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Overweight, Obesity Rates Increased in Children with Congenital Heart Disease: Presented at AAP

By Jill Taylor

NEW ORLEANS, LA -- November 5, 2003 -- Children with congenital heart disease suffer more from obesity and being overweight than children as a whole in the United States. The problem increases with patient age, especially in boys, and may be related to the children's and their parent's concerns that exercise could prove deleterious to their heart.

While children with congenital heart disease have traditionally been thought of as small or fragile, advances in care enable them to live a relatively normal life. However, unlike their healthy counterparts, the prevalence of obesity in children with congenital heart disease is unknown.

In a study presented November 1^st at the American Academy of Paediatrics (AAP) National Conference and Exhibition, Ruey-Kang Chang, MD, MPH, and colleagues from the David Geffen School of Medicine, University of California at Los Angeles, California, United States, conducted a cross-sectional survey of paediatric congenital heart disease patients who had undergone surgical repair and performed interviews with families regarding participation in and attitudes toward physical activity.

Height, weight, calculated body mass indices (BMI) and clinical history were collected for 208 patients aged 6 to 17. They were divided into two groups: children with significant clinical issues and children with no significant clinical issues. Face-to-face interviews with 40 children aged 6 to 13 and their parents were conducted from a validated questionnaire used in the National Children and Youth Fitness Survey (NCYFS).

Overall, 20% of children met criteria for obesity (BMI >95^th percentile), and 35% were overweight (BMI >85^th percentile). Additionally, the prevalence of obesity and overweight was significantly higher in boys (p=0.05 and 0.02, respectively) and increased rapidly with age, from 36% at 6 to 11 years to 51% at 12 to 17 years.

Interestingly, patients without clinical problems tended to a have higher rate of overweight (37%) than patients with clinical problems (31%). Although 64% of children reported that being physically active was important, most indicated that they or their parents worry about their heart when they exercise.

Among parents, 69% believed that having more exercise would be good for their children. Sixty eight percent reported their child had never participated in organised sports, and 32% of children had physician notes regarding participation in physical education at school.

Dr. Chang believes that based on these results, paediatric cardiologists should spend more time counselling the family and the child about participation in physical activity. "Because we don't know how much the children can do and how much will be good for them, a problem may be that a lot of clinicians actually discourage physical activity without a thorough evaluation when such discouragement may not actually be warranted," he told Doctor's Guide.


[Study title: Obesity and Decreased Physical Activity-- New Morbidities in Children with Congenital Heart Disease.]

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