Children represent the future, so that their healthy well -being and growth must be high at the top of the development agendas of all societies. However, a recent report by the World Health Organization (WHO) and published in Lancet alert about the future that awaits the youngest (1). Specifically, the report reveals that health and, therefore, the future of children and adolescents in the world is in danger mainly due to poor environmental quality (due to the increase in the planet's temperature and the lack of energy resources and of water) and the increase in childhood obesity. This last point, which has already become a worldwide pandemic, according to the WHO report is linked to a determining factor: overexposure to harmful advertising. If we attend to the data reported by the report, it is worrying to think that in some countries children get to watch every year between 13,000 and 30,000 ads only on television. These data can multiply if we count those who see through social networks such as Instagram or Tik Tok. This advertising, mainly linked to junk food, alcohol, tobacco and sugary drinks, pushes children to consume this type of products, translating into an increase in childhood obesity figures. In fact, the report itself indicates that, in the last 40 years, the number of children and adolescents with obesity has multiplied by ten.

These data have very serious consequences for health. That is why WHO describes this rapid increase in childhood obesity as ' one of the most serious public health challenges of the 21st century '. And although we often think that obesity is only problematic in adulthood, nothing is further from reality. The deleterious effects of overweight and childhood obesity were confirmed in a study published in The New England Journal of Medicine , the second most prestigious scientific journal in the medical field (2). The analysis of the data of more than 6,300 participants who were measured by the body mass index (BMI) in childhood and adulthood - with an average follow -up of 23 years -, concluded that overweight and obesity in that First stage of life contribute to the development of numerous heart disease. Compared to people who had a normal BMI throughout the follow -up, those with an BMI raised from childhood to adulthood had a higher risk of type 2 diabetes, arterial hypertension, dyslipidemia and carotid atherosclerosis. For example, in those people with obesity during childhood and adulthood, the risk of having type II diabetes or hypertension multiplied by 5 and 3, respectively, compared to those with Normapeso ( Figure 1 ). Interestingly, the data also showed that people with overweight or obesity in childhood, but that they stopped having it when they reached adulthood, had a cardiovascular risk profile similar to that of people who had never had obesity. This shows a key aspect for health systems and that, if childhood obesity is successfully treated, cardiovascular risk can be significantly reduced.

Cardiac events could be predicted from childhood

In line with the link between cardiovascular risk factors during childhood and the development of cardiovascular disease in adulthood, another very interesting work has recently been published in The New England Journal of Medicine (3). It is known that cardiovascular risk factors in adults lead to cardiac events and other cardiovascular diseases. The new study has found, for the first time, that five risk factors present in childhood - BMI, blood pressure, cholesterol, triglycerides and tobacco -, individually or together, are clinically related to the appearance of cardiovascular diseases from 40 years of age ( Figure 2). Thus, for example, in some cases the risk of having cardiovascular disease was nine times greater in adults who had more risk factors during the first years of life . And similar to what happened in the previous study (2), Jacobs et al. They showed that if, for example, it stopped smoking or gone from having obesity to having a normal BMI between childhood and adulthood, the risk of cardiovascular disease during adulthood was reduced (3). The investigation involved more than 38,000 participants, who was followed during childhood and adolescence and later for an average period of 35 years. In summary, this new work shows that children with an BMI and high blood pressure, an altered lipid profile and that they begin to smoking, probably have a greater risk of suffering a heart event over their years as an adult.

Conclusions

As we said in a previous article , no treatment can save as many lives as good prevention strategies. And in this case it is irrefutable that the prevention of cardiovascular disease must begin from the first years of life. While it is true that starting to lead a healthy lifestyle during adulthood - how to improve diet, quit smoking and drink alcohol or be more active - can mitig Childhood, guarantee that children and adolescents can develop and maintain healthy habits in those early stages of life will probably prevent greater long -term damage.

References:

1. Clark H, Coll-Seck Am, Banerjee A, Peterson S, Dalglysh SL, America S, et al. Future for the World's Children? To Who-Unicef-Lancet Commission. Lancet 2020; 395 (10224): 605–58.

2. Jonala M, Magnussen CG, Berenson GS, Venn A, Burns Tl, Sabin Ma, et al. Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors. N English J Med. 2011; 365 (20): 1876–85.

3. Jacobs DR, Woo JG, Sinaiko Ar, Daniels SR, Ikonen J, Jonala M, et al. Cardiovascular Childhood Risk Factors and Adult Cardiovascular Events. N English J Med. 2022; 386 (20): 1877–88.