Metabolically Healthy Obesity in Kids

Regular readers will recall the numerous postings on the issue of healthy obesity in adults, i.e. excess weight that in otherwise apparently healthy adults.

It may not come as a complete surprise that the same phenomenon occurs in kids.

The only paper that I am aware of that has examined this issue is considerable detail was just published by Rhiannon Prince and colleagues from the University of Alberta in Diabetes Care.

The study included 181 kids (8-17 year old) referred to a pediatric obesity program in Edmonton, Alberta, for significant obesity defined as above the 85th percentile.

Participants were classified as metabolically healthy or unhealthy based on measurements of insulin resistance and cardiometabolic risk factors like (blood pressure, serum lipids, and glucose).

Based on these measures, the prevalence of metabolically healthy kids was between 20 and 30%.

The strongest independent predictor of good health was the amount of moderate-to-vigorous physical activity – the more active the kids, the less likely they were to be metabolically unhealthy.

Other predictors included waist circumference and dietary fat intake – both of which increased the odds of being unhealthy.

Thus, this study shows that even amongst kids and adolescents with severe obesity referred to an obesity centre, as many as one in three may present without discernible cardiometabolic risk factors.

As mentioned before, it will be of great interest to know what happens to these metabolically healthy obese kids over time.

Also, as the authors rightly note, there findings can help determine for whom health services for managing pediatric obesity should be prioritized, especially in circumstances when boys and girls present with CR factors.

@DrSharma
Leipzig, Germany

Prince RL, Kuk JL, Ambler KA, Dhaliwal J, & Ball GD (2014). Predictors of Metabolically Healthy Obesity in Children. Diabetes care PMID: 24574347

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