The prevalences of overweight and obesity in
children have risen alarmingly during the past three decades. Obesity
in childhood is a predictor of the development of type 2 diabetes mellitus and heart
. Curbing the "obesity epidemic" may prevent a shorter lifespan
for today's children.
A high body mass index (BMI) in childhood is
known to be associated with a high risk of obesity in adulthood. Although
childhood overweight and obesity frequently persist into adulthood,
some children with a high BMI become nonobese as adults. It was not previously
known if the link between childhood obesity and heart disease risk persists
when overweight or obese children lose weight and become nonobese as adults.
Data from four large studies of risk factors of
heart disease were analysed. These studies that tracked risk factors over two
decades found that weight loss produced a dramatic reduction of the risk of type 2
diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis in
6328 subjects were included in the study.
The heart disease risk profile of obese or overweight children who became
nonobese by young adulthood was similar to those of subjects who had been of
normal weight throughout their lives. The data also showed that persons
who had normal BMI in childhood but who became obese as adults had adverse
If the hypothesis is true, it definitely is a cue for physicians to
rewrite the age old statement that 'once childhood obesity is established,
cardiovascular risk is also determined'. Treatment of childhood obesity may
substantially reduce the risk of heart disease.
It is high time to target interventions for
obesity prevention and treatment to children at high risk for becoming obese.
Obesity, once established, is hard to treat.
The study, published in The New England Journal of Medicine,
has a major limitation that the
subjects were predominantly white. Authors caution against generalising the
results to other races or ethnic groups.
Childhood Adiposity, Adult Adiposity, and
Cardiovascular Risk Factors; Markus Juonala, M.D., Ph.D., Costan G. Magnussen,
Ph.D., Gerald S. Berenson, M.D., Alison Venn, Ph.D., Trudy L. Burns, M.P.H.,
Ph.D., Matthew A. Sabin, M.D., Ph.D., Sathanur R. Srinivasan, Ph.D., Stephen R.
Daniels, M.D., Ph.D., Patricia H. Davis, M.D., Wei Chen, M.D., Ph.D., Cong Sun,
M.D., Ph.D., Michael Cheung, M.D., Ph.D., Jorma S.A. Viikari, M.D., Ph.D.,
Terence Dwyer, M.D., M.P.H., and Olli T. Raitakari, M.D., Ph.D.; N Engl J Med 2011; 365:1876-1885November 17, 2011.