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High cardiovascular risk in severely obese young children and adolescents
  1. Nathalie M A van Emmerik1,
  2. Carry M Renders2,
  3. Marije van de Veer1,
  4. Stef van Buuren3,4,
  5. Olga H van der Baan-Slootweg5,
  6. Joana E Kist-van Holthe1,
  7. Remy A HiraSing1
  1. 1Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Faculty of Earth and Life Sciences, Department of Health Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
  3. 3Netherlands Organisation for Applied Scientific Research, TNO Quality of Life, Prevention and Health Care, Leiden, The Netherlands
  4. 4Department of Methodology and Statistics, University of Utrecht, Utrecht, The Netherlands
  5. 5Childhood Obesity Clinic, Treatment Center Heideheuvel, Hilversum, The Netherlands
  1. Correspondence to Joana Kist-van Holthe, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands; j.kist{at}


Objective To assess the prevalence of cardiovascular risk factors in severely obese children and adolescents.

Methods A nationwide prospective surveillance study was carried out from July 2005 to July 2007 where paediatricians were asked to report all new cases of severe obesity in 2–18-year-old children to the Dutch Paediatric Surveillance Unit. Severe obesity is defined by gender and age-dependent cut-off points for body mass index based on Dutch National Growth Studies corresponding to the adult cut-off point of 35 kg/m2. Paediatricians were asked to complete a questionnaire for every severely obese child regarding socio-demographic characteristics and cardiovascular risk factors (blood pressure, fasting blood glucose and lipids).

Results In 2005, 2006 and 2007, 94%, 87% and 87%, respectively, of paediatricians in the Netherlands responded to the monthly request from the Dutch Paediatric Surveillance Unit and 500 children with newly diagnosed severe obesity were reported. 72.6% (n=363) of paediatricians responded to a subsequent questionnaire. Cardiovascular risk factor data were available in 255/307 (83%) children who were correctly classified as severely obese. 67% had at least one cardiovascular risk factor (56% hypertension, 14% high blood glucose, 0.7% type 2 diabetes and up to 54% low HDL-cholesterol). Remarkably, 62% of severely obese children aged ≤12 years already had one or more cardiovascular risk factors.

Conclusion A high number (2/3) of severely obese children have cardiovascular risk factors. Internationally accepted criteria for defining severe obesity and guidelines for early detection and treatment of severe obesity and comorbidity are urgently needed.

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