Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood.

Vesna Herceg-Čavrak,Julio Alvarez-Pitti,Claudio Borghi,Elke Wühl,Beatriz Gonzalez Lopez-Valcarcel,Artur Mazur,Małgorzata Wójcik,Dorota Drozdz,Michał Brzeziński,Empar Lurbe,Rosita Gabbianelli

doi:10.3390/nu13114176

Abstract

Obesity has become a major epidemic in the 21st century. It increases the risk of dyslipidemia, hypertension, and type 2 diabetes, which are known cardiometabolic risk factors and components of the metabolic syndrome. Although overt cardiovascular (CV) diseases such as stroke or myocardial infarction are the domain of adulthood, it is evident that the CV continuum begins very early in life. Recognition of risk factors and early stages of CV damage, at a time when these processes are still reversible, and the development of prevention strategies are major pillars in reducing CV morbidity and mortality in the general population. In this review, we will discuss the role of well-known but also novel risk factors linking obesity and increased CV risk from prenatal age to adulthood, including the role of perinatal factors, diet, nutrigenomics, and nutri-epigenetics, hyperuricemia, dyslipidemia, hypertension, and cardiorespiratory fitness. The importance of ‘tracking’ of these risk factors on adult CV health is highlighted and the economic impact of childhood obesity as well as preventive strategies are discussed.

Highlights

The increasing prevalence of overweight and obesity, key components of the metabolic syndrome (MetS), in the pediatric and adult population poses a high risk of health complications and is associated with social and economic consequences.According to the World Health Organization (WHO), the worldwide overall prevalence of obesity has nearly tripled since 1975
Some suggest a lower prevalence of overweight and obesity in children who were fed breast milk compared with infant formula, optimal duration of breastfeeding to provide substantial benefits remains unknown [14]
Glucose excess is directly associated with hyperinsulinemia, while fructose excess increases uric acid levels and very-low-density lipoprotein (VLDL) levels leading to hyperuricemia and liver steatosis [18]

Summary

Introduction

The increasing prevalence of overweight and obesity, key components of the metabolic syndrome (MetS), in the pediatric and adult population poses a high risk of health complications and is associated with social and economic consequences. Among children and adolescents aged 5 to 19, the prevalence of overweight and obesity has risen even more dramatically: overweight increased from just 4% in 1975 to over 18% in 2016, while obesity increased from under 1% in 1975, to 6% in girls and 8% in boys. Numerous studies have shown the existence of a CV continuum, in which pathological processes begin as a result of various risk factors and lead to permanent changes and CV complications through endothelial damage, vascular and myocardial remodeling, and atherosclerotic processes. These changes may begin in early childhood and over time significantly increase the CV risk in young adults. In this review we will discuss the importance of an early diagnosis and effective treatment of childhood obesity and the linked early and potentially reversible cardiovascular damage in children and adolescents to prevent CV complications, which remain the main cause of morbidity and mortality in the general population

Perinatal and Early Life Risk Factors

Maternal Risk Factors

Early Childhood Risk Factors

Molecular Techniques and Their Contribution to Understanding Programming

Diet as a Risk Factor for Obesity and Cardiovascular Complications

Nutrigenomics and Nutri-Epigenetics

Obesity or Cardiorespiratory Fitness—What Does Really Matter?

The Role of Tracking in Increased CV Risk in Adulthood

The Economic Impact of Childhood Obesity

Preventive Strategies for Hypertension in Children

Conclusions

25 Years Later