Mar. 23, 1999 DALLAS, March 23 -- Slowing the pace at which children put on excess pounds may reduce their risk of heart disease later in life, researchers report in today's Circulation: Journal of the American Heart Association.
Alan R. Sinaiko, M.D., lead author of the study and professor of pediatrics at the University of Minnesota Medical School in Minneapolis, says new findings show that the risks factors associated with cardiovascular disease in adults -- high blood pressure, obesity, high cholesterol levels and insulin resistance -- might be mitigated by slowing the rate of weight gain during childhood and adolescence.
The study shows that the rate of weight gain is as important as the person's overall weight, so even if an individual is overweight early in childhood, slowing the rate at which excess pounds are put on may help reduce the risk of heart disease later in life.
"The findings from the study show that the overweight 7-year-old child is not necessarily fated to become the overweight 24-year-old adult who is at risk for heart disease," he says. They do, however, suggest that prevention of heart disease is feasible by controlling weight during childhood and adolescence.
The Minneapolis Children's Blood Pressure Study was started in 1977 with blood pressure screening of 10,423 first-through-third graders in the Minneapolis public schools. The 679 people still taking part in the study came from an original sample of 1,207 children selected for the study. The children were followed from ages 7 to 23, with repeated measures of height, weight and blood pressure. At age 23, blood was sampled to measure cholesterol and insulin, a hormone that helps metabolize glucose, the body's main food source.
Sinaiko says that body weight in childhood tends to predict the prevalence of risk factors that crop up when people are in their early 20s, in particular, the insulin resistance syndrome -- the condition in which insulin is associated with obesity and the risk for cardiovascular disease.
In the study, rates of increase in both weight and body mass index -- a relative measure of fatness -- during childhood and adolescence correlated with higher levels of cholesterol, insulin and high blood pressure in adulthood.
Researchers found that individuals above the median for weight gain during childhood and adolescence had greater insulin levels in young adulthood. Their levels were 190 pmol/L compared to 116 pmol/L for individuals below the median for weight gain.
The study results have an added importance because the number of overweight young people is rising, indicating, as the population ages, an increase in the number of people susceptible to coronary heart disease.
"The potential public health implications are compelling," Sinaiko says. "The prevalence of overweight youth is increasing, and childhood obesity predicts adult obesity. Public policy needs to develop a strategy for healthier children without turning the childhood population into weight and diet overreactors."
The problem, acknowledges Sinaiko, requires new strategies to help children, their parents and physicians cope with issues of excess weight gain. The sage advice to eat sensibly, stay away from junk foods and get more exercise is still the best, but "the truth is all these things take great effort," he says.
Co-authors of the study are Richard P. Donahue, Ph.D., State University of New York at Buffalo; David R. Jacobs Jr., Ph.D., and Ronald J. Prineas, M.D., Ph.D., University of Minnesota School of Public Health.
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