Abstract
Objective. Obesity, an epidemic in children in the United States and abroad, is associated with risk factors for cardiovascular disease (CVD). Less is known about the consequences of morbid obesity in children. In the rural Appalachian population, obesity rates have reached such high proportions that it is difficult to target individual children. Consequently, there is a need to determine whether the morbid obesity category is useful for recommending comprehensive assessment and intervention for the highest risk children. Results from the Coronary Artery Risk Detection In Appalachian Communities (CARDIAC) program informed the use of the morbidly obese category of body mass index (BMI) as a surrogate measure of CVD risk. Design. A total of 23 263 5th grade West Virginia students in the United States participated in a comprehensive risk factor screening between 2003 and 2008. Methods. Screening included the calculation of BMI, resting blood pressure, presence of acanthosis nigricans, and fasting lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides). Results. Six percent of participants were morbidly obese (BMI >99%). The morbidly obese category provided additional risk factor information than that provided by typically given weight categories, in addition to being a highly specific indicator of additional CVD risk factors. Conclusion. These findings suggest that children diagnosed as morbidly obese have significantly greater chance of experiencing various CVD risk factors than those without morbid obesity diagnosis; these results suggest that the morbidly obese BMI category can be effectively used to target those children at greatest risk when resources are limited.
Acknowledgements
The CARDIAC Project is mutually funded by the WV Bureau of Public Health, the Benedum Foundation, the Center for Disease Control and Prevention, and the Robert Wood Johnson Foundation. This work would not have been possible without the RHEP coordinators, school nurses, and CARDIAC team.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.