Childhood Obesity and Stroke: A Rising Health Concern

Children


A recent study determined whether there is a relationship between childhood obesity and risk of stroke in adulthood.

Childhood obesity is a rising health concern that has reached epidemic proportions throughout the world. Obese children have a high risk of developing health problems as adults. One of the major health concerns related to childhood obesity is ischemic stroke that occurs due to an obstruction within a blood vessel supplying blood to the brain. Among young adults, it is the leading cause of acquired disability, loss of productive life-years, and death. Childhood obesity and stroke as a possible consequence have become critical public health concerns because of their high impact on an individual’s short-term as well as long-term health.

Body mass index (BMI), a measure of body fat based on height and weight, is used to categorize a person as underweight, normal weight, overweight, or obese.  Many studies have investigated the associations between childhood BMI and risk of adult ischemic stroke but the results have been inconsistent. However, it is important to clearly understand this association because of the high prevalence and implicated health concerns of childhood obesity.

A recent population-based cohort study in Denmark, published in the journal JAMA Neurology, investigated if childhood BMI and change in BMI are associated with adult ischemic stroke. The investigators used the Copenhagen School Health Records Register of 307,677 Danish children, 7 to 13 years of age born between 1930 and 1987.  BMI measurements (weight in kilogram divided by height in meters squared) at ages 7 and 13 were taken from 1936 to 2002 and followed up for a median of 26.4 years through national health registers from 1977 to 2012 in Denmark. The dates of analysis were September 1, 2015, to May 27, 2016.

During the follow-up period of the study, 3,529 women and 5,370 men were diagnosed with ischemic stroke. Among these, 23% of women and 23.4% of men were 55 years old or younger. However, no significant association between BMI and risk of later adult ischemic stroke was seen in adults older than 55 years.

The results of this large study clearly showed that above-average childhood BMI and an increase in childhood BMI are associated with an increased risk of early ischemic stroke. This occurred in patients who were younger than 55 years but not older than 55 years. In addition, the risk was found to be significantly higher in the heaviest children.

Strengths of this study include a large population-based cohort, measurements obtained by physicians and nurses, a long follow-up through national registers, and the relevance of the findings to individuals born as late as the 1980s. A low overall prevalence of overweight and obese children in the cohort is the main limitation of the study.

In conclusion, this study provides strong evidence of the association between childhood obesity and stroke. An above-average childhood BMI leads to an increased risk of ischemic stroke that is independent of child’s weight at birth. Increase in BMI during 7 to 13 years is associated with an increased occurrence of ischemic stroke before or at 55 years of age. Early personalized intervention to reduce and maintain childhood weight may help to reduce the risk of early stroke.

Written by Preeti Paul, MS Biochemistry

Reference:

Line K. Gjaerde et al., Association of Childhood Body Mass Index and Change in Body Mass Index with First Adult Ischemic Stroke, JAMA Neurology, published online August 21, 2017



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