New risks seen for obese children

New risks seen for obese children
Study finds link to heart disease and diabetes
By Carolyn Y. Johnson, Globe Correspondent | June 3, 2004

An unexpectedly high percentage of obese children have some of the symptoms
that have been linked to heart disease and diabetes in adults, according to
a study being published today.

The researchers found that metabolic syndrome -- a group of symptoms
associated with an increased risk of heart disease in adults -- was more
common in obese children than previously reported, and that the syndrome
was most prevalent in the most obese group.

''Metabolic syndrome in general is a string of risk factors for
cardiovascular disease and diabetes," said Dr. Ram Weiss of Yale University
School of Medicine, lead author of the study being published in the New
England Journal of Medicine. ''Children have developed diabetes at a faster
tempo than you see in adults," he added, referring to the last decade in
pediatric medicine. So Weiss and his colleagues decided to study whether
children are suffering from increased rates of metabolic syndrome, too.

Adults with metabolic syndrome have high blood sugar, high levels of
triglycerides, low levels of ''good" HDL cholesterol, high blood pressure,
and abdominal obesity -- all of which predispose them to heart disease and
type 2 diabetes. Obese children are known to have many of these symptoms
already. But the researchers wanted to quantify the group of symptoms among
a large group of multiethnic children with various degrees of obesity.

''There is no agreed-upon definition for metabolic syndrome in pediatrics,"
Weiss said. ''We used a very conservative definition." The researchers
defined new thresholds of the adult risk factors, modified for children and
adolescents. Subjects with at least three of the risk factors met the
criteria for metabolic syndrome.

Although none of the 51 non-obese subjects had metabolic syndrome, 39
percent of the 244 moderately obese subjects and nearly half of the 195
severely obese subjects did.

Other studies have shown that severely obese adults are twice as likely to
die of any cause as moderately obese adults. The new results may hint that
the degree of obesity is also an important factor in the overall health of
children.

''The study is confirmatory evidence that we are really in the midst of an
epidemic that increases every day," according to Dr. Lori Laffel, chief of
the pediatric and adolescent unit at Joslin Diabetes Center in Boston.
''Obesity-related illnesses are going to overtake smoking as a major
preventable risk factor for disease."

According to the US Centers for Disease Control and Prevention, about 15
percent of children and adolescents in the United States are overweight. If
that number continues to grow, the obesity epidemic will exacerbate other
health problems. ''The way to reduce insulin resistance [a precursor to
type 2 diabetes] or obesity is the same: Lose weight or exercise," Weiss
said.

Eight of the subjects with metabolic syndrome developed type 2 diabetes
after the study, according to Weiss. ''Maybe diabetes is only the tip of
the iceberg, and we'll see heart disease develop," he said. ''Nobody really
knows, but the assumption is if the adult has cardiovascular risk, so will
the child."