Philip J. Goscienski, M.D.
It's something that pediatricians never had to contend with a couple of generations ago: huge numbers of school kids with hypertension and type 2 diabetes. In a group of obese adolescents described in the New England Journal of Medicine in 2002, nearly all (97 percent) had at least four markers that eventually lead to heart attack and stroke. Fatty deposits in the aorta, the main artery leading from the heart and the coronary arteries that bring oxygen to the heart muscle, begin to show up as early as three years of age.
The knowledge that risk factors that foretell heart attack, stroke and type 2 diabetes are evident very early is not something that has just suddenly appeared. Studies on a large childhood population that began in Bogalusa, Louisiana in the early 1970s revealed that 5- to 10-year-old children who had 4 or more markers for heart disease were all obese. Eighty percent of obese adolescent children had high blood pressure.
Fatty liver disease is directly related to obesity and it is present in approximately half of obese children. It eventually leads to cirrhosis, severe scarring of the liver that physicians of my era saw only among alcoholics and persons with infectious hepatitis. By the time today's newborns reach early middle age it will have become the leading reason for liver transplantation. Yet those who are trying to estimate the future cost of medical care are barely aware of it.
Pediatricians in training at major medical centers of our largest cities are learning how to spot risk factors for chronic diseases that didn't occur until at least middle age in the past. It is extremely likely that a child who is overweight or obese during early childhood will remain so into adult life. Using standard growth charts that should be on every child's medical record from the time of the first well-baby visit, health care providers are able to identify abnormal weight gain.
Besides recognizing overweight and obesity very early, healthcare workers who care for children should not hesitate to look for clues that reveal the risk of later heart disease, stroke, type 2 diabetes and other problems that will eventually severely reduce the quality of life of that young patient. The necessary changes in diet and lifestyle cost nothing. The current trend can only lead to national insolvency.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at firstname.lastname@example.org.