Obesity rates are climbing and children and adolescents are no exception to this trend. Both obesity itself and factors that lead to obesity are known to increase the risk of cardiovascular disease in adults but evidence has also begun to suggest that obesity in childhood may significantly impact the cardiovascular health when they are adults. Cardiovascular disease can include heart arrhythmias, heart attacks, or stroke which can decrease quality of life and lead to early death.
Researchers wanted to assess the risk of fatal cardiovascular events in adulthood according to the BMI range during adolescence. The study, published in The New England Journal of Medicine, found that an increased BMI in late adolescence was strongly associated with cardiovascular mortality in young adulthood or midlife.
The cohort study assessed information gathered from 2,454,693 Israeli adolescents with a mean age of 17 years from January 1, 1967 to December 31, 2010. The study began with medical information gathered during assessment before military services and followed the participants for up to 43 years.
During the study time frame 9.1% of participants had deaths associated with cardiovascular disease such as heart attacks, stroke, or sudden death. The average age of death was 47.4 years for coronary heart disease, 46 years for stroke, and 41.3 years for sudden death.
Increasing BMI was associated with a greater risk of cardiovascular mortality. Compared to adolescents with a BMI in the lower end of normal, risk of death from cardiovascular causes:
There was also an increased risk in participants in the higher end of normal compared to those at the lower end of normal but effects were smaller than those in the overweight and obese categories.
Cohort studies are observational studies. These studies simply observe events as they unfold, but do not interfere or introduce factors that can affect the outcome. This means the study cannot confirm that obesity early in life is a risk factor for death from cardiovascular disease but suggests that there may be a link. This is a large study which generally increases the reliability of outcome, however outcomes from other studies suggest that high normal BMI may have protective effects instead of increasing the risk. There is also some concern over the reliability of BMI as a measurement tool for true overweight or obesity.
Work with your child's doctor to assess your child's weight and plan healthy lifestyle habits. Weight management in children is different than adults and can change depending on the child's age. No matter what your child's weight, focus on a healthy diet with plenty of fruits and vegetables and a minimum of sugary or processed food. Encourage your child to be physically active and set a good example for them to follow. Healthy habits adopted in childhood are more likely to stick as they grow into adults. Vast amounts of research support that these habits have a significant impact on the risk for cardiovascular diseases.
Family Doctor—American Academy of Family Physicians
Healthy Children—American Academy of Pediatricians
Childhood obesity facts. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthyschools/obesity/facts.htm. Updated August 27, 2015. Accessed May 12, 2016.
Obesity in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 3, 2016. Accessed May 12, 2016.
Twig G, Yaniv G, et al. Body mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 2016 Apr 13. Available at: http://www.nejm.org/doi/full/10.1056/NEJMoa1503840. Accessed May 12, 2016.
Last reviewed May 2016 by Michael Woods, MD