Regular exercise helps obese youths reduce, reverse risk for heart disease, study shows

Regular exercise can help obese children shrink more than just their waistlines, new research shows. The activity also can help them to reduce – and even reverse – their risk of developing cardiovascular disease, including hardening of the arteries.

The research, conducted at the University of Rostock in Germany, appears in the Nov. 7, 2006 edition of the Journal of the American College of Cardiology.

“We think the most important message is that atherosclerosis – hardening of the arteries – starts during childhood in the presence of such risk factors as obesity and sedentary lifestyle,” said lead researcher Andreas Alexander Meyer, MD, a pediatrician and pediatric cardiologist at the University of Rostock Children’s Hospital. “Regular exercise is one of the most important activities we can do on our own to reduce the risk and reverse the early development of atherosclerosis.”

This information is vital, Dr. Meyer said, as the need continues to grow to help children protect their health without becoming dependent upon prescription medications. According to the World Health Organization, childhood obesity already is “epidemic in some areas and on the rise in others.” Worldwide, an estimated 22 million children under age 5 are overweight. In some countries, including the United States, more than 30 percent of all children are considered obese.

For their study, Dr. Meyer and his colleagues defined obesity as having a body mass index (BMI) in excess of the 97th percentile for German children. BMI is determined by a mathematical formula that uses height and weight to calculate body fat.

In adults, a BMI between 18 and 24.9 is considered normal, a BMI between 25 and 29.9 is considered overweight, and a BMI of 30 or more is considered obese. Specific ranges don’t exist for children, but most of the teen-agers in the University of Rostock study had BMIs ranging from 24 to 35.

Compared with normal children, the obese youths also already were showing signs of early hardening of the arteries as well as thickening of the arterial lining where atherosclerosis originates.

For the study, the researchers randomly assigned 67 obese teens to one of two groups. The first group exercised three times per week for six months. The youths participated in an hour of swimming and aqua aerobics on Mondays, 90 minutes of team sports on Wednesdays, and 60 minutes of walking on Fridays. The other teens added no exercise to their normal routines.

After six months, the researchers found that the youths who were exercising regularly had significantly improved the flexibility of their arteries, allowing the arteries to carry more oxygen-rich blood to the body when needed. The teens also had shrunk the expanded inner layer of their arteries and reduced several other risk factors for cardiovascular disease, including lowering their BMIs, cutting triglyceride and cholesterol levels, and lowering blood pressure.

Previous research has indicated that the heart-healthy benefits of exercise wear off if regular activity is discontinued, Dr. Meyer said, so encouraging all children to maintain an exercise routine is important.

“We think that 90 minutes of exercise, three times per week is the minimum children need to reduce their cardiovascular risk,” Dr. Meyer said. “And it’s important that children enjoy exercise, so we recommend games like soccer, football, basketball and swimming – especially for obese children.

“Low perseverance and motivation seem to be distinctive for overweight children,” he said, noting his concern over the number of teens who dropped out of the six-month study. “We have intensive talks with children and their parents about their medical status and vascular changes. We let them know that it is their own decision to change their prognosis.”

To help children to monitor their success, Dr. Meyer recommends regular visits to the pediatrician combined with continuous support and encouragement from parents.

Albert P. Rocchini, MD, did not participate in the research, but is a pediatric cardiologist at C.S. Mott Children’s Hospital at the University of Michigan. Dr. Rocchini said he, too, is concerned about motivating overweight children, especially teen-agers, to lead healthier lives.

“That’s a very difficult problem,” Dr. Rocchini said. “Sometimes education helps to let them know that they aren’t invincible and they do have factors that will affect them very adversely as they grow older. We want young people to understand that now is the time to start dealing with health issues before they become permanent. But it takes time to get through to them.”

Studies like this help with the education process, Dr. Rocchini said, because they show how and why carrying extra weight can lead to cardiovascular disease. Not all previous studies have documented vascular changes in obese children.

“I would take this as good and bad news,” Dr Rocchini said of the study. “The bad news is, (early evidence of disease) is there, but the good news is it’s not fixed and permanent. There’s something you can do to make it better. That’s the important message to share with people.”

Source: American College of Cardiology 

Male? Obese? Twice as likely to die early

Study finds lifelong doubling in death risk for men who are obese at age 20 years

Stockholm, Sweden: Men who enter adult life obese face a life-long doubling of the risk of dying prematurely, new research has found.

In a study presented today (Tuesday) at the International Congress on Obesity in Stockholm, researchers tracked more than 5,000 military conscripts starting at the age of 20 until up to the age of 80. They found that at any given age, an obese man was twice as likely to die as a man who was not obese and that obesity at age 20 years had a constant effect on death up to 60 years later. They also found that the chance of dying early increased by 10% for each BMI point above the threshold for a healthy weight and that this persisted throughout life, with the obese dying about eight years earlier than the non-obese.

“As the obesity epidemic is still progressing rapidly, especially among children and adolescents, it is important to find out if obesity in early adulthood has lifelong mortality effects,” said the study’s leader, Esther Zimmermann, a researcher at the Institute of Preventive Medicine, Copenhagen University Hospital and the Institute of Biomedical Sciences at University of Copenhagen in Denmark. “Previous studies have investigated obesity and mortality in middle-aged populations, which only tells us about the detrimental effects of obesity in middle age. Our study sheds light on how obesity at age 20 years affects obesity throughout adult life. It is the first study with such a long follow-up time and thus the first study to investigate the lifelong effect.”

