Skip to main content
Top
Published in: BMC Pediatrics 1/2014

Open Access 01-12-2014 | Research article

Overweight and obesity in children with congenital heart disease: combination of risks for the future?

Authors: Sandra Mari Barbiero, Caroline D’Azevedo Sica, Daniela Schneid Schuh, Claudia Ciceri Cesa, Rosemary de Oliveira Petkowicz, Lucia Campos Pellanda

Published in: BMC Pediatrics | Issue 1/2014

Login to get access

Abstract

Background

Children who have unhealthy lifestyles are predisposed to develop hypertension, dyslipidemia and other complications. The epidemic of obesity is also affecting children with congenital heart disease. The aim of this study is to estimate the prevalence of obesity and describe associated risk factors, including family history in children with congenital heart disease.

Methods

A cross-sectional study with 316 children and adolescents with congenital heart disease seen in an outpatient clinic of a reference hospital. Collected sociodemographic data included family history of chronic disease, dietary habits, laboratory tests (total cholesterol, HDL and LDL/cholesterol, triglycerides, fasting glucose, CRP, hematocrit and hemoglobin), and anthropometric assessment. Anthropometric data of the caregivers was self-reported.

Results

The prevalence of excess weight was 26.9%. Altered levels of total cholesterol were observed in 46.9%, of HDL in 32.7%, LDL in 23.6% and of triglycerides levels in 20.0%. A higher frequency of family history of obesity (42.6%; p = 0.001), dyslipidemia (48.1%; p = <0.001), diabetes (47.4%; p = 0.002), hypertension (39.2%; p = 0.006) and ischemic disease (43.7%; p = 0.023), as well as significantly higher values of triglycerides (p = 0.017), glycemia (p = 0.004) and C-reactive protein (p = 0.002) were observed among patients with excess weight.

