Childhood BMI and Risk of Coronary Heart Disease in Adulthood: Another Nail in the Coffin?

I just finished reading two interesting articles and an accompanying editorial published in the December 6, 2007 issue (subscribers get the issues a few days before the official publication date). The first article is entitled “Childhood Body-Mass Index and Risk of Coronary Heart Disease in Adulthood,” written by Jennier L. Baker and colleagues from the Institute of Preventive Medicine, Center for Health and Society in Copenhagen, Denmark (N Eng J Med 2007;357:2329-37). The second article is entitled “Adolescent Overweight and Future Adult Coronary Artery Disease,” was written by Kristen Bibbins-Domingo and colleagues from the Departments of Medicine, Epidemiology and Biostatistics, and Pharmacy at the University of California, San Francisco and San Francisco General Hospital and the College of Physicians and Surgeons, Columbia University. The editorial was entitled “Childhood Obesity- the Shape of Things to Come,” written by David S. Ludwig.

Both studies showed essentially the same thing- that overweight adolescents become overweight adults and develop serious complications associated with the overweight. There is really nothing new here except that the data are rather alarming and will, I hope, dispell the curent trend in the press to suggest that being overweight isn’t all that bad. I even heard a piece on NPR this afternoon about a study of people with BMIs up to 35, that apparently showed even rather obese people are in good enough condition to “pass” the treadmill test.

Wake up America

We as a society are exceedingly good at basically ignoring scientific data we don’t like. Whether it’s data about global warming, the high prevalence of people who do not have health insurance, or obesity, we work hard to find reasons to ignore the data. With respect to the obesity epidemic, we are particularly adept at giving only token consideration to the serious health issues. I continue to be amazed by the fast food ads on TV, which push higher and higher calorie (mostly fat) meals. Of course, the fast food indiustry knows that we haven’t really changed our eating habits a bit, despite the obesity data, and that the megameals sell.

So, what can we do?

The editorial accompanying the articles is pretty tame but it does summarize what most people already know about the prevalence and health risks of obesity. It is worth reading but isn’t particularly inspiring. I actually have no idea what would be inspiring. But I do urge physicians to stop burying their collective heads in the sand and let their patients know that obesity is bad for all of us, whether child or grown-up, and that we should develop individual prevention/treatment plans NOW, if we are to avoid disaster later. Does that mean I can’t have a triple cheeseburger tonight (maybe I’ll skip the fries)?

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