Obesity and cardiovascular disease risk in children and adolescents

Obesity is an important risk factor for cardiovascular disease (CVD) that affects health throughout an individual’s life. Despite these well-established associations of risk throughout the life course, debate continues over how to best assess this risk in pediatric populations. This article discusses the state of the art in this field, comprising three areas with clinical and research implications: measurement of adiposity, emerging cardiometabolic risks, and the debates surrounding pediatric metabolic syndrome (MetS). Body mass index for age percentiles remain the most economical assessment option, although other measurements may improve accuracy. Newly discovered fat-derived cardiometabolic factors have the potential to improve risk prediction and become targets for earlier intervention, but more research is needed. Finally, although MetS has received increasing attention, some question its validity and utility as a pediatric diagnosis. While important questions remain, there is consensus that prevention and treatment of childhood obesity should be the first-line approach to reducing the immediate and future risk of CVD.