Conclusion

The presence of modifiable risk factors and the variables associated to excess weight in this population was similar to that described in the literature for children without congenital disease. As these children already present the risks associated to heart disease, it is particularly important to promote a healthy lifestyle in this group.
Literature
1.
go back to reference Kelishadi R, Hashemipour M, Sheikh-Heidar A, Ghatreh-Samani S: Changes in serum lipid profile of obese or overweight children and adolescents following a lifestyle modification course. ARYA Atheroscler. 2012, 8: 143-148.PubMedPubMedCentral Kelishadi R, Hashemipour M, Sheikh-Heidar A, Ghatreh-Samani S: Changes in serum lipid profile of obese or overweight children and adolescents following a lifestyle modification course. ARYA Atheroscler. 2012, 8: 143-148.PubMedPubMedCentral
2.
go back to reference Gupta N, Goel K, Shah P, Misra A: Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev. 2012, 33: 48-70. 10.1210/er.2010-0028.CrossRefPubMed Gupta N, Goel K, Shah P, Misra A: Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev. 2012, 33: 48-70. 10.1210/er.2010-0028.CrossRefPubMed
4.
go back to reference Moons P, Deyk KV, Dedroog D, Troost E, Budts W: Prevalence of cardiovascular risk factors in adults with congenital heart disease. Eur J Cardiovasc Prev Rehabil. 2006, 13: 612-616. 10.1097/01.hjr.0000197472.81694.2b.CrossRefPubMed Moons P, Deyk KV, Dedroog D, Troost E, Budts W: Prevalence of cardiovascular risk factors in adults with congenital heart disease. Eur J Cardiovasc Prev Rehabil. 2006, 13: 612-616. 10.1097/01.hjr.0000197472.81694.2b.CrossRefPubMed
5.
go back to reference Muller-Riemenschneider F, Nocon M, Willich SN: Prevalence of modifiable cardiovascular risk factors in german adolescents. Eur J Cardiovasc Prev Rehabil. 2010, 17: 204-210. 10.1097/HJR.0b013e328334703d.CrossRefPubMed Muller-Riemenschneider F, Nocon M, Willich SN: Prevalence of modifiable cardiovascular risk factors in german adolescents. Eur J Cardiovasc Prev Rehabil. 2010, 17: 204-210. 10.1097/HJR.0b013e328334703d.CrossRefPubMed
6.
go back to reference Shustak RJ, McGuire SB, October TW, Phoon CK, Chun AJ: Prevalence of obesity among patients with congenital and acquired heart disease. Pediatr Cardiol. 2012, 33: 8-14. 10.1007/s00246-011-0049-y.CrossRefPubMed Shustak RJ, McGuire SB, October TW, Phoon CK, Chun AJ: Prevalence of obesity among patients with congenital and acquired heart disease. Pediatr Cardiol. 2012, 33: 8-14. 10.1007/s00246-011-0049-y.CrossRefPubMed
7.
go back to reference Cohen MS: Clinical practice: the effect of obesity in children with congenital heart disease. Eur J Pediatr. 2012, 171: 1145-1150. 10.1007/s00431-012-1736-2.CrossRefPubMed Cohen MS: Clinical practice: the effect of obesity in children with congenital heart disease. Eur J Pediatr. 2012, 171: 1145-1150. 10.1007/s00431-012-1736-2.CrossRefPubMed
8.
go back to reference Hansen SR, Dorup I: Energy and nutrient intakes in congenital heart disease. Acta Paediatr. 1993, 82: 166-172. 10.1111/j.1651-2227.1993.tb12632.x.CrossRefPubMed Hansen SR, Dorup I: Energy and nutrient intakes in congenital heart disease. Acta Paediatr. 1993, 82: 166-172. 10.1111/j.1651-2227.1993.tb12632.x.CrossRefPubMed
9.
go back to reference Ratanachu-Ek S, Pongdara A: Nutritional status of pediatric patients with congenital heart disease: Pre- and post cardiac surgery. J Med Assoc Thai. 2011, 94 (Suppl 3): S133-S137.PubMed Ratanachu-Ek S, Pongdara A: Nutritional status of pediatric patients with congenital heart disease: Pre- and post cardiac surgery. J Med Assoc Thai. 2011, 94 (Suppl 3): S133-S137.PubMed
10.
