Report of the National Heart, Lung, and Blood Institute's Working Group on obesity and other cardiovascular risk factors in congenital heart disease.

Obesity among North American youth has risen to epidemic levels and is expected to result in costly and burdensome health problems, most notably type 2 diabetes mellitus and premature coronary artery disease. In the 2001–2002 National Health and Nutrition Examination Survey survey, 31% of children aged 6 to 19 years were overweight, defined as body mass index (BMI) at the 85th to 95th percentile, or obese (BMI ≥95th percentile).1 Recent research indicates that a significant portion of children with congenital heart disease (CHD) are also obese or overweight.2 Although much has been written on obesity prevention and management of children with normal hearts,3 little is known about how children with CHD will be affected. The National Heart, Lung, and Blood Institute convened a Working Group (WG) on obesity and other cardiovascular risk factors in congenital heart disease in May 2009 to address knowledge gaps, challenges, and opportunities related to research, policies, and the clinical care of children born with CHD who also have or are at risk for obesity and other cardiovascular risk factors.4 The WG was composed of individuals with expertise in pediatric obesity and pediatric cardiology with the goals of summarizing the existing evidence on obesity and cardiovascular risk prevention and treatment in the CHD population, raising awareness of missing data, and presenting data from “healthy” children with potential applicability to children with CHD. In this report, we discuss the prevalence of obesity, potential etiological factors, possible sequelae, and obesity and cardiovascular risk management and treatment in patients with CHD. The recommendations of the WG are presented. There are no longitudinal data on weight trends in children with CHD, and only recently have concerns been raised about obesity. In 2005, Stefan et al5 demonstrated that children with CHD whose activities are restricted are …

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