Changes in blood fats and other markers of it

A new study presented this year at the European Congress on Obesity (ECO) in Maastricht, the Netherlands, and simultaneously published in Obesity Research and Clinical Practice, found that changes in blood fats and other markers of heart health and diabetes are detectable as early as age six in overweight children.

The study of nearly 1,000 Danish children also established that routine dental checkups provide a good opportunity to measure BMI.

“The prevalence of childhood obesity is high, and the short- and long-term complications of childhood obesity are numerous,” says the study’s first author, Dr Christine Frithioff-Bøjsøe, of the Children’s Obesity Clinic, European Center for Obesity Management, Copenhagen Holbaek University Hospital, Holbaek, Denmark.

“Overweight in early childhood often extends into adolescence and adulthood and is associated with a higher risk of heart disease, liver disease, type 2 diabetes and other metabolic conditions later in life. therefore, early identification and treatment of overweight provides a critical opportunity to improve a child’s health for years to come.

The study, which was led by Dr Frithioff-Bøjsøe, Professor Jens-Christian Holm and colleagues from the Childhood Obesity Clinic, sought to find out whether it is practical to use existing contacts in the primary health care sector to detect overweight at an early age.

Dental assistants and public health nurses were trained in weight and height measurement and performed BMI assessments during routine dental clinic appointments (children in Denmark have right to regular dental appointments from the age of one) and during health visits in schools.

The dental assistants recruited 335 preschoolers (ages 2.5 and 5) into the study. In addition, 657 school-age children (6-8 years old) were recruited by public health nurses, bringing the total number of participants to 992 (494 boys).

All children had their BMI assessed at the start of the study. A subset of 392 children had their blood pressure measured and donated a blood sample, which was tested for a range of cardiometabolic risk markers.

BMI assessments and other tests were repeated about a year later.

At the start of the study, the proportion of overweight children was 13.7% in both groups (preschoolers and schoolchildren).

Differences in cardiometabolic risk markers between overweight and non-overweight children were minor in preschool children.

Among schoolchildren, however, there were clear differences in blood test results between those who were overweight and those who were normal weight.

Overweight school children had significantly higher levels of fasting glucose, insulin, triglycerides and alanine aminotransferase, which may indicate a higher risk of type 2 diabetes, cardiovascular disease and liver disease.

Overweight levels had not changed in preschool children when measured again about a year later, but had risen to 17% among school children.

The study authors say their research shows that it is practical to use existing health services, including dental clinics, to assess the degree of overweight in a general pediatric population.

Dr Frithioff-Bøjsøe adds: “We also overcame barriers identified in other studies, including concerns about lack of adequate training, patient and caregiver offense and child stigma.”

The researchers say that although the levels of risk markers measured in the study were still within the normal range, the increases are still concerning, especially at such a young age.

Dr Frithioff-Bøjsøe explains: “By the age of 11, 15-20% will be overweight and a large group will later have high blood cholesterol, fatty liver or prediabetes, as well as life seriously affected. Thus, early detection of these changes would be a major step forward in preventing the development of the disease.

The authors conclude: “We found increased risk markers for heart and liver disease and diabetes in overweight school children. These changes were not detectable a few years earlier in overweight preschoolers and suggest that preschool – as young as 2.5 years of age – may provide a critical window for detecting and managing overweight.

“This, in turn, would allow weight loss interventions to start early and reduce the risk of an overweight child becoming an overweight adult, or even a teenager, and other conditions such as type 2 diabetes. “

Dr Christine Frithioff-Bøjsøe, Childhood Obesity Clinic, European Center for Obesity ManagementDepartment of Pediatrics, Copenhagen Holbaek University Hospital, Holbaek, Denmark T) +45 50932520 E) [email protected]

Alternate contact: Tony Kirby at the ECO Media Center. T) +44 7834 385827 E) [email protected]

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