How much weight loss is needed to improve cardiometabolic outcomes in children with obesity?

Many children with obesity do not present with cardiometabolic risk factors, such as high blood pressure, high cholesterol, and insulin resistance.

A couple of years ago, we reported that 20 – 30% of children may be classified as ‘metabolically healthy obesity’ (MHO), despite having a high level of body fat. Despite this heterogeneity, it’s clear that most boys and girls with obesity have one or more risk factors, placing them at increased risk for chronic health conditions such as cardiovascular disease (CVD) and type 2 diabetes (T2D).

As a companion to the recently-published clinical practice guidelines in the Journal of Clinical Endocrinology and Metabolism, Rajjo and colleagues published a systematic review (see pdf below) that examined the degree of weight loss that was associated with improvements in blood pressure and cholesterol levels. As the authors highlighted, the degree of weight loss that was associated with improvements in traditional risk factors was fairly modest (e.g., a 1 mg/dL increase in HDL-cholesterol was associated with <1.0 kg weight loss).

The source of motivation for families to make healthy lifestyle changes can come from many different places. For those who are driven to make changes to reduce risk factors for CVD and T2D, these findings offer encouraging, clinically useful information, especially for those in pediatric weight management.

GB

Weight Loss and Cardiometabolic Improvements in Children – JCEM, 2016

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