. Participants were prospectively evaluated for the association between BMI, waist circumference, and fat mass; this association was directly assessed at ages 9 to 12 years and at ages 15 to 16 years.
The cardiovascular risk factors of systolic and diastolic blood pressure; concentrations of fasting glucose, insulin, and triglycerides; low-density lipoprotein (LDL) cholesterol levels; and high-density lipoprotein (HDL) cholesterol levels were examined when the participants reached ages 15 to 16 years.
Among those who were overweight or obese in childhood (ages 9 – 12 years), reaching normal weight by adolescence (ages 15 – 16 years) was associated with better cardiovascular risk profiles vs those who remained overweight, the analysis found.
The study also found that the association between adiposity measured in childhood (ages 9 – 12 years) and cardiovascular risk factors in adolescence (ages 15 – 16 years) was stronger in boys vs girls. The study authors suggested that this finding “might have been influenced by sex differences occurring during the transition to puberty and might be related to where fat is placed—that is, preferentially more subcutaneous and ‘safe’ weight gain in girls than in boys.”
Girls who were overweight or obese at ages 9 to 12 years but were normal weight at ages 15 to 16 years achieved similar risk factors for cardiovascular disease as girls who were normal weight at both ages. However, boys who similarly lost weight by ages 15 to 16 years had higher systolic blood pressure, higher triglyceride and lipid concentrations, and lower HDL cholesterol levels than those who were normal weight at both ages. The boys who lost weight did have better cardiovascular risk profiles than those who remained overweight at ages 15 to 16 years.
Risks for cardiovascular disease were increased markedly for the children at the upper end of the weight distribution. The authors stated that the linear nature of the risk highlighted the “importance of prevention strategies aimed at shifting population distribution of childhood adiposity downwards.”
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