Some First Graders Risk
Heart Disease
Many Kids Have Bad Cholesterol, High Blood Pressure
,
Nov. 11, 2003 (Orlando, Fla.) -- If kids in rural North Carolina are any indication, almost 60% of schoolchildren may be well on their way to developing heart disease, says a heart disease researcher.
Joanne S. Harrell, PhD, professor of nursing and director of the Center for Research on Chronic Illness at the University of North Carolina at Chapel Hill School of Nursing, tells WebMD that several researchers have reported that "obesity is a real problem for our schoolchildren, but in this study we found risk factors that pose real dangers for these children."
The researchers found that many of these children had one or more risk factors for developing metabolic syndrome, which greatly increases the likelihood of developing both heart disease and diabetes. Risk factors for metabolic syndrome are high blood pressure, high triglycerides, low levels of HDL "good" cholesterol, glucose intolerance, elevated insulin levels, and excess body weight.
Even Young Children at Risk
The researchers found risk factors for metabolic syndrome in children as young as 8 or 9, Harrell says. Almost 9% of these youngest children already had at least three risk factors, she says. These types of risk factors are usually seen in middle-aged and elderly people.
Harrell is studying more than 2,000 North Carolina schoolchildren aged 8 to 17. A little less than 50% were white, about 40% were black, and 10% were other races. Although she is now reporting her initial findings, she plans to follow them for the next four years.
Harrell presented her study at the American Heart Association's Scientific Sessions 2003.
Although identifying risk factors in these very young children was disturbing, she says children at puberty had the highest rate of multiple risk factors.
While both boys and girls had evidence of the risk factors, "The risk among girls was about 1.6 times higher than among boys," she says.
The single most common risk factor was low HDL, which was found in about 42% of the children. Low HDL was defined as less than 40 in boys and less than 50 in girls. Low HDL is more common in kids that aren't physically active. As might be expected, one in four children was also overweight, she says.
In each child, the researchers measured body mass index -- a measure of weight in relation to height -- blood pressure, cholesterol, and blood sugar (glucose) levels.
Asked if the risk factors can be reversed, Harrell says, "We all know the answer to this: Lose weight. But the question is, how can we accomplish that goal?" She says that she favors programs that integrate family, school, and community. Among the more important aspects, she says, would be a renewed interest in physical education programs in schools. In recent years, budgetary constraints have left many schools with little or no organized gym programs.
"Worse, we are now hearing that some schools do not allow children to run at recess. This, of course, is driven by concerns about liability problems if a child is hurt on the playground," she says. That approach is not only wrong-headed, but also dangerous to children, according to Harrell.
Families Should Get Involved
Rodman D. Starke, MD, former scientific director of the AHA, says Harrell's study "confirms again that we have an epidemic of obesity. Now, we are seeing this extending to metabolic syndrome, which takes us another step."
"My take on this is that it should be approached from a family standpoint: Families need to turn off the television -- and the computer -- and do some fun activity together."
Harrell agrees that family activities such as "walking, hiking, swimming -- as long as the activity is fun" can be a great help. Finally, she notes that among children, increasing exercise is often easier than controlling diet. But combining both a healthy diet and exercise has been shown to be most effective at dropping excess weight.
SOURCES: American Heart Association Scientific Sessions 2003, Orlando, Fla., Nov. 9-12, 2003. Joanne S. Harrell, PhD. Rodman Starke, MD.