March 23, 2012
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Middle schoolers may require obesity prevention programs to manage cardiometabolic risk

Marcus MD. Pediatrics. 2012;doi:10.1542/peds.2011-2696.

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As BMI categories shift in middle schoolers, so do cardiometabolic risk factors, indicating the need for programs to promote healthy lifestyles in children of this age range, according to a study published online.

Marsha D. Marcus, PhD, and colleagues of the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center studied 3,993 middle school children who participated in HEALTHY, a study that looked at the risk for type 2 diabetes using anthropometric measurements, blood pressure, glucose, insulin and lipids. Students were then classified into five categories: underweight, healthy weight, overweight, obese or severely obese.

The researchers reported that 49.8% of children were overweight or obese, and that shifts in BMI category over time were common; these shifts had no association with school intervention condition, household education, sex, race, ethnicity, pubertal status or changes in height. The BMI category changes had clinically significant worsening of cardiometabolic risk, with boys who experienced increases in BMI category being more vulnerable to negative category changes than girls.

Marcus and colleagues said these shifts in BMI category have been reported in previous studies, and additional studies show these changes are “clinically meaningful.” The risk assessment indicates that middle school children would benefit from targeted programs that could help them maintain a healthy BMI to prevent obesity.

“There is compelling evidence for the relevance of universal obesity prevention efforts that target middle school-aged children across all BMI categories to enhance downward shifts in BMI category for overweight and obese children and mitigate increases in BMI category among children in the healthy weight range,” the researchers concluded.

Disclosure: Some researchers reported financial ties to the scientific advisory boards for Con Agra Foods, NutriSystem and United Health Group.