Severe obesity in children: prevalence, persistence and relation to hypertension

Abstract

BackgroundNewer approaches for classifying gradations of pediatric obesity by level of body mass index (BMI) percentage above the 95th percentile have recently been recommended in the management and tracking of obese children. Examining the prevalence and persistence of severe obesity using such methods along with the associations with other cardiovascular risk factors such as hypertension is important for characterizing the clinical significance of severe obesity classification methods.MethodsThis retrospective study was conducted in an integrated healthcare delivery system to characterize obesity and obesity severity in children and adolescents by level of body mass index (BMI) percentage above the 95th BMI percentile, to examine tracking of obesity status over 2–3 years, and to examine associations with blood pressure. Moderate obesity was defined by BMI 100-119% of the 95th percentile and severe obesity by BMI ≥120% × 95th percentile. Hypertension was defined by 3 consecutive blood pressures ≥95th percentile (for age, sex and height) on separate days and was examined in association with obesity severity.ResultsAmong 117,618 children aged 6–17 years with measured blood pressure and BMI at a well-child visit during 2007–2010, the prevalence of obesity was 17.9% overall and was highest among Hispanics (28.9%) and blacks (20.5%) for boys, and blacks (23.3%) and Hispanics (21.5%) for girls. Severe obesity prevalence was 5.6% overall and was highest in 12–17 year old Hispanic boys (10.6%) and black girls (9.5%). Subsequent BMI obtained 2–3 years later also demonstrated strong tracking of severe obesity. Stratification of BMI by percentage above the 95th BMI percentile was associated with a graded increase in the risk of hypertension, with severe obesity contributing to a 2.7-fold greater odds of hypertension compared to moderate obesity.ConclusionSevere obesity was found in 5.6% of this community-based pediatric population, varied by gender and race/ethnicity (highest among Hispanics and blacks) and showed strong evidence for persistence over several years. Increasing gradation of obesity was associated with higher risk for hypertension, with a nearly three-fold increased risk when comparing severe to moderate obesity, underscoring the heightened health risk associated with severe obesity in children and adolescents.

Race and Obesity in Adolescent Hypertension

“…This pattern of obesity prevalence among the 4 groups has also been reported in a clinical electronic medical recordbased study of 117 618 children between the ages of 6 and 17 years in California, Colorado, and Minnesota. 14 Other diverse cohorts have also demonstrated a higher prevalence of obesity in Hispanic and African American populations relative to the non-Hispanic white population. 15,16 We observed a spike in sustained hypertension prevalence among adolescents with a BMI <5th percentile (Fig 2).…”

Slik måler du blodtrykk på barn

“…Overvekt og fedme hos barn er et økende helseproblem og en viktig risikofaktor for utvikling av HT (29). Hos barn med overvekt og fedme er prevalensen av HT henholdsvis 4-11 prosent og 11-33 prosent (30).…”

The childhood obesity epidemic: A mini review

“…Children who participated in physical activity 5-7 times/week were less likely to have persistent low selfesteem than were those who rarely participated. [2] Environmental, socioeconomic, and lifestyle risk factors often overlap, in that environmental factor can result in unhealthy diets and insuffi cient physical activity. Family physicians should consider genetic and medical risk factors for overweight and obesity.…”

“…Children who participated in physical activity 5-7 times/week were less likely to have persistent low self-esteem than were those who rarely participated. [2] Parents can be a good example for their children by modeling healthful eating behaviors and being physically active. Parents can also be effective advocates by being involved in efforts in their schools, and community to expand the access and availability of opportunities for physical activity and healthful eating.…”