Childhood Obesity: Future Health Issues

Obesity is an ongoing global epidemic, moreover, childhood obesity is an alarming public health concern for a wide range of reasons, one of those is cardiovascular disease (CVD). Research indicates that childhood obesity not only affects immediate health but also makes them more likely to suffer from high blood pressure later in life.

Hypertension (high blood pressure) is another global public health challenge due to its high prevalence and the associated risk of cardiovascular disease. Approximately 1.28 billion adults between the ages of 30-79 years old are living with hypertension, which is the main cause of strokes, heart attacks, and chronic disease. High blood pressure is one of the most preventable and treatable causes of premature deaths, with the modifiable risk factors including being physically inactive, maintaining a sedentary lifestyle, following an unhealthy diet, and being overweight/obese. 

Recent research that will be presented at the European Congress on Obesity (ECO 2024) in Venice on May 12-15, 2024, suggests that high blood pressure may even originate early in life, and that preventing overweight and obesity during the early developmental years may help to reduce the substantial disease burden that is associated with high blood pressure later in life. 

The results of this Swedish population-based study showed that blood pressure in adult men increased in a linear relationship with higher childhood BMI at 8 years old and a greater BMI change during puberty, independent of each other, while in women, blood pressure in middle age increased in a linear association with greater BMI during puberty but not with childhood BMI.

“Our results suggest that preventing overweight and obesity beginning in childhood matters when it comes to achieving a healthy blood pressure in later life,” says lead author Dr. Lina Lilja from the University of Gothenburg in a statement. “Children and teenagers living with overweight or obesity might benefit from targeted initiatives and lifestyle modifications to reduce the substantial disease burden associated with high blood pressure in later life from diseases such as heart attacks, strokes, and kidney damage.”

For this study data from 1,683 participants who were enrolled in both the BMI Epidemiology Study Gothenburg (BEST) cohort and the Swedish CArdioPulmonary bioImage Study (SCAPIS) population-based cohorts, was analyzed to examine the association between BMI during development and blood pressure in midlife using school health care records, medical examination history, or military health records. 

The analysis revealed that both childhood and pubertal BMI changes for men resulted in an increase of one BMI unit from average BMI in childhood and was associated with a 1.30 mmHg increase in systolic blood pressure and a 0.75 mmHg increase in diastolic blood pressure, independent of each other. One BMI unit increase in pubertal BMI was associated with a 1.03 mmHg increase in systolic blood pressure and a 0.53 mmHg increase in diastolic blood pressure in middle age, independent of each other. Additionally, among women, one BMI unit increase in pubertal BMI was associated with a 0.96 increase in systolic blood pressure and a 0.77 increase in diastolic blood pressure in middle age, irrespective of childhood BMI; while childhood BMI was not linked to increases in blood pressure at midlife, irrespective of the pubertal BMI change. 

“Although the differences in blood pressure are not very large, if blood pressure is slightly elevated over many years, it can damage blood vessels and lead to cardiovascular and kidney disease”, explains co-author Dr. Jenny Kindblom from Sahlgrenska University Hospital in Sweden. “Our findings indicate that high blood pressure may originate in early life. Excessive fat mass induces chronic low-grade inflammation and endothelial dysfunction [impaired functioning of the lining of the blood vessels] already in childhood. Higher amounts of visceral abdominal fat increases the risk of developing hypertension in adults. And we have previously shown that a large pubertal BMI change in men is associated with visceral obesity [fat around the internal organs] at a young adult age. So enlarged visceral fat mass might, in individuals with a high BMI increase during puberty, be a possible mechanism contributing to higher blood pressure.”

“This study is important given the rising tide of obesity among children and teens. It is vital that we turn the focus from high blood pressure in adults to include people in younger age groups,” adds Kindblom. 

It was noted that this was an observational study and that the study was not without limitations. The researchers also noted that additional research is required to have a clearer understanding of the associations and/or definite cause-and-effect link between obesity in developmental years and blood pressure in adulthood.