Some
Children On Fast Track To Heart Disease
Lifestyle Choices A Major Issue
An estimated one in eight US schoolchildren has
risk factors that could signal heart disease in the years to come.
That is the sobering conclusion of a
study presented at the American Heart Association's annual
conference.
Researchers
found about 13 percent of the schoolchildren studied have three or
more of the risk factors for what physicians call metabolic syndrome,
a precursor of cardiovascular disease.
Girls had a 1.6 times higher risk than boys,
says Dr. Joanne S. Harrell, a professor of nursing and director of University
of North Carolina at Chapel Hill's Center for Research on Chronic Illness.
Metabolic syndrome includes risk factors
such as high blood pressure, elevated triglycerides (a fatty substance
found in the blood), obesity, and low levels of the so-called "good" HDL
cholesterol. If someone has metabolic syndrome, he or she is at early
risk of heart disease as well as at risk for diabetes.
If nothing is done, Dr. Harrell says, there
is a good chance the children could develop both heart disease and
type 2 diabetes.
Researchers
Look at Lifestyle Behaviors
Her team followed more than 3,200 students,
about half boys and half girls between the ages of eight and 17,
in a rural North Carolina county with no cities of more than 50,000 people.
The researchers decided to study students
in rural areas with high minority populations because they knew such children
have slightly higher obesity rates, and that type 2 diabetes is more common
in minorities.
They evaluated each student's body mass index
(BMI) - a ratio of weight to height - to determine if it was high enough
to be labeled obese, as well as other risk factors such as blood pressure,
blood fats, and how well their body utilized glucose. A BMI of 30 and
above is considered obese; 25 and higher is overweight.
More than half of the children had a least
one of the six risk factors for metabolic syndrome, 27 percent had two
or more, and more than 13 percent had three or more risk factors. Some
children who had three or more factors were only eight or nine
years old.
The most common risk factor, found in more
than 43 percent of the children, was a low HDL cholesterol level. More
than one in four of the students were classified as overweight.
In all, slightly more than 16 percent of
the girls and about 11 percent of the boys had three or more
risk factors for metabolic syndrome. That was due, Dr. Harrell says, to
the higher levels of excess weight in the girls.
Experts
Point to Mounting Evidence
Dr. Henry C. McGill, a senior scientist emeritus
at the Southwest Biomedical Research Institute in San Antonio, says, "There's
no surprise in this study. The evidence [of heart-disease risk factors
in children] just keeps piling up."
Recently, Dr. McGill wrote an editorial in
the Journal of the American Medical Association, commenting
on two other new studies linking risk factors found in children that help
predict heart problems later.
One, the so-called Bogalusa Heart Study,
followed Louisiana children into young adulthood and found high levels
of the "bad" LDL cholesterol was the best predictor later in life of a
condition called increased carotid artery thickness.
In the second study, Finnish researchers
followed more than 2,000 children and teens and measured blood pressure,
cholesterol, weight levels, and smoking habits. They found if the subjects
had several risk factors earlier in life, they were at increased risk
of hardening of the arteries that can lead to heart problems later.
Dr. McGill says the studies should definitely
be a wake-up call for parents and pediatricians.
"My message is, we have got to start early
to stop heart disease in middle age," Dr. McGill says.
"Start with smoking," he urges. "Get them
to quit."
Then, work on the weight.
"The epidemic of obesity at all ages, especially
in children, is a time bomb that will soon explode to cause a renewal
of the epidemic of coronary heart disease and wipe out the gains of the
last 30 years, during which time the mortality rate of CHD [coronary heart
disease] has decreased by more than 50 percent," Dr. McGill says.
Always consult your child's physician for
more information.
Online
Resources
American
Academy of Pediatrics
American
Heart Association
Centers
for Disease Control and Prevention (CDC)
National
Heart, Lung, and Blood Institute
National
Institutes of Health (NIH)
National
Library of Medicine, at NIH
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