Abstract
Overweight and obesity in youth is a worldwide public health problem. Overweight and obesity in childhood and adolescents have a substantial effect upon many systems, resulting in clinical conditions such as metabolic syndrome, early atherosclerosis, dyslipidemia, hypertension and type 2 diabetes (T2D). Obesity and the type of body fat distribution are still the core aspects of insulin resistance and seem to be the physiopathologic links common to metabolic syndrome, cardiovascular disease and T2D. The earlier the appearance of the clustering of risk factors and the higher the time of exposure, the greater will be the chance of developing coronary disease with a more severe endpoint. The age when the event may occur seems to be related to the presence and aggregation of risk factors throughout life.The treatment in this age-group is non pharmacological and aims at promoting changes in lifestyle. However, pharmacological treatments are indicated in special situations.The major goals in dietary treatments are not only limited to weight loss, but also to an improvement in the quality of life. Modification of risk factors associated to comorbidities, personal satisfaction of the child or adolescent and trying to establish healthy life habits from an early age are also important. There is a continuous debate on the best possible exercise to do, for children or adolescents, in order to lose weight. The prescription of physical activity to children and adolescents requires extensive integrated work among multidisciplinary teams, patients and their families, in order to reach therapeutic success.The most important conclusion drawn from this symposium was that if the growing prevalence of overweight and obesity continues at this pace, the result will be a population of children and adolescents with metabolic syndrome. This would lead to high mortality rates in young adults, changing the current increasing trend of worldwide longevity. Government actions and a better understanding of the causes of this problem must be implemented worldwide, by aiming at the prevention of obesity in children and adolescents.
Highlights
The worldwide concept of metabolic syndrome in children and adolescents is still a matter of discussion mainly because studies on this age group are scarce
Metabolic Syndrome Diagnosis in Children and Adolescents Several large epidemiology cohort studies have documented that obesity and metabolic syndrome are associated with cardiovascular outcomes in adults, such as myocardial infarction, cerebrovascular disease and sudden death [1]
There has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents [2]
Summary
The worldwide concept of metabolic syndrome in children and adolescents is still a matter of discussion mainly because studies on this age group are scarce. In obese adolescents with metabolic syndrome, there was an improvement in cardiovascular risk factors such as a decrease in blood pressure, triglyceride levels, glucose levels and in insulin resistance (determined by HOMAR), as well as an increase in HDL-cholesterol levels [37] It was noted in this study that, the reduction in insulin resistance was associated to weight loss. Several studies have shown that both obese children and adolescents respond well to 30-40 minutes of physical activity, 3 times a week, improving cardiovascular conditioning and the metabolic syndrome components such as hypertriglyceridemia, hyperinsulinemia and arterial hypertension, even if weight loss is minimal, as long as the intervention is continuous and combined with good dietary counseling [44,45]. The proper treatment and especially the prevention must be attentively looked at by everyone involved in caring for children at risk of T2D mellitus
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