go back to reference Moola F, Fusco C, Kirsh JA: The perceptions of caregivers toward physical activity and health in youth with congenital heart disease. Qual Health Res. 2011, 21 (2): 278-291. 10.1177/1049732310384119. United StatesCrossRefPubMed Moola F, Fusco C, Kirsh JA: The perceptions of caregivers toward physical activity and health in youth with congenital heart disease. Qual Health Res. 2011, 21 (2): 278-291. 10.1177/1049732310384119. United StatesCrossRefPubMed
11.
go back to reference Massin MM, Hövels-Gürich H, Seghaye MC: Atherosclerosis lifestyle risk factors in children with congenital heart disease. Eur J Cardiovasc Prev Rehabil. 2007, 14: 349-351. 10.1097/01.hjr.0000224483.72726.1a.CrossRefPubMed Massin MM, Hövels-Gürich H, Seghaye MC: Atherosclerosis lifestyle risk factors in children with congenital heart disease. Eur J Cardiovasc Prev Rehabil. 2007, 14: 349-351. 10.1097/01.hjr.0000224483.72726.1a.CrossRefPubMed
12.
go back to reference Martinez-Quintana E, Rodriguez-Gonzalez F, Nieto-Lago V, Novoa FJ, Lopez-Rios L, Riano-Ruiz M: Serum Glucose and Lipid Levels in Adult Congenital Heart Disease Patients. Metabolism. 2010, United States: 2010 Elsevier Inc, 1642-1648. Martinez-Quintana E, Rodriguez-Gonzalez F, Nieto-Lago V, Novoa FJ, Lopez-Rios L, Riano-Ruiz M: Serum Glucose and Lipid Levels in Adult Congenital Heart Disease Patients. Metabolism. 2010, United States: 2010 Elsevier Inc, 1642-1648.
13.
go back to reference Yoshinaga M, Takahashi H, Shinomiya M, Miyazaki A, Kuribayashi N, Ichida F: Impact of having one cardiovascular risk factor on other cardiovascular risk factor levels in adolescents. J Atheroscler Thromb. 2010, 17: 1167-1175. 10.5551/jat.5264.CrossRefPubMed Yoshinaga M, Takahashi H, Shinomiya M, Miyazaki A, Kuribayashi N, Ichida F: Impact of having one cardiovascular risk factor on other cardiovascular risk factor levels in adolescents. J Atheroscler Thromb. 2010, 17: 1167-1175. 10.5551/jat.5264.CrossRefPubMed
14.
go back to reference Murrin CM, Kelly GE, Tremblay RE, Kelleher CC: Body mass index and height over three generations: evidence from the lifeways cross-generational cohort study. BMC Public Health. 2012, 12: 81-10.1186/1471-2458-12-81.CrossRefPubMedPubMedCentral Murrin CM, Kelly GE, Tremblay RE, Kelleher CC: Body mass index and height over three generations: evidence from the lifeways cross-generational cohort study. BMC Public Health. 2012, 12: 81-10.1186/1471-2458-12-81.CrossRefPubMedPubMedCentral
15.
go back to reference Pardini R: Validation of the international physical activity questionaire (ipaq version 6): Pilot Study in brazilian young adults. Rev Bras Ciên e Mov. 2001, 9: 45-51. Pardini R: Validation of the international physical activity questionaire (ipaq version 6): Pilot Study in brazilian young adults. Rev Bras Ciên e Mov. 2001, 9: 45-51.
16.
go back to reference De Onis M, World Health Organization: Who Child Growth Standards. Methods and Development Length/Height-for-age, Weight-for-age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-age. 2006, Geneva De Onis M, World Health Organization: Who Child Growth Standards. Methods and Development Length/Height-for-age, Weight-for-age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-age. 2006, Geneva
17.
go back to reference Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011, 128 (Suppl 5): S213-S256. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011, 128 (Suppl 5): S213-S256.
18.
go back to reference Back Giuliano Ide C, Caramelli B, Pellanda L, Duncan B, Mattos S, Fonseca FH, Sociedade Brasileira de Cardiologia: I diretriz de prevenção da aterosclerose na infância e na adolescência. Arq Bras Cardiol. 2005, 85: S4-S36. Back Giuliano Ide C, Caramelli B, Pellanda L, Duncan B, Mattos S, Fonseca FH, Sociedade Brasileira de Cardiologia: I diretriz de prevenção da aterosclerose na infância e na adolescência. Arq Bras Cardiol. 2005, 85: S4-S36.
19.
