Children are at greater risk for heart disease now than they were a decade ago. A study from the U.S. Centers for Disease Control and Prevention (CDC) compared data from 1999 with data from 2008. The CDC found that 23% of teens are at risk for diabetes, up from 9% in 1999. About 35% of teens are overweight or obese. About 15% have blood pressure that is higher than normal. By 2008, 43% of teens had at least one risk factor for heart disease. The study included information from 3,383 adolescents, ages 12 through 19. Results appeared in the May 21 issue of the journal Pediatrics. The Associated Press wrote about the study.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
One in four adolescents is on the path to diabetes.
Ten years ago, that number was one in ten.
Researchers from the Centers for Disease Control (CDC) looked at data from the National Health and Nutrition Examination Survey (NHANES), a national survey of data about health and nutrition from thousands of people. Specifically, they looked at data about adolescents from 1999-2008. They were interested in knowing how many adolescents had one or more of the major risk factors for cardiovascular heart disease (CVD). The risk factors were:
- Hypertension (high blood pressure) or pre-hypertension (a blood pressure close to high)
- High or borderline high LDL (low-density lipoprotein cholesterol, also called "bad" cholesterol)
- Diabetes or pre-diabetes
They also looked at rates of overweight and obesity, to see whether being overweight or obese increased the risk of having these risk factors—and they looked at trends over the nine-year period.
Here’s what they found:
- Rates of overweight (roughly 15%) and obesity (roughly 20%), while high, remained stable over the time period
- About 15% were hypertensive or pre-hypertensive; this also remained stable
- About 20% had high or borderline-high LDL values, which also did not increase over the time period
- Diabetes or pre-diabetes increased markedly: from 9% in 1999 to 23% in 2007-2008
Being overweight definitely plays a role. About 60% of obese adolescents and 50% of overweight ones had at least one risk factor for CVD. But overweight is not the only risk factor—37% of normal-weight adolescents had at least one risk factor. And because rates of obesity and overweight did not increase over the years, overweight cannot be the entire explanation for the increases in diabetes and pre-diabetes.
It may be that unhealthy lifestyle—lack of exercise and poor diet—is driving the increase in diabetes, even before it affects weight. It may also be that the body mass index (BMI), which is a calculation done using height and weight, may not always be the best measurement to look for risk of heart disease. More and more, researchers are suggesting that measuring waist circumference is important, because unhealthy fat tends to be stored there.
But whatever the explanation for the data, it is scary data with huge implications for the future health of our youth.
What Changes Can I Make Now?
This study makes it very clear that we need to make some changes. If you are a parent, here are some must-do's:
- Know your child's BMI and whether it's healthy or not. The CDC has a great BMI calculator.
- Know your child's blood pressure and whether it's healthy or not. Normal values depend on age, gender, and height. Blood pressure should be taken yearly at checkups.
- Talk to your doctor about checking your child's cholesterol and diabetes. Routine screening of cholesterol levels is recommended at ages 9-11 and again at 17-21. Testing for diabetes is recommended for all overweight and obese children.
- Get your child moving! An hour a day of active exercise (active play is totally fine) is recommended.
- Give your child a healthy diet full of fruits, vegetables, whole grains, and low-fat meat and dairy. Check out ChooseMyPlate.gov for information and ideas.
All of us, parents or not, need to do everything we can to make healthy foods and exercise opportunities available to all adults and children. Each one of us can—and should—help.
What Can I Expect Looking to the Future?
This study suggests that in the future we will have more diabetes and heart disease. The future of our children is looking grim; this may very well be the generation that dies before their parents. We need to take this study and the other studies that have been saying the same thing very seriously, and take action.
Lives are at stake.
