Children with Heart Disease Tend to be Obese

A study by researchers at The Children’s Hospital of Philadelphia and Children’s Hospital Boston suggests that children with congenital and acquired heart disease are more likely to be overweight or obese compared to normal children. Findings of the study have been published in the current issue of Pediatrics.

Clinicians from the two hospitals jointly reviewed the medical details of 2,921 children between ages of six and 19 years. All of these children visited one of the two hospitals for cardiology outpatient care in 2004. 1,523 children out of the study population had either acquired or congenital heart disease.

Children with no significant heart disease – roughly half the population – were designated the control group for the study. Overweight and obesity rates among these children were almost the same – 25% – as those found in the general population of children as measured by the Centers for Disease Control and Prevention.

The researchers found that in the heart disease group, children with heart transplants, rhythm problems and mild heart disease also had similar rates of prevalence of obesity as the control group. On the other hand, children with heart disease who had undergone the Fontan operation for treating highly complex forms of congenital heart disease were significantly less likely to be overweight or obese.

Such children had a 15.9% prevalence rate of overweight and obesity compared to the more than 25% rate found in both the control group and heart patients as a whole. While children who have had the Fontan operation often have chronic growth and development problems, the researchers found the nearly one in six rate of obesity among such children highly alarming.

According to the researchers, the 25% rate of overweight and obesity among the heart disease group children is not significantly different than that in the general population. However, the health risks from obesity can have major negative effects on the already shortened life expectancy that these children face due to their underlying heart disease.

“Children with congenital heart disease may have unique risk factors which may contribute to the development of obesity,” said Dr. Nelangi M. Pinto, a Pediatric Cardiologist and primary investigator of the study. “The long-term impact of superimposed obesity on children with heart disease is unknown but is likely to increase morbidity and mortality as it does in adults with heart disease.”

The researchers believe that activity restrictions, whether explicitly recommended by physicians or not, might play a crucial role in the children becoming obese. The researchers also found that discussions about weight were relatively uncommon during cardiology clinic visits. In their opinion, doctors should counsel families on exercise routines that can be safe and appropriate for these children.

“Awareness and discussion of weight control, exercise and other lifestyle issues must become an important part of the evaluation of all children with heart disease during cardiology visits,” said Dr. Meryl S. Cohen, a Pediatric Cardiologist at The Children’s Hospital of Philadelphia and senior author of the study. “It is also important to note that activity restrictions are not solely determined by cardiologists but may also be initiated by parents or self-imposed by the children themselves.”

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