Obese Children Who Lose Weight Decrease Future CV Risks

Fat kids often turn into fat adults with a host of related health problems: diabetes, high blood pressure, clogged arteries. But a study finds that if those heavy kids lose weight they may be on a par with people who were never overweight.


A meta-analysis released today in the New England Journal of Medicine looked at weight status and health among 6,328 people who were followed from childhood for an average of 23 years. The study subjects were divided into four categories: those who were normal weight as kids and not obese as adults; those who were overweight or obese as kids but not obese as adults; those who were overweight or obese as kids and obese as adults, and those who were normal weight as kids but obese as adults.


In some studies being overweight in childhood was associated with a risk of developing type 2 diabetes and high-risk cholesterol levels in adulthood, and in all studies those weights were linked with high blood pressure and high triglyceride levels.


As expected, "our data confirm both the increase in CV risk associated with childhood overweight or obesity and the tracking of adiposity between childhood and adulthood," the investigators said.


A total of 774 subjects had been overweight or obese as children, and 500 of them (64.6%) remained obese as adults. Another 147 subjects had been obese as children, and 121 (82.3%) of them remained obese as adults. In these subjects, overweight or obesity were strong predictors of type 2 diabetes, hypertension, poor cholesterol profiles, and reduced carotid-artery intima-media thickness (a proxy measure for incipient CV disease, since the cohorts were too young to have experienced CV events).


Among 5,554 subjects who had had normal weight as children, 812 (14.6%) were obese as adults. As expected, these subjects who were of normal weight in childhood but became overweight or obese as adults also had adverse CV risk profiles.


However, subjects who had been overweight or obese as children but became nonobese by young adulthood had CV risk profiles similar to those of subjects who had been of normal weight throughout their lives, Dr. Juonala and his associates wrote (N. Engl. J. Med. 2011;365:1876-85).


For example, the subjects who had been normal weight throughout the study and those who had been overweight or obese as children but became nonobese by young adulthood had no increased relative risk for developing type 2 diabetes, whereas those who were overweight or obese in childhood and remained so in young adulthood had a 5.4-fold increase in relative risk for developing type 2 diabetes, and those who were obese in childhood and remained so in young adulthood had a 4.5-fold increase in relative risk.


This study was limited in that the subjects were predominantly white, so the results cannot be generalized to other races or ethnic groups, the authors added.


This pooled analysis was supported by funding for the original four longitudinal cohort studies. Dr. Juonala reported no relevant financial disclosures. His coauthors reported ties to Pfizer, Merck, and AstraZeneca.