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There is no doubt that the prevalence of overweight and obesity is rapidly rising throughout the world. Although the USA continues to report the highest national obesity rates, the prevalence of obesity in both developed and developing countries is increasing dramatically and is approaching or matches US rates in some countries.1 This obesity epidemic is associated with a plethora of metabolic, psychological, social and financial consequences, with obesity itself and its consequent risks tracking from childhood into adulthood.2 Thus there is an obvious and immediate need for effective obesity prevention interventions among children and adolescents.
The studies by Wang et al3 and Hawkins et al4 address two separate but related issues regarding overweight and obesity among children and adolescents living in China and the UK. Wang et al studied the association between body mass index (BMI), percentage body fat (including fat mass index and lean mass index) and blood pressure in a cohort of 2500 Chinese twins aged 6–18 years of age. Their results indicate that both BMI and percentage body fat are significantly related to blood pressure. Important to note is that BMI was the strongest predictor of blood pressure, particularly systolic blood pressure.
These findings are important for two reasons. Firstly, they illustrate that it is not necessary to obtain direct measures of body fat in addition to BMI when assessing risk of high blood pressure in this population. This increases the potential for large-scale, repeated follow-up of this population, as BMI is much easier and less expensive to measure. Secondly, these results indicate that adiposity is positively associated with blood pressure even in this relatively lean group of children and adolescents. Thus it would appear that it is never too early to intervene in children to promote the maintenance of healthy weight, which …