Abstract 1474: Cardiovascular Impact of Pediatric Obesity Epidemic Across Generations
The prevalence of overweight and obese children has tripled in one generation’s time; 31.9% of US children and adolescents are overweight. Our aim was to evaluate secular changes in body mass index (BMI) and left ventricular mass in today’s children vs. those a generation ago.
Methods: All patients between 2–19 years of age who underwent echocardiography in 1986 – 88 (Prior Era) and in 2008 (Current Era) at Cincinnati Children’s Hospital Medical Center and who were without any heart disease or systemic disease were included. BMI, BMI z-score, LV mass indexed to height raised to a power the 2.7 (LVMI), and relative wall thickness (RWT) were calculated. Cardiac geometries were assigned based on LVMI and RWT: normal, concentric hypertrophy, eccentric hypertrophy, or concentric remodeling. Regression analysis was performed to identify determinants of LVMI.
Results: There were 350 patients in the Prior Era and 351 age- and gender-matched patients in the Current Era. Mean BMI and LVMI were both significantly higher in the Current Era (19.93±5.58 vs. 18.08±3.81 kg/m2, p<0.0001, 32.65±7.79 vs. 31.41±8.11 g/m2.7, p<0.04 respectively). There was no significant difference in cardiac geometry (p=0.14). Determinants of LVMI were older age, male gender and elevated BMI (p<0.0001, p<0.0001, p<0.001 respectively); African-American race trended toward significance (p=0.06).
Conclusions: Today’s children have higher LVMI and BMI than their counterparts a generation ago. Health care professionals should not accept current trends in childhood BMI and LVMI when determining if a child is healthy and normal from a cardiac standpoint. Reversal of this trend is needed, and intervention is required.