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Making the Case for Earlier Intervention
CHORI Scientists Show Correlation Between Childhood Obesity, Poor Diets and Precursors for Heart Disease

CHORI scientists Ashutosh Lal, MD, Michele Mietus-Snyeder, MD, Bruce Ames, PhD, and their colleagues in CHORI's Center for Nutrition & Metabolism, made waves at this spring's Annual Preventative Cardiology Meeting of the American Heart Association in Atlanta in March, 2011. Their presentation, Metabolic Burden of Nutritional Deficiency in Obese Children and Adolescents, highlighted research showing that obese children who were consuming poor diets presented with an alarmingly high number of precursors for heart disease later in life.

"We looked at different aspects of the metabolism of children with obesity as compared to children without obesity and showed that many of the processes that eventually lead to heart disease are already visible in obese children," says Dr. Lal.

“Many of the processes that eventually lead to heart disease are already visible in obese children.”

Heart disease is the number one cause of death in the United States, and may eventually become the number one cause of death worldwide. As a result, there is a great deal of interest in targeted interventions, especially in children, to reduce the incidence of cardiovascular disease in adults. Dr. Lal's study, which used highly sensitive methods to measure different levels of metabolism in obese and normal-weight children, underscores the necessity of early interventions.

The differences between the obese and normal-weight children were enormous," says Dr. Lal. "C-reactive protein levels, which are a marker of increased inflammation, were almost ten times higher than in healthy-weight children. Insulin levels were off the charts, indicating a predisposition for type 2 diabetes. And the levels of oxidative stress, were 125 percent higher."

The other significant difference between the obese and normal-weight children was the quality of their diets.

"While neither groups' diet met the currently recommended dietary guidelines for nutritional intake, the quality of the diet was definitely worse in the children with obesity, in particular with regard to a significant lack of fruit and dairy consumption," Dr. Lal explains.

Significantly, diets of the children in the obese group were low in potassium, and vitamins C, D, and A all nutrients found in fortified dairy products and fresh produce. As a result, clinicians who deal with obese children shouldn't just be focused on reducing the amount a child eats, points out Dr. Lal. Instead, they should focus on the quality of what the child eats, making sure that the diet is sufficient in micronutrients.

“It’s not just the quantity of the diet that is important, but the quality. You can get calories from almost anything, but you can’t get micronutrients from just anything.”

As Dr. Lal explains, "There was a clear association between lower quality diets and increased markers of inflammation and other metabolic abnormalities associated with heart disease in adulthood."

While the process by which a poor diet lacking in micronutrients might produce the biochemical changes seen in the study requires further exploration, the results couldn't be clearer in terms of providing earlier interventions for obese children.

"These kids who have significant markers for heart disease are going about their daily lives like nothing is really going on. What we show here is that serious things are really going on underneath the surface that we must pay significant attention to, because the changes that result in heart disease are already being set in motion," says Dr. Lal.


Friday, June 10, 2011 9:55 AM

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