Overweight children face heart risks as young as 3, study says

When children are overweight, heart-health risk factors such as dangerous cholesterol levels and artery inflammation can start as early as age 3, according to a University of Miami study published in this week's medical journal Obesity.

"There's clearly a link between weight and cardiovascular risk," said Sarah Messiah, a UM research assistant professor and lead author of the study. "When a doctor sees an overweight child at age 3, he has to talk to the parents about it. The negative health processes are not 20 years down the road - they're already starting."

Steven E. Lipshultz, another author of the study and chair of pediatrics at the UM Medical School, said: "This is a new concept, since many have felt that although children are obese, the health consequences do not manifest clinically until they are older."

The new study updates a 2009 paper by Messiah. The information in the study is culled from health records of 3,644 3-to-6-year-old children from the 1999-2008 National Health and Nutrition Examination Surveys, a nationwide databank.

Earlier studies had detected such problems, but mostly in children ages 8 and older. In the United States, 19 percent of children 2 to 18 are obese, and 30 percent are overweight, according to the U.S. Centers for Disease Control and Prevention.

"We're seeing lots of children at risk for becoming diabetic, and it can happen in their 20s instead of their 40s," Messiah said.

The UM study measured children's waist circumference and body-mass index (BMI), which is calculated from a person's height and weight and is considered a good indicator of obesity, according to the CDC.

"This is the first time it's been documented in a multiethnic group like this," Messiah said.

The study showed sharp differences among racial and ethnic groups. In 6-year-old black and Hispanic boys and all 5-year-old girls, those with high BMI and waist size tended to have higher inflammation levels. In 3-year-old Hispanic girls and 5-year-old Hispanic boys, those with high BMI and waist size tended to have lower levels of HDL, the "good" cholesterol.

"We don't know why," she said. "It's probably a combination of genetics and behavior."

Messiah expressed opposition to a new proposal in the Florida Legislature, sponsored by Republican state Rep. Larry Metz, that might remove the requirement for Florida middle schools to offer physical education courses.

"Exercise is one way we can prevent these problems," she said. "To take that away in light of the obesity epidemic doesn't make a lot of sense."

Florida's American Heart Association on Monday also opposed Metz's bill, calling it "dangerous to our children."

And at AHA's November meeting in Orlando, the American Academy of Pediatrics publicized new guidelines calling for cholesterol screening as a routine part of regular well-child doctor visits for all children.

The academy had engaged a panel of experts who surveyed hundreds of previous studies and concluded in a new paper that, while family history and tobacco use are significant risk factors for future heart problems, obesity "tracks more strongly than any other risk factor."

It said 84 percent of people who were obese as children remained obese as adults.

And in November, Medicare announced for the first time it will pay for screenings and other services to prevent obesity in the 65-and-over patients it covers. Messiah said she hopes Medicaid eventually will agree to pay for such screenings for children.

"If the Medicare program works well, I hope Medicaid will do the same," she said.

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