Health and fitness of German schoolchildren: Overweight and obesity are significantly associated with cardiovascular risk factors

Abstract

Background: Obesity and a lack of exercise represent a risk for cardiovascular diseases in children. The goal of the study was to assess the cardiovascular health and physical fitness of German primary and secondary schoolchildren and to determine possible influencing factors. Methods: In a prospective cross-sectional study 357 children (aged 9.6 ± 1.7 years) were investigated for cardiovascular risk factors. Pulse wave velocity (PWV) measurements were performed to assess arterial elasticity as well as ergometry and fitness tests. Results: Of all children 24% were overweight (body mass index, BMI >90th percentile) or obese (BMI >97th percentile). Almost all these children suffered from visceral obesity (99%). Children with overweight/obesity more frequently showed a lower vascular elasticity (PWV standard deviation score, SDS 0.8 ± 1.0 vs. 0.2 ± 0.9 for children without overweight, p < 0,001; PWV values >95th percentile in 24% vs. 3%). The presence of overweight/obesity, primary school age, higher blood pressure and lower high-density lipoprotein cholesterol (HDL) were independent predictors for reduced arterial elasticity. Furthermore, overweight/obese children exhibited higher systolic blood pressure, a disadvantageous lipid profile, higher uric acid and alanine transaminase (ALT) values as well as reduced physical fitness and higher media screen times. BMI was significantly associated with glomerular filtration rate. Conclusion: The higher cardiovascular risk accompanying elevated BMI and reduced physical fitness is exacerbated by additional risk factors for the development of a metabolic syndrome. Furthermore, signs of structural changes of the vasculature can be detected. The data implicate a comprehensive assessment of the individual cardiovascular risk in overweight/obese children and underline the necessity for preventive measures to be implemented into the children’s daily routine early in life in order to reduce cardiovascular morbidity in adulthood.