AAP advises pediatricians to examine cardiometabolic risk factors when treating child obesity

To address the growing number of overweight and obese children in the U.S., the American Academy of Pediatrics (AAP) is recommending that pediatricians turn their attention to cardiometabolic risk factors associated with the condition.

The recommendation, published July 24 in study that appeared in Pediatrics, was led by Sheela N. Magge, MD, the director of research at the Children's National Health System's Division of Endocrinology and Diabetes.

"In so many areas of medicine, we find that strategies designed for adults simply do not meet the unique needs of children and adolescents," Magge said in a statement. "Rather than focusing on specific cut-off levels of risk factors or whether a child's condition fits a particular definition of metabolic syndrome, we propose that pediatricians look for youth with multiple component risk factors, such as high blood sugar, hypertension, obesity and abnormal lipid levels. These children should be targeted for more intensive intervention efforts."

The AAP identifies adults with metabolic syndrome (MetS) as having higher blood sugar, increased waist circumference, elevated triglycerides, decreased high-density lipoprotein cholesterol and high blood pressure. But the researchers struggled using these same metrics with children.

"Given the absence of a consensus on the definition of MetS, the unstable nature of MetS and the lack of clarity about the predictive value of MetS for future health in pediatric populations, pediatricians are rightly confused about MetS," Magge et al. wrote.

In the meantime, they suggest that physicians should perform annual obesity screenings based on body mass index. Additionally, they should test children for high blood pressure and cholesterol. If young patients have risk factors, treatment should include lifestyle modifications, such as adopting a healthier diet and becoming more active.

"Identifying children with multiple cardiometabolic risk factors will enable pediatricians to target the most intensive interventions to patients who have the greatest need for risk reduction and who have the greatest potential to experience benefits from such personalized medicine," the authors wrote.