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CDC: US adolescents carry substantial burden of CVD risk factors, prediabetes
Researchers at the CDC said they are concerned with an increased prevalence of cardiovascular disease risk factors and prediabetes in adolescents, regardless of weight status, based on data from the National Health and Nutrition Examination Survey.
Previous research has shown that overweight and obese children are more likely to develop CVD risk factors than their peers. However, Ashleigh L. May, PhD, researcher for the Division of Nutrition, Physical Activity and Obesity at the CDC, and colleagues said childhood CVD risk factors may follow adolescents into adulthood.
NHANES studied 3,383 adolescents aged 12 to 19 years (34% overweight or obese), from 1999 to 2008, to determine the incidence of four specific biological CVD risk factors: 1) prehypertension/hypertension, 2) borderline-high/high LDL cholesterol, 3) low HDL cholesterol, and 4) prediabetes/diabetes.
“The results of this study indicate that US adolescents bear a substantial burden of risk factors for CVD. In our nationally representative study, 49% of the overweight and 61% of the obese adolescents had greater than one CVD risk factor in the 1999-2008 period of study,” the researchers said.
According to data, the overall prevalence for each of the four risk factors was more than 10%, except for low HDL cholesterol (>35 mg/dL), and borderline-high/high LDL cholesterol was the most common risk factor overall (22%).
A significant decrease in low HDL cholesterol, from 9% to 3% (P<.05), was noticed when comparing the prevailing risk factors within later study cycles. Additionally, overall prevalence for prediabetes/diabetes was 15%.
Although the adolescents had no significant change in prehypertension/hypertension and borderline-high/high LDL cholesterol prevalence from 1999-2000 to 2007-2008, prediabetes/diabetes increased by 12%, the researchers said.
“Adolescence represents a window of opportunity for assessment of CVD risk factors and the promotion of lifestyles that will affect the development and progression of CVD,” they concluded.
Disclosure: The researchers report no relevant financial disclosures.
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It really has leveled off over the last few surveys, yet the frequency of pre-diabetes really has increased. We’ve tied that to obesity and it’s an important issue.
Another paper (Weiss R. et al. Predictors of Changes in Glucose Tolerance Status in Obese Youth. Diabetes Care 2005; 28:902-909) showed that children with pre-diabetes, if they continued to gain weight, are at risk for developing diabetes, whereas those who lost weight, increased activity, changed their lifestyle, they were able to revert to normal.
We know that adults with pre-diabetes and impaired fasting glucose, are associated with CVD risk, and we see that obese adolescents have the risk factors for CVD.
I anticipate that these children are more at risk for developing CVD than adolescents with normal glucose tolerance. That’s not surprising; these are all manifestations of insulin resistance. The things that will improve insulin resistances, other than medications, are weight loss and fitness. Increased activity will help both.
I think it’s important to identify these children and to encourage lifestyle change. Although all overweight and obese children require lifestyle counseling and monitoring for co-morbidities, those who already have impaired glucose tolerance and impaired fasting glucose are most at risk for early CV risk and need more intensive education, counseling, and follow-up in this regard than children with normal glucose tolerance.
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We have a potential national tragedy on our hands. One in 3 adolescents aged 12-19 years is overweight or obese and they have these risk factors for CVD in the future. It doesn’t augur for a very healthy society 20 years from now. We need to do something about it.
Tackling this problem will require a coordinated national effort involving health care providers, schools, government policy and the food industry. The solution lies in a public health policy; it’s not likely to come from a drug that’s going to stop you from eating. It should be a top priority as a public health matter for the United States. The solution requires a coordinated national public health policy approach to solving this problem; not because of stigmas attached to appearance, but because of the impact on health.
If we’re going to have a public health approach to a problem like smoking, we should have a public health approach to a problem like obesity and overweight. It might inconvenience some people, but it will benefit the greater good.
The study only confirms what people are concerned about- what are we going to do with this problem.
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