NEJM Audio Summary - Nov 17, 2011

Excerpted Script

"Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors"
by Markus Juonala from University of Turku, Turku University Hospital, Finland.
In four prospective cohort studies, obese adults who were overweight or obese in childhood had increased rates of cardiovascular risk factors. Subjects with consistently high adiposity status from childhood to adulthood, as compared with persons who had a normal BMI as children and were nonobese as adults, had an increased risk of type 2 diabetes (relative risk, 5.4), hypertension (relative risk, 2.7), elevated low-density lipoprotein cholesterol levels (relative risk, 1.8), reduced high-density lipoprotein cholesterol levels (relative risk, 2.1), elevated triglyceride levels (relative risk, 3.0), and carotid-artery atherosclerosis (increased intima–media thickness of the carotid artery) (relative risk, 1.7) . Persons who were overweight or obese during childhood but were nonobese as adults had risks of the outcomes that were similar to those of persons who had a normal BMI consistently from childhood to adulthood. Overweight or obese children who were obese as adults had increased risks of type 2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. The risks of these outcomes among overweight or obese children who became nonobese by adulthood were similar to those among persons who were never obese.
Albert Rocchini, from  C.S. Mott Children's Hospital, Ann Arbor, Michigan, writes in editorials, that the authors found that, over an interval of almost 25 years, only 15% of subjects who were of normal weight as children were obese as adults, whereas 65% of those who were overweight or obese as children and 82% of those who were obese as children were obese as adults. These figures suggest that targeting interventions for obesity prevention and treatment specifically to children who are at high risk for becoming obese will prove to be a more valuable and more cost-effective strategy than targeting these interventions to whole populations of children.　（317 words / 150 sec = 127 wpm）

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