Obesity in children is rapidly becoming a national crisis in the United States. Diseases are being diagnosed in obese children that had formerly been seen only in adults, such as high blood pressure, type II diabetes and signs of atherosclerosis ("hardening of the arteries"). But many researchers see these risk factors in the context of an overall family history of heart disease. A current study, published in the October 2002 issue of the European Journal of Pediatrics, explores this association.
According to the American Heart Association, almost five million children between the ages of 6 and 17 are considered overweight, with many more classified as overweight. Obesity is generally defined as being more than 20 percent over one's ideal weight.
There are three ways of calculating whether a child is obese:
* Compare the child's weight-to-height ratio with those of
same-age, same-sex peers. Pediatricians should have these charts available.
* Do an abdominal skin-fold test, a painless measurement that provides a
good indication of the actual amount of fat tissue present in a younger person.
This test is performed by a health-care provider.
* Calculate the child's
body mass index (BMI), based on recently published data. The BMI can be
calculated by anyone who knows the child's age, height and weight, as described
below.
A body mass index is calculated the same for children as it is for adults. However, the method used to determine whether that BMI indicates obesity is different. It is different for children because 1) children are still growing and 2) gender differences are more pronounced in childhood.
In 2000, the Centers for Disease Control and Prevention developed a chart method for determining obesity in children based on BMI. The chart outlines the range of BMIs that are considered normal (the 50th percentile) for individuals aged two to 20. It also shows which BMIs are unusually high or low for each age group.
Based on which percentile the child is in, the CDC provides
the following classifications for BMI in young people aged two to 20:
| Percentile | Classification |
|---|---|
| Below the 5th percentile: | Underweight |
| At or above the 85th percentile: | At risk of becoming overweight |
| At or above the 95th percentile: | Overweight |
Other experts consider BMIs over the 85th percentile to reflect being overweight and BMIs over the 95th percentile to reflect obesity.
The current study sought to predict heart disease events based on suspected risk factors. A total of 285 children and adolescents was divided into four groups: obese; obese with high blood pressure; high blood pressure only; and diabetic only. Then the groups were divided according to whether a child had a family history of heart disease. Results showed a higher body mass index in children with a positive family history, especially when heart disease occurred before age 55 in a parent or grandparent. In addition, the study found higher lipoprotein levels in children with positive family histories. The researchers concluded that higher body mass index and lipoproteins, combined with a positive family history, can predispose children to future heart disease.
Source: Heart Center Online.
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