Key result
Secondary prevention programs including dietary restriction and exercise effectively reduce cardiovascular risk factors in childhood obesity, though long-term safety data for medical therapies are lacking.
Childhood obesity drives early subclinical atherosclerosis, highlighting the importance of diet and exercise for secondary prevention, while primary prevention evidence remains less robust.
Supports diet/exercise programs for CV risk reduction in childhood obesity; leaves open long-term medical therapy safety and primary prevention needs.
Atherosclerosis of arterial vessels starts early in life, often in childhood. Subclinical atherosclerotic lesions can already be detected non-invasively in children presenting with cardiovascular risk factors. Impairment of endothelial function, pathologically altered intimamedia thickness and increased arterial stiffness are evident long before cardiovascular events occur. Childhood obesity is a key player in the pathogenesis of cardiovascular disorders since obesity causes metabolic, immunological and haemodynamic alterations preceding disease onset. The effectiveness of secondary prevention programmes that include dietary restriction and exercise has been well demonstrated. Pharmacotherapy and bariatric surgery can be helpful in the extremely obese who have co-morbidities, but long-term risk and safety profile results are lacking. Evidence of primary prevention programmes to avoid risk factor accumulation and disease onset is not as strong. Nevertheless, the positive effects of dietary recommendations and exercise programmes on risk factors have been documented.
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Beck et al. (2009) conducted a review in Cardiovascular risk and childhood obesity. Secondary prevention programs (dietary restriction and exercise) was evaluated. Secondary prevention programs including dietary restriction and exercise effectively reduce cardiovascular risk factors in childhood obesity, though long-term safety data for medical therapies are lacking.
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