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What Is Best Predictor of Future Cardiovascular Risk in Kids? Body mass index (BMI) is the ratio of weight of the body in kilograms to the square of its height in meters. Because of its ease of measurement and calculation, it is the most widely used tool for measuring body fat. In many prior studies, the long-term consequences of childhood obesity have used BMI as the primary measuring tool. However, researchers from the University of Georgia, the Menzies Research Institute in Hobart, Australia and the Murdoch Childrens Research Institute in Melbourne, Australia suggested that waist circumference, rather than BMI, is the best clinical measure to predict a child's risk for cardiovascular disease and diabetes later in life. In the findings published on September 28, 2010 in the International Journal of Obesity, they reported that children with high waist circumference values (in the top 25 percent for their age and sex) were between 5 and 6 times more likely than children with low waist circumferences (in the bottom 25 percent) to develop metabolic syndrome by early adulthood. Metabolic syndrome refers to a group of risk factors linked to overweight and obesity that could raise the risk of developing medical disorders including heart disease, stroke and Type-2 diabetes. In general, a person who has metabolic syndrome is twice as likely to develop heart disease and 5 times as likely to develop diabetes as those without metabolic syndrome.
About 25 percent of American adults have metabolic syndrome and the number is growing. Metabolic syndrome is expected in the near future to overtake smoking as the leading risk factor for heart disease. The aim of the study is to identify which clinical measure of childhood body composition can best predict long-term cardio-metabolic health risks and the study is believed to be one of the first for such purpose. The long-term study consisted of a 20-year follow up of 2,188 Australians who had participated in the 1985 Australian Schools Health and Fitness Survey, when they aged between 7 and 15 years. The data collected included height and weight, waist and hip circumferences and skinfold thickness. When they became adult, they then attended one of the 34 study clinics held across Australia between the years of 2004 to 2006, where they underwent a range of health and fitness assessments. Their component indicators of the metabolic syndrome, including waist circumferences, fasting blood glucose, blood pressure and lipids, were measured. After comparing a wide range of body composition measures, waist circumference was indentified as the best measure for predicting subsequent risks. Despite the usefulness, BMI does not distinguish between fat and non-fat weight or indicate where the fat is located. Its limitation can also lead to misclassification of certain individuals like those with increased muscle mass or the elderly. Waist circumference measurements, on the other hand, indicate the amount of fat located centrally in the body. Waist circumference measures the distance around the abdomen, which has been shown by prior studies to be particularly bad for cardio-metabolic health. This also explains why waist circumference is strongly associated with adult metabolic syndrome. Parents would undoubtedly wish to know whether their children would be 5 to 6 times more likely to have early cardio-metabolic health issues. And, it is clear from the findings that measuring body composition could identify those children who are at higher risk for future health problems in a simple and cost effective manner. Researchers do realize that introducing waist circumference measurement in schools could be controversial because of potential stigmatization. However, they still insist of implementing, as early identification of children at higher risk for future health problems due to excess body fat is a very important task. Bear in mind that metabolic syndrome could be prevented or delayed by making changes in one’s lifestyle. Nevertheless, successfully controlling metabolic syndrome might require effort and teamwork with the respective healthcare providers on a long-term basis.
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