DID YOU KNOW...
About Obese Children and Atherosclerosis?

By Elizabeth Langford

  • 42 million children worldwide are overweight or obese
  • Obese children are likely to become obese adults
  • Being overweight during childhood is associated with increased risk of coronary artery disease in adulthood

Atherosclerosis

Atherosclerosis is the gradual accumulation of fat and plaque along the arteries. This disease process occurs in all humans beginning in childhood, but its progression is accelerated by the following factors:

  • Obesity
  • Smoking/smoke exposure
  • Dyslipidemia (high blood fat levels)
  • High cholesterol
  • Family history and genetics

As more plaque accumulates on artery walls, the arteries become narrower. Narrowed arteries provide less space for blood flow.

Blocked blood flow increases the risk for:

  • Heart attack
  • Stroke
  • Aneurysm
  • Gangrene

Carotid Artery Intima Media Thickness (CIMT) – Measuring Cardiovascular Risk

Carotid artery intima media thickness (CIMT) is a measurement of the amount of plaque on artery walls taken by ultrasound. This is a marker of atherosclerosis and heart disease in adults. High CIMT measurement has been associated with:

  • Cardiovascular risk factors
  • Coronary artery disease
  • Stroke
  • Progression of coronary atherosclerosis

Obese Children and Adolescents

A study published in January 2010 revealed that obese children (6-19 years old) have CIMT measurements similar to 45-year-old adults (Le et al., 2010).

Blood Vessel Stiffness

Another study has shown that obese children have stiff aortas. The aorta is the largest artery in the body which delivers blood from the heart to the rest of the arteries in the body. A stiff aorta usually results in increased blood pressure, because the heart has to work harder to pump blood through arteries. Thus, stiff blood vessels are an early indicator of cardiovascular disease.

Implications

In the past 30 years, obesity rates in Canadian youth have tripled. In 2004, 26% of children and adolescents aged 2 to 17 were overweight or obese. Globally, over 42 million children under the age of 5 are overweight. The long-term impact of the current epidemic of childhood obesity is unclear. Due to the current trends in childhood obesity, it has been estimated that rates of coronary artery disease in young and middle-age adults will significantly increase in the near future.

What Can Be Done?

The major question is can this aging of vessels be reversed with lifestyle alterations? A few studies have reported short-term positive changes in vascular function and decreased CIMT measures after an exercise program or statin therapy in obese children. However, more studies are needed to determine the long-term reversibility of the damage caused by obesity during childhood.

Although the reversibility is still questionable, this evidence fully supports the need to prevent obesity in children to avoid the early progression of atherosclerosis.

References:

  1. Le, J., Zhang, D., Menees, S., Chen, J., Raghuveer, G. (2010). "Vascular age" is advanced in children with atherosclerosis-promoting risk factors. Circ Cardiovasc Imaging, (3)8-14.
  2. Raghuveer, G. (2010). Lifetime cardiovascular risk of childhood obesity. Am J Clin Nutr, 91(suppl):1514S-9S.
  3. Statistics Canada. (2004).
  4. World Health Organization. (2010).

The articles, on the Cardiac Health Foundation of Canada website, are presented with the understanding that the Foundation is providing information only and not rendering medical advice. Please check with your family physician, specialist or health care professional before implementing any of the ideas expressed in these articles.