Childhood obesity linked to poor heart health signs at 11–12 years

Anastasia Tsirtsakis

9/07/2020 4:55:40 PM

Dr James Best speaks to newsGP about the important role GPs can play in addressing childhood overweight and obesity.

Legs of a toddler.
Researchers have found a high Body Mass Index in children as young as 2–3 years of age has an association with poor heart health in childhood.

Almost one quarter of children in Australia aged 5–17 years are overweight or obese, increasing their risk for a range of diseases in adulthood.
But the health effects may be seen much earlier than previously thought.
A new study, published in Pediatrics, has found that when it comes to poor heart health specifically, the effects of a high Body Mass Index (BMI) can be seen as early as 11 years of age.
The study, led by the Murdoch Children’s Research Institute (MCRI), involved 1811 children who had their height and weight measured every two years over a decade to determine their cardiovascular disease scores.
At age 11–12, the participants underwent a full heart health assessment looking at their blood pressure, blood vessel health, cholesterol and glucose levels.
The results showed that overweight and obesity from early childhood onwards were strongly associated with higher cardiometabolic risk at 11–12 years of age, with concerning evidence including stiffer arteries and thickened arterial lining.
Cumulative exposure to a high BMI from 2–3 years of age was found to carry the greatest risk.
Lead researcher, Dr Kate Lycett said that up until now, little was known about when and how early life BMI impacted heart health in childhood, with most studies only looking at standard risk factors such as blood pressure alone.
‘Previous studies have tended to rely on a single BMI measurement in childhood and then examined subsequent heart health outcomes in adulthood,’ she said.
‘This overlooks the considerable BMI changes as part of normal childhood growth.’
Dr James Best, Chair of the RACGP Specific Interests Child and Young Person’s Health network, told newsGP he was ‘confronted’ that the study found ‘such a clear result and so early in life’.
‘Most GPs would have a sense that childhood obesity is an issue and that it can cause problems later in life,’ he said.
‘But I think this study gives a sense of urgency to what underlies it.’
Childhood obesity is on the rise due to a number of societal factors, from lack of activity to poor dietary choices.
Professor Melissa Wake, co-author of the study, said the findings highlight the need to intervene early.
‘Public health efforts are needed in the very early years to prevent problems with obesity and being overweight, to avoid the risk of adolescent and adult cardiovascular disease,’ she said.
‘Such policies include increasing taxes on processed foods high in fat and sugar, safer and improved public transport and walking to school pathways, and making community-based sporting activities more affordable and accessible.’
But any policy changes, Dr Lycett said, will require strong support from the clinical community.
Dr Best agrees, and believes that GPs are best placed to play a leading role in addressing weight issues in childhood.
‘Children being overweight has become normalised … it’s a big public health issue and GPs are the ones who should be raising it,’ he said.
‘We really need to be measuring BMIs in children, and not just weight and height, BMI percentiles [too], which our software can now do.’
Dr Best believes it is predominantly a cultural issue, with healthy habits starting in the home.
‘We really need to be educating parents of child patients who are overweight that it is not normal and that it does have very significant health implications,’ he said.
‘Children just simply should not be having sweet drinks and fast food. The majority do not have enough vegetables in their diet – which is a startling fact.
‘Healthy eating and activity choices should be done at a family level. And of course, modelling. If parents are making the right choices themselves, then they will teach their children to do the same.’
When broaching the subject during a consultation, Dr Best says it is important to frame the conversation in a positive way, with a health focus.
‘It’s not just about reducing weight. It’s about healthy eating and healthy activity; you’re just encouraging a healthy lifestyle,’ he said.
‘Because children want to be healthy, and I think if you approach it in that way it becomes less judgmental.
‘It needs to be done in a sensitive and respectful manner – but it needs to be done.’
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