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 

Are you being your own best friend or your worst enemy?

Some obese people perceive body size as OK, dismiss need to lose weight

Some obese people misperceive that their body size is normal and think they don’t need to lose weight, according to research presented at the American Heart Association’s Scientific Sessions 2009.

In the Dallas Heart Study of 5,893 people, researchers found that 8 percent of the 2,056 who were obese said they were satisfied with their body size or felt they could gain weight.

“Almost one in 10 obese individuals are satisfied with their body size and didn’t perceive that they need to lose weight,” said Tiffany Powell, M.D., lead author of the study and a cardiology fellow at the University of Texas Southwestern Medical Center in Dallas. “That is a sizeable percentage who don’t understand they are overweight and believe they are healthy.”

Participants included about 50 percent blacks, 20 percent Hispanics and 30 percent whites, similar to other urban populations, Powell said. About half – 54 percent – were women. African Americans (14 percent) and Hispanics (11 percent) were significantly more likely than whites (2 percent) to be satisfied with their body size and believe that they did not need to lose weight.

Using the sex-specific Stunkard nine-figure scale, participants chose the figure that represented their present body size and the figure that represented their ideal body size. Self-perceived ideal body size was classified as below normal, normal and above normal. Body size discrepancy, a measure of body size satisfaction, was calculated as the difference between self-perceived actual and self-perceived ideal body sizes.

Those with a misperception of body size believed they were healthy. But 35 percent of them had high blood pressure, 15 percent had high cholesterol, 14 percent had diabetes and 27 percent were current smokers. These risk factors are similar to obese individuals who acknowledged they had a weight problem and needed to lose weight, Powell said.

Overall, 2 percent to 3 percent of the study population perceived an above-normal body size as ideal. Compared to subjects who perceived their ideal body size as normal, those who perceived ideal body size to be above normal were more likely to be women, African American and had higher body mass index, blood pressure and higher insulin resistance.

Researchers also found:

• Those who misperceived their body size were less likely to go to a physician. In fact, 44 percent didn’t visit a physician during the past year, compared to 26 percent of obese participants who correctly perceived they needed to lose weight.
• There was no significant difference between the two groups in socioeconomic status or access to health care due to insurance status.
• Among those who did see a physician in the past year, the obese individuals who did not feel they needed to lose weight were much less likely to report that their physician had told them they need to lose weight compared to those who perceived they needed to lose weight (38 percent vs 68 percent). Moreover, only 38 percent talked with their physician about dietary changes, while 64 percent of those with a more accurate body perception talked about changes.
• Obese people who were satisfied with their body size didn’t exercise, while obese individuals who recognized they had a weight problem exercised regularly, on average.

The major limitation of the study is that researchers couldn’t infer causality between associated beliefs and behaviors because the study is cross-sectional.

“This is an important population that we aren’t seeing or targeting,” Powell said. “Understanding and countering this misconception may be a novel and perhaps vitally important target for obesity prevention and treatment. Because many of these individuals believe they are healthier than they really are, they do not go to the doctor and thus community interventions will be needed. However, Powell also emphasized that her findings show that physicians need to talk with their obese patients about exercise and weight loss. “The onus falls on us as physicians to determine who this population is and how to talk with them.”

Source: American Heart Association

How much do you weight? Be honest, you’re life could depend on it…

Obese and overweight women, children underestimate true weight

Overweight and obese mothers and their children think they weigh less than their actual weight, according to research reported at the American Heart Association’s Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention 2011 Scientific Sessions.

In the study of women and children in an urban, predominantly Hispanic population, most normal weight women and children in the study correctly estimated their body weight, but most obese women and children underestimated theirs.

“Obesity is a well-known risk factor for the development of many diseases, including heart disease and diabetes,” said Nicole E Dumas, M.D., lead author and an internal medicine resident at Columbia University Medical Center in New York City. Dumas and colleagues surveyed women and their pre-adolescent children attending an urban, primary care center in New York City. They asked the subjects about their age, income, heart disease risk factors, and perceptions of their body size using silhouette images that corresponded to specific body mass index (BMI) types — for example, underweight, normal and overweight.

The researchers also recorded participants’ height, weight and BMI, which is a measurement of body weight based on height. A BMI of 25-29 is overweight, and a BMI over 30 is obese.

The researchers found:

• 65.8 percent of the mothers surveyed were overweight or obese.
• 38.9 percent of children surveyed were overweight or obese.
• 81.8 percent of obese women underestimated their weight compared to 42.5 percent of overweight and 13.2 percent of normal weight women; similarly, 86 percent of overweight or obese children underestimated their weight compared to 15 percent of normal weight children.
• Of mothers with overweight or obese children, almost half (47.5 percent) thought their children were of normal weight.
• Children selected larger body images than those chosen by their mothers to describe an “ideal” or “healthy” body image for a woman.
• 41.4 percent of the children in the study thought their moms should lose weight.

“These findings imply that not only is obesity prevalent in urban America, but that those most affected by it are either unaware or underestimate their true weight,” she said. “In addition, obesity has become an acceptable norm in some families. Strategies to overcome the obesity epidemic will need to address this barrier to weight loss.”

Future research should include interventions that study the effect of increased accuracy of body image perception on weight loss among families.

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Co-authors are Robert R Sciacca, Eng.Sc.D.; Jennifer Decolongon, M.D.; Juviza K. Rodriguez, B.A.; and Elsa-Grace V Giardina, M.D.

Author disclosures are on the manuscript. The study was funded by the Department of Health and Human Services and the Arlene and Joseph Taub Foundation.

Note: Actual presentation time is 5 p.m. ET, Wednesday, March 23, 2011.

Statements and conclusions of study authors published in American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available atwww.americanheart.org/corporatefunding.

Source: American Heart Association