The American Heart Association conference entitled “Obesity: Impact on Cardiovascular Disease” was held May 22–24, 1998, in Amelia Island, Fla. It was cosponsored by Futura Media Services and the American Heart Association Councils on Cardiovascular Nursing; Arteriosclerosis, Thrombosis, and Vascular Biology; Cardiovascular Disease in the Young; Clinical Cardiology; Epidemiology and Prevention; and High Blood Pressure Research; the AHA Nutrition Committee; and the AHA Prevention Coordinating Committee. The proceedings are summarized briefly in this report. A monograph of the conference will be published by Futura Publishing Company, Inc.
Obesity is an important determinant of cardiovascular disease (CVD). Previous epidemiological studies of obesity have documented a modest association of obesity and risk of CVD, especially in younger age groups. The study of obesity and CVD should now focus on weight change over time, especially differences between childhood versus younger and older adult weight gains, and the distribution of body fat, especially visceral or intra-abdominal fat. Weight gain during young adult life may be one of the most important determinants of cardiovascular risk factors. Increased intra-abdominal fat, or waist circumference, is probably related to a constellation of risk factors, the so-called insulin resistance syndrome. It is also associated with higher levels of inflammatory markers such as C-reactive protein and fibrinogen.
The increasing prevalence of obesity in children is cause for great concern. There is no definition of obesity in children that relates body mass index (BMI) to health outcomes. However, >20% of children aged 6 to 17 years are >20% overweight at the 85th percentile of BMI, and 10% of children aged 6 to 17 are overweight at the 95th percentile. It appears that 50% of children who are overweight are also overweight as adults, but it is not possible to identify any individual child who will become an overweight adult. CVD risk …