Getting a Head Start in Preventing Cardiovascular Disease

One in four children in the United States are currently at risk for obesity by age 5 and there will be a 3-fold increase in the next 30 years, according to the latest research presented by Steven E. Lipshultz, MD.

Lipshultz is a professor and chairman, of the Department of Pediatrics, at the University of Miami.

His presentation, “Pediatric Cardiovascular Disease Prevention,” focused on examining the prevalence of childhood obesity, the factors that influence the rise, and studies that have demonstrated promising interventions.

Lipshultz began his presentation by focusing on the fetal origins of obesity and cardiovascular risks. Determinants associated with these conditions include: cocaine use, prematurity, race, maternal age, antiretroviral therapy, inflammation, or infection, maternal calcium levels, and maternal smoking habits. All the above affect fetal growth which may lead to negative cardiovascular outcomes, he said.

Lipshultz also highlighted a study that demonstrated that if a child’s parents are overweight or diabetic, the child was most likely to become an overweight adult. In another study, the NICHD Project Viva, the findings demonstrated that increased maternal age affected a child’s risk of developing high blood pressure. The same study also demonstrated that a mother’s smoking habits increased the likelihood that a child would become obese, with smoking during pregnancy containing the highest risk. Other research highlighted, demonstrated that women who smoked during pregnancy also had children that were more likely to develop cardiac conditions, including increased cholesterol levels.

Research also demonstrates that children who developed cardiac risk as adults tended to be smaller in size and body weight in their first two years.

Methods that can help prevent obesity in children involve active interventions that must take place at least during elementary school. For example, Lipshultz highlighted one study that included an interventional program in daycares that also worked with family members. The findings reveal that in the intervention group, the children increasingly turned to nutritional options and began to eat less junk food.

The HOPS study, which included interventions with teachers by dieticians, included a total participation of 5,000 children (intervention and control group). Results demonstrated that there was a significant reduction in total fats and saturated fats eaten. Likewise, both Body Mass Index and weight improved significantly. Academic performance was also trending upward, he said.

The work needs to be done now, as increasingly, childhood obesity is a growing problem. Lipshultz included data from a study that revealed 9.5% of overweight children ages 8-11 have metabolic syndrome. For those age 12-14, 44% have metabolic syndrome.

Lipshultz stated that there needs to be a paradigm shift for the treatment of Pediatric Metabolic Syndrome; prevention should come first and treatment second, he said.

A final treatment, which may be a bit controversial is pediatric laparoscopic gastric bypass surgery. Research demonstrates that even four-years post-surgery these pediatric patients are able to maintain healthy BMIs and significantly reduce cholesterol, which decreases the risk of cardiovascular events.