Obese kids with big bellies at greatest heart risk

NEW YORK (Reuters Health) - Big bellies in obese kids mean greater heart disease risks, just as they do for heavy grown-ups, new research shows.

Obese children with waists bigger than 90 percent of their peers had lower "good" HDL cholesterol, higher harmful triglyceride levels, and greater insulin resistance -- a risk factor for type 2 diabetes -- compared to obese kids with smaller waists, researchers found.

This "tells us they are at more risk for heart problems later on in life," Dr. Reda Bassali of the Medical College of Georgia in Augusta told Reuters Health.

A large waist circumference is a well-established risk factor for heart disease and type 2 diabetes in obese adults, Bassali and colleagues note in the International Journal of Pediatric Obesity.

To investigate whether the same might be true for kids, they looked at 188 healthy obese children 7 to 11 years old. Sixty percent were black, and 39 percent were boys. Thirty-five of the children were severely obese, while 119 had waist circumferences above the 90th percentile for children their age and sex.

Compared with children with smaller waists, children with large waists were 27 times more likely to be severely obese, 3.6 times as likely to have low levels of heart-healthy HDL cholesterol, 3 times as likely to have high triglycerides, and 3.7 times as likely to have high fasting insulin levels, the researchers found.

Checking waist circumference in obese children could be an effective way to identify those who are at greatest risk of developing diabetes and heart disease, they write in their report.

For now, Bassali noted, it's likely not practical for busy pediatricians to check waist circumference for all their obese patients. However, "it's something to keep an eye on in overweight kids when we see that their waist circumference seems to be excessive," the researcher said.

The only way to lose belly fat, he added, is to lose weight by eating less and exercising.

SOURCE: International Journal of Pediatric Obesity, 2009.