go back to reference Barbiero SM, Pellanda LC, Cesa CC, Campagnolo P, Beltrami F, Abrantes CC: Overweight, obesity and other risk factors for ihd in brazilian schoolchildren. Public Health Nutr. 2009, 12 (5): 710-715. 10.1017/S1368980008003200. EnglandCrossRefPubMed Barbiero SM, Pellanda LC, Cesa CC, Campagnolo P, Beltrami F, Abrantes CC: Overweight, obesity and other risk factors for ihd in brazilian schoolchildren. Public Health Nutr. 2009, 12 (5): 710-715. 10.1017/S1368980008003200. EnglandCrossRefPubMed
20.
go back to reference Elm E, Altman D, Egger M, Pocock S, Gotzsche P: the strengthening the reporting of observational studies in epidemiology (strobe) statement: Guidelines for reporting observational studies. 2007, 370: 1453-1457. Elm E, Altman D, Egger M, Pocock S, Gotzsche P: the strengthening the reporting of observational studies in epidemiology (strobe) statement: Guidelines for reporting observational studies. 2007, 370: 1453-1457.
21.
go back to reference Messiah SE, Arheart KL, Natale RA, Hlaing WM, Lipshultz SE, Miller TL: Bmi, waist circumference, and selected cardiovascular disease risk factors among preschool-age children. Obesity (Silver Spring). 2012, 1942-1949. United States Messiah SE, Arheart KL, Natale RA, Hlaing WM, Lipshultz SE, Miller TL: Bmi, waist circumference, and selected cardiovascular disease risk factors among preschool-age children. Obesity (Silver Spring). 2012, 1942-1949. United States
22.
go back to reference Pinto NM, Marino BS, Wernovsky G, de Ferranti SD, Walsh AZ, Laronde M, Hyland K, Dunn SO, Cohen MS: Obesity is a common comorbidity in children with congenital and acquired heart disease. Pediatrics. 2007, 120: e1157-e1164. 10.1542/peds.2007-0306.CrossRefPubMed Pinto NM, Marino BS, Wernovsky G, de Ferranti SD, Walsh AZ, Laronde M, Hyland K, Dunn SO, Cohen MS: Obesity is a common comorbidity in children with congenital and acquired heart disease. Pediatrics. 2007, 120: e1157-e1164. 10.1542/peds.2007-0306.CrossRefPubMed
23.
go back to reference Glowinska B, Urban M, Koput A: Cardiovascular risk factors in children with obesity, hypertension and diabetes: Lipoprotein(a) levels and body mass index correlate with family history of cardiovascular disease. Eur J Pediatr. 2002, 161: 511-518. 10.1007/s00431-002-1040-7.CrossRefPubMed Glowinska B, Urban M, Koput A: Cardiovascular risk factors in children with obesity, hypertension and diabetes: Lipoprotein(a) levels and body mass index correlate with family history of cardiovascular disease. Eur J Pediatr. 2002, 161: 511-518. 10.1007/s00431-002-1040-7.CrossRefPubMed
24.
go back to reference Update on the 1987 task force report on high blood pressure in children and adolescents: A working group report from the national high blood pressure education program. National high blood pressure education program working group on hypertension control in children and adolescents. Pediatrics. 1996, 98: 649-658. Update on the 1987 task force report on high blood pressure in children and adolescents: A working group report from the national high blood pressure education program. National high blood pressure education program working group on hypertension control in children and adolescents. Pediatrics. 1996, 98: 649-658.
25.
go back to reference Pall D, Kiss I, Katona E: Importance of ambulatory blood pressure monitoring in adolescent hypertension. Kidney Blood Press Res. 2012, 35 (2): 129-134. 10.1159/000331057. Switzerland: BaselCrossRefPubMed Pall D, Kiss I, Katona E: Importance of ambulatory blood pressure monitoring in adolescent hypertension. Kidney Blood Press Res. 2012, 35 (2): 129-134. 10.1159/000331057. Switzerland: BaselCrossRefPubMed
26.
go back to reference Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, Goldfield G, Connor Gorber S: Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act. 2011, 98: 8-England Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, Goldfield G, Connor Gorber S: Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act. 2011, 98: 8-England
