Early childhood increase in BMI affects cardiometabolic risk factors by mid-teens

By Nicole MacKee
Children whose body mass index (BMI) is increasing by the age of 2 years are on track to develop cardiometabolic risk factors, such as central adiposity and an abnormal lipoprotein profile, by their mid­-teens, according to Australian researchers.

In a study published in The Journal of Pediatrics, researchers analysed data from 410 children who had had their height and weight assessed from birth to age 14 years as part of the Child­hood Asthma Prevention Study. Of these participants, 190 had had their cardiometabolic risk factors assessed at 14 years of age.

The researchers identified three groups of children: those with a normal BMI; those whose BMI had increased in their first two years of life (‘early rising BMI’); and those whose BMI had increased in their first five years (‘late rising BMI’).

They found that children with an early rising BMI trajectory had a significantly higher waist circumference and a more atherogenic lipoprotein profile at age 14 years than children with a late rising BMI.

Lead author Dr Jennifer Barraclough, Consultant Cardiologist at the Mater Hospital and Honorary Consultant Cardiologist at Royal Prince Alfred Hospital, The University of Sydney, told Medicine Today it was surprising to see adverse cardiometabolic impacts at such a young age.

‘We thought that it might be the case that the earlier your BMI started to rise, the worse off you would be, but we didn’t know that we would see that difference by 14 years, which is pretty concerning given the amount of adolescent obesity in Australia,’ Dr Barraclough said.

‘We don’t want parents to be excessively concerned about their children’s weight, but we want people to be aware that we have to be instituting healthy dietary and physical activity habits from a very young age.’

The researchers also assessed participants’ vascular structure and function at age 14 years. They found no significant difference across the three weight trajectory groups on measures including diastolic blood pressure, carotid intima-media thickness and carotid to radial pulse wave velocity.

Dr Barraclough said these findings suggested that it may be possible to reverse these cardiometabolic risk factors before long­-term damage was done.

‘The fact that there was no significant difference in these subclinical markers of vascular disease suggests that we may be able to reverse this trajectory if we identify these kids early and educate their families,’ she said. ‘We see too much cardiovascular disease in adults – it’s still the leading cause of death – and prevention is our best tool.’
J Pediatr 2019: 1-7; https://doi.org/10.1016/j.jpeds.2018.12.034.