Most scientific literature has suggested that obesity precedes the development of blood lipid disorders such as abnormally high cholesterol. Even in very young children, overweight or obesity can set off a cascade of early risk factors for cardiovascular disease that includes hypercholesterolemia, hypertension, and insulin resistance. Tershakovec et al., publishing in the American Journal of Clinical Nutrition, found that normal-weight children may be hypercholesterolemic, and that this condition predisposes young girls to the development of overweight and obesity later in childhood. The Bogalusa Heart study, which examined the early natural history of cardiovascular disease in children and young adults, enrolled 58 children with abnormally high cholesterol concentrations (hypercholesterolemia) and 215 children with normal cholesterol levels when they were 5 to 6 years old and followed them for the next 6 years. The group was equally divided between girls and boys, and 41% of the children were black. None of the children were obese at the start of the study. The only difference between the two groups other than cholesterol levels was that the non-hypercholesterolemic children were significantly taller than the hypercholesterolemic children. In the following years, the hypercholesterolemic girls' body mass indexes (BMI) increased at a greater rate than the non-hypercholesterolemic girls', and by age 11-12 years, 45.2% of the hypercholesterolemic girls were overweight or obese, in comparison to 21.6% of the non-hypercholesterolemic girls. This effect was independent of race. In the same age range for boys, BMIs were no different for hypercholesterolemic and non-hypercholesterolemic subjects.
Although the relationship between hypercholesterolemia and weight gain is unclear, the authors propose that abnormally high cholesterol may be a marker of an altered metabolism, which later results in excess adiposity. When the result is obesity, blood lipid disorders can become exacerbated, and blood pressure and insulin concentrations may increase.
Reference: Tershakovec, Andrew et al. Persistent hypercholesterolemia is associated with the development of obesity among girls: the Bogalusa Heart Study. Am J Clin Nutr 2002;76:730-5.
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