27.
go back to reference Rivera IR, Silva MA, Silva RD, Oliveira BA, Carvalho AC: Physical inactivity, tv-watching hours and body composition in children and adolescents. Arq Bras Cardiol. 2010, 95: 159-165. 10.1590/S0066-782X2010005000065.CrossRefPubMed Rivera IR, Silva MA, Silva RD, Oliveira BA, Carvalho AC: Physical inactivity, tv-watching hours and body composition in children and adolescents. Arq Bras Cardiol. 2010, 95: 159-165. 10.1590/S0066-782X2010005000065.CrossRefPubMed
28.
go back to reference Massin M: the cardiovascular risk in children with congenital heart disease. Arch Mal Coeur Vaiss. 2007, 100 (5): 448-453. FrancePubMed Massin M: the cardiovascular risk in children with congenital heart disease. Arch Mal Coeur Vaiss. 2007, 100 (5): 448-453. FrancePubMed
29.
go back to reference Pasquali SK, Marino BS, Pudusseri A, Wernovsky G, Paridon SM, Walker SA, Cohen MS: Risk factors and comorbidities associated with obesity in children and adolescents after the arterial switch operation and ross procedure. Am Heart J. 2009, 158: 473-479. 10.1016/j.ahj.2009.06.019.CrossRefPubMed Pasquali SK, Marino BS, Pudusseri A, Wernovsky G, Paridon SM, Walker SA, Cohen MS: Risk factors and comorbidities associated with obesity in children and adolescents after the arterial switch operation and ross procedure. Am Heart J. 2009, 158: 473-479. 10.1016/j.ahj.2009.06.019.CrossRefPubMed
30.
go back to reference Costa Silva Zemdegs J, Barreto Corsi L, De Castro Coelho L, Duarte Pimentel G, Toyomi Hirai A, Sachs A: Lipid profile and cardiovascular risk factors among first-year brazilian university students in são paulo. Nutr Hosp. 2011, 26: 553-559.PubMed Costa Silva Zemdegs J, Barreto Corsi L, De Castro Coelho L, Duarte Pimentel G, Toyomi Hirai A, Sachs A: Lipid profile and cardiovascular risk factors among first-year brazilian university students in são paulo. Nutr Hosp. 2011, 26: 553-559.PubMed
31.
go back to reference Dwivedi S, Aggarwal A: Central obesity, hypertension and coronary artery disease: the seed and soil hypothesis. World J Cardiol. 2011, 3: 40-42. 10.4330/wjc.v3.i1.40.CrossRefPubMedPubMedCentral Dwivedi S, Aggarwal A: Central obesity, hypertension and coronary artery disease: the seed and soil hypothesis. World J Cardiol. 2011, 3: 40-42. 10.4330/wjc.v3.i1.40.CrossRefPubMedPubMedCentral
32.
go back to reference Roche SL, Silversides CK: Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease. Can J Cardiol. 2013 Roche SL, Silversides CK: Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease. Can J Cardiol. 2013
33.
go back to reference Sonneville KR, Rifas-Shiman SL, Kleinman KP, Gortmaker SL, Gillman MW, Taveras EM: Associations of obesogenic behaviors in mothers and obese children participating in a randomized trial. Obesity (Silver Spring). 2012, 20: 1449-1454. 10.1038/oby.2012.43.CrossRef Sonneville KR, Rifas-Shiman SL, Kleinman KP, Gortmaker SL, Gillman MW, Taveras EM: Associations of obesogenic behaviors in mothers and obese children participating in a randomized trial. Obesity (Silver Spring). 2012, 20: 1449-1454. 10.1038/oby.2012.43.CrossRef
34.
go back to reference Camargo AP, Barros Filho Ade A, Antonio MA, Giglio JS: the non perception of obesity can be an obstacle to the role of mothers in taking care of their children. Cien Saude Colet. 2013, 18: 323-333. 10.1590/S1413-81232013000200004.CrossRefPubMed Camargo AP, Barros Filho Ade A, Antonio MA, Giglio JS: the non perception of obesity can be an obstacle to the role of mothers in taking care of their children. Cien Saude Colet. 2013, 18: 323-333. 10.1590/S1413-81232013000200004.CrossRefPubMed
35.
