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(Circulation. 2003;108:e9071.)
© 2003 American Heart Association, Inc.

Overweight Children

Robin Fox, FRCP

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Among those who attended the AHA Scientific Sessions 2003, the prevalence of obesity was notably low, but in the surrounding streets and shops of Orlando, Fla, the picture was very different. The United States is indeed a leader in obesity—a condition now pandemic, with a billion people affected worldwide. The explanation, seemingly, lies in humankind’s hunter-gatherer inheritance, which leaves us ill equipped to deal with today’s abundant diet and sedentary lifestyle. About one third of obese individuals (mainly those with central obesity) develop either type 2 diabetes mellitus or its milder variant, the metabolic syndrome, in which hyperinsulinemia leads to excess cardiovascular risk. We face the prospect that the pandemic, as it gains momentum, will reverse all the population benefits achieved over the past decades through control of hyperlipidemia, hypertension, and tobacco smoking. Indeed, a plenary session was titled "The Obesity Epidemic: Will It Undo the Last 40 Years of Progress?" In it, Dr Scott M. Grundy (Dallas, Tex) summarized the pharmacological strategies for suppressing different components of the metabolic syndrome—hyperlipidemia, prothrombotic state, hypertension. He was hopeful, also, that cardiovascular risk will prove reducible by agents that lessen insulin resistance.

Dr Grundy did not discuss a proposal made in the British Medical Journal last June whereby a daily "polypill" (statin, antihypertensives, folic acid, aspirin), if taken by most men and women over age 55 years, would substantially reduce the population incidence of heart disease and stroke. Though this concept has been widely derided by the medical profession, it received sympathetic . . . [Full Text of this Article]