Abstract
The prevalence of obesity in childhood is high and continues to increase globally.
It is currently estimated that 381 million children worldwide have overweight or obesity.
This disease stems from multiple complex pathways that can present early in life.
This is particularly concerning because childhood obesity is associated with cardiovascular
risk factors that can lead to early atherosclerosis and premature cardiovascular disease
(CVD). Hypertension, dysglycemia, dyslipidemia, and systemic inflammation are associated
with vascular changes in childhood, and these contribute to increased risk of cardiovascular
events in adulthood if not adequately treated. Interventions to treat childhood obesity
include multicomponent family-based behaviour modification programs, which have been
demonstrated to have moderate short-term effects on weight-related outcomes; their
effects on cardiovascular risk factors, however, are less well understood. Although
supervised, structured exercise interventions result in improvements in blood pressure,
inflammation, carotid artery intima media thickness, dysglycemia, dyslipidemia, and
endothelial dysfunction in children with obesity in the short term, our understanding
of how to translate these interventions into long-term sustainable exercise or physical
activity recommendations remains uncertain. Research focus in these areas will help
in treating childhood obesity and associated CVD risk factors to prevent CVD development
in adulthood.
Résumé
L’obésité juvénile est un problème très prévalent qui ne cesse d’augmenter à l’échelle
mondiale. Selon les estimations, quelque 381 millions d’enfants dans le monde souffriraient
d’embonpoint ou d’obésité. Cette maladie résulte de plusieurs parcours complexes,
qui peuvent s’amorcer très tôt au cours de la vie. Il s’agit d’un phénomène particulièrement
préoccupant, l’obésité juvénile étant associée à des facteurs de risque cardiovasculaire
pouvant entraîner une athérosclérose précoce et l’apparition prématurée de maladies
cardiovasculaires (MCV). L’hypertension, la dysglycémie, la dyslipidémie et l’inflammation
générale sont toutes associées à des changements vasculaires survenant durant l’enfance
qui, s’ils ne sont pas pris en charge comme il se doit, augmentent le risque de manifestations
cardiovasculaires à l’âge adulte. Les interventions visant à traiter l’obésité juvénile
comprennent des programmes de modification des habitudes de vie à plusieurs volets
s’adressant aux familles, qui se sont révélés avoir des effets à court terme modérés
sur les issues liées au poids; leur incidence sur les facteurs de risque cardiovasculaire
est toutefois moins bien comprise. Même si des programmes d’activité physique structurés
et supervisés ont à court terme des effets bénéfiques sur la pression artérielle,
l’inflammation, l’épaisseur de l’intima média carotidienne, la dysglycémie, la dyslipidémie
et la dysfonction endothéliale chez les enfants obèses, on ne comprend pas encore
bien comment transposer ces interventions en recommandations en matière d’activité
physique applicables à long terme. Des recherches plus poussées sur ces questions
aideront à traiter l’obésité juvénile et les facteurs de risque de MCV qui y sont
associés, afin de prévenir l’apparition de MCV à l’âge adulte.
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Article info
Publication history
Published online: July 02, 2020
Accepted:
June 26,
2020
Received:
February 3,
2020
Footnotes
See page 1358 for disclosure information.
Identification
Copyright
© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