go back to reference Pemberton VL, McCrindle BW, Barkin S, Daniels SR, Barlow SE, Binns HJ, Cohen MS, Economos C, Faith MS, Gidding SS, Goldberg CS, Kavey RE, Longmuir P, Rocchini AP, Van Horn L, Kaltman JR: Report of the national heart, lung, and blood institute’s working group on obesity and other cardiovascular risk factors in congenital heart disease. Circulation. 2010, 121: 1153-1159. 10.1161/CIRCULATIONAHA.109.921544.CrossRefPubMedPubMedCentral Pemberton VL, McCrindle BW, Barkin S, Daniels SR, Barlow SE, Binns HJ, Cohen MS, Economos C, Faith MS, Gidding SS, Goldberg CS, Kavey RE, Longmuir P, Rocchini AP, Van Horn L, Kaltman JR: Report of the national heart, lung, and blood institute’s working group on obesity and other cardiovascular risk factors in congenital heart disease. Circulation. 2010, 121: 1153-1159. 10.1161/CIRCULATIONAHA.109.921544.CrossRefPubMedPubMedCentral
36.
go back to reference Hipple B, Nabi-Burza E, Hall N, Regan S, Winickoff JP: Distance-based training in two community health centers to address tobacco smoke exposure of children. BMC Pediatr. 2013, 56: 13- Hipple B, Nabi-Burza E, Hall N, Regan S, Winickoff JP: Distance-based training in two community health centers to address tobacco smoke exposure of children. BMC Pediatr. 2013, 56: 13-
37.
go back to reference Coelho SA, Rocha SA, Jong LC: Consequências do tabagismo passivo em crianças. Cienc Cuid Saude. 2012, 11: 294-301. Coelho SA, Rocha SA, Jong LC: Consequências do tabagismo passivo em crianças. Cienc Cuid Saude. 2012, 11: 294-301.
38.
go back to reference Pandey AKP, Pandey S, Blaha MJ, Agatston A, Feldman T, Ozner M, Santos RD, Budoff MJ, Blumenthal RS, Nasir K: Family history of coronary heart disease and markers of subclinical cardiovascular disease: Where do we stand?. Atherosclerosis. 2013, 228 (2): 285-294. 10.1016/j.atherosclerosis.2013.02.016.CrossRefPubMed Pandey AKP, Pandey S, Blaha MJ, Agatston A, Feldman T, Ozner M, Santos RD, Budoff MJ, Blumenthal RS, Nasir K: Family history of coronary heart disease and markers of subclinical cardiovascular disease: Where do we stand?. Atherosclerosis. 2013, 228 (2): 285-294. 10.1016/j.atherosclerosis.2013.02.016.CrossRefPubMed
39.
go back to reference Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A: Early life risk factors for obesity in childhood: Cohort study. BMJ. 2005, 330: 1357-10.1136/bmj.38470.670903.E0.CrossRefPubMedPubMedCentral Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A: Early life risk factors for obesity in childhood: Cohort study. BMJ. 2005, 330: 1357-10.1136/bmj.38470.670903.E0.CrossRefPubMedPubMedCentral
40.
go back to reference Vickers MH: Developmental programming of the metabolic syndrome - critical windows for intervention. World J Diabetes. 2011, 2: 137-148. 10.4239/wjd.v2.i9.137.CrossRefPubMedPubMedCentral Vickers MH: Developmental programming of the metabolic syndrome - critical windows for intervention. World J Diabetes. 2011, 2: 137-148. 10.4239/wjd.v2.i9.137.CrossRefPubMedPubMedCentral
41.
go back to reference Heerwagen MJ, Miller MR, Barbour LA, Friedman JE: Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol. 2010, 299: R711-R722. 10.1152/ajpregu.00310.2010.CrossRefPubMedPubMedCentral Heerwagen MJ, Miller MR, Barbour LA, Friedman JE: Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol. 2010, 299: R711-R722. 10.1152/ajpregu.00310.2010.CrossRefPubMedPubMedCentral
Metadata
Title
Overweight and obesity in children with congenital heart disease: combination of risks for the future?
Authors
Sandra Mari Barbiero
Caroline D’Azevedo Sica
Daniela Schneid Schuh
Claudia Ciceri Cesa
Rosemary de Oliveira Petkowicz
Lucia Campos Pellanda
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2014
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-14-271

Other articles of this Issue 1/2014

BMC Pediatrics 1/2014 Go to the issue