School children have leading risk factors for cardiovascular disease and diabetes: the Wausau SCHOOL project

Abstract

Introduction: Risk factors for cardiovascular disease and diabetes acquired in childhood commonly persist in later life and are particularly strong predictors of subclinical atherosclerosis in young adults. A rising tide of obesity and other lifestyle-related risk factors threatens to negate much of the success achieved in the prevention and treatment of these diseases. The SCHOOL project (School Children Have Leading Risk Factors for Cardiovascular Disease and Diabetes), was designed to measure the prevalence and magnitude of known risk factors in school-age children in Wausau, Wis.

Methods: Demographic data, anthropomorphic measures, family health history, diet and activity indices, and numerous laboratory measures were collected from a representative sample of students in grades 2, 5, 8, and 11.

Results: Clinically important disturbances of lipid metabolism were very common, even in the youngest participants. Of the children studied, 39% had at least 1 lipid abnormality and 22% had 2 or more. Abnormal blood pressure, overweight, and cigarette smoking were present in 29%, 16%, and 11% respectively. While elevated fasting glucose levels were uncommon, insulin resistance was noted in 25% of the sampled population and nearly 50% of sampled children with a body mass index greater than the 85th percentile in this survey. The number of children with multiple risk factors rose dramatically with age. By 11th grade, 38% of those surveyed had 2 or more risk factors and 23% had 3 or more.

Conclusions: Using conservative definitions, significant abnormalities of lipid metabolism and other risk factors for cardiovascular disease and diabetes were common in our children. Risk profiles in older adolescents were worse than in the younger students and similar to what would be expected for adults with known coronary heart disease. In our community there is a growing consensus that we must take advantage of the multiple opportunities that exist to favorably alter the lifestyle patterns that put our children at risk.