In the study, the researchers compared mortality in a sample of 1,930 obese male military conscripts with that in a random sample of 3,601 non-obese male conscripts. Body mass index (BMI) was measured at the average ages of 20, 35 and 46 years, and the researchers investigated that in relation to death in the next follow-up period. A total of 1,191 men had died during the follow-up period of up to 60 years. The results were adjusted to eliminate any influence on the findings from year of birth, education and smoking.

“At age 70 years, 70% of the men in the comparison group and 50% of those in the obese group were still alive and we estimated that from middle age, the obese were likely to die eight years earlier than those in the comparison group,” Zimmermann said. The researchers also investigated the effect of the broad BMI range on mortality from the age of 20 and found the lowest death risk in the men who had a BMI of 25. Underweight men had a slightly elevated risk, and the risk of early death crept up steadily by 10% for each BMI unit above 25 for those men who were overweight or obese.

Zimmermann said it is unclear whether it is being obese at age 20 that conferred the men’s increased death risk or whether the lifelong effect is due to obesity often being a lifelong condition for them. She said more research is warranted to find the answer to that question.

“More than 70% of the obese young men were still obese at the follow-up examinations, whereas only 4% of the men in comparison group developed obesity during follow-up. Obesity seems to be a persistent condition and it appears that if it has not occurred in men by the age of 20, the chance of it developing later are quite low. The persistence of obesity may partly explain why obesity at 20 years of age has lifelong mortality effects, but it needs to be proven whether that is the full explanation or whether, by itself, being obese at an early age increases the risk of early death,” she said.

Zimmermann said her group plans to study the patterns of ill health that caused the early death in the obese group, in order to determine whether the same diseases are causing death at different ages. Such information may shed some light on the mechanisms through which obesity works at different ages, she said.

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Her study was funded by grants from the Cluster for Endocrinology and Metabolism, University of Copenhagen, Denmark.

Source: International Association for the Study of Obesity

Obese Adolescents at Greatest Risk of Becoming Severely Obese Adults

Obese adolescents are 16 times more likely to become severely obese by age 30 than their healthy weight or even overweight peers, according to a new study from the University of North Carolina at Chapel Hill.

Public health researchers found that nearly 40 percent of obese adolescents are expected to become severely obese by age 30, compared to only 2.5 percent of healthy weight and overweight teenagers.

The study was published in the Nov. 10, 2010, issue of theJournal of the American Medical Association. It is believed to be the first longitudinal study to examine the persistence and development of severe obesity over the transition from the teenage to adult years.

The link found between adolescent obesity and adult severe obesity suggests intervention programs might be most effective during childhood or adolescence, before the worst weight gain occurs, said senior study author Penny Gordon-Larsen, Ph.D., associate professor of nutrition in the UNC Gillings School of Global Public Health and a fellow of the Carolina Population Center.

“Severe obesity can lead to life-threatening complications, including diabetes, hypertension, hyperlipidemia, asthma and arthritis, as well as substantial reductions in life expectancy,” she said. “It’s critical that we identify who is most at risk for this condition, and when they are most vulnerable to it. Then we’ll have better evidence for when and how to effectively intervene.”

Current weight loss drugs are either minimally effective or come with a high risk of side effects, while people who have bariatric surgery, or “stomach stapling” operations, can suffer major potential complications, said Natalie The, Ph.D., postdoctoral research associate and lead author of the study. Therefore, preventing severe obesity may be the most effective strategy to avoid obesity-related health risks, she said.

Researchers defined adult severe obesity as a body mass index (BMI) of greater than or equal to 40, and being overweight and obese as a BMI greater than 25.

The study found that while 1.2 percent of males and 2.4 percent of females who were normal weight as adolescents became severely obese as adults, 37 percent of males and 51 percent of females who were obese as adolescents became severely obese as adults. The risk of becoming severely obese was highest in black females.

“While we know that the transition from the teenage years to the adult years is one of high risk for weight gain, few studies have tracked individuals over time to understand the risk of developing severe obesity,” The said.

To measure the association between obesity in adolescence and severe obesity in adulthood, researchers studied data from the U.S. National Longitudinal Study of Adolescent Health. More than 8,800 people aged 12-21 in 1996 were followed into adulthood (ages 24-33 in 2007-2009).

Results showed that across all weight, sex and racial and ethnic groups, 7.9 percent of these teenagers who were not severely obese as adolescents became severely obese as young adults 13 years later. On the other hand, 70 percent of the teens who were severely obese remained so as they aged.

On average, over the period of the study, a teenage female of 5 feet 4 inches tall weighing 130 pounds who never developed severe obesity gained about 30 pounds; however a female of the same height who did become severely obese gained about 80 pounds.

“Obese adolescents are at considerably high risk for becoming adults with severe obesity,” Gordon-Larsen said. “Given the rapid rise in severe obesity and its associated health risks, early prevention efforts are critically needed.”

Along with Gordon-Larsen and The, the study co-authors were Chirayath Suchindran, Ph.D., professor of biostatistics, Kari North, Ph.D., associate professor of epidemiology, and Barry Popkin, Ph.D., professor of nutrition, all of the UNC Gillings School of Global Public Health.

The study’s title is “Association of Adolescent Obesity with Risk of Severe Obesity in Adulthood.”

Source: University of North Carolina at Chapel Hill