Interventions Urged to Curb Metabolic Syndrome in Kids

NEW YORK (Reuters Health) – Metabolic syndrome is rising globally among young people, with close to 26 million children and 36 million adolescents affected, according to a landmark systematic review and modeling analysis.

“The Global Burden of Disease study (https://www.thelancet.com/gbd) reported a continuous rise in childhood obesity between 1980 and 2015 at the global level, (which) has most likely fueled the prevalence of metabolic syndrome, as overweight and obesity are intimately linked with (the disorder),” Dr. Jean Joel Bigna of Centre Pasteur of Cameroon in Yaounde told Reuters Health by email.

“Population-wide policies and initiatives to promote a healthier food and physical activity environment for the whole population, or large population groups, are the most likely to lead to a significant reduction in the burden of metabolic syndrome,” he said. Such interventions include:

– Legislative frameworks for marketing restrictions on unhealthy foods and beverages to children;

– Nutrition labelling to help consumers making healthier dietary choices;

– Taxation to reduce intake of unhealthy highly processed food products;

– Subsidies to improve consumption of healthy foods including fruits and vegetables;

– Supply-chain incentives to increase the production of healthy foods;

– Social marketing campaigns and nutrition education programs for the promotion of healthy lifestyles;

– Promotion of physical activity by increasing safe space for recreational activities and an environment that encourages non-motorized transportations; and

– Promotion of physical activity and healthy diet in schools, as well as programs education students on healthy lifestyles.

The team searched the literature to determine a crude estimate of metabolic syndrome for their report in The Lancet Child and Adolescent Health. A metabolic syndrome diagnosis had to meet at least three criteria: high systolic or diastolic blood pressure (≥90th percentile for age, sex, and height); waist circumference in at least the 90th percentile for age, sex, and ethnic group; fasting plasma glucose 5.6 mmol/L or greater; fasting plasma triglycerides 1.24 mmol/L or greater; and fasting plasma high density lipoprotein cholesterol 1.03 mmol/L or less.

One hundred and sixty-nine studies with 306 prevalence datapoints and 55,0405 children and adolescents from 44 countries in 13 regions were included.

The global prevalence of metabolic syndrome in 2020 was estimated to be 2.8% for children and 4.8% for adolescents, equating to around 25.8 million children and 35.5 million adolescents.

In children and adolescents, respectively, prevalences were 2.2% and 5.5% in high-income countries, 3.1% and 3.9% in upper-middle-income countries, 2.6% and 4.5% in lower-middle-income countries, and 3.5% and 7.0% in low-income countries.

Prevalence in children varied from 1.4% in northwestern Europe to 8.2% in Central Latin America, whereas prevalence for adolescents ranged from 2.9% in east Asia to 6.7% in high-income English-speaking countries.

The three countries with the highest prevalence estimates in children were Nicaragua (5.2%), Iran (8.8%), and Mexico (12.3%); for adolescents, those countries were Iran (9.0%), United Arab Emirates (9.8%), and Spain (9.9%).

Dr. Bigna said, “The battle against metabolic syndrome in children and adolescents is mostly outside the hospital. However, clinicians can play an important role in educating and encouraging parents on maintaining a healthy lifestyle for their children. Careful attention should be given to body habitus assessment when children and adolescents are seen in clinical settings, and appropriate actions should be taken for those who are overweight or obese.”

Dr. Eric Cioe-Peña, Director of Global Health at Northwell Health in New Hyde Park, New York, commented in an email to Reuters Health, “This article is a great summary of one of the greatest threats to global health, which is as countries are able to deliver cheaper and cheaper nutrition to its citizenship the level of quality of affordable food has mirrored the food availability and higher income countries – i.e., caloric density and the emphasis of carbohydrate-based diets is now affecting many countries regardless of income status.”

“Medicine is inherently local and the solutions to these problems must be local,” he noted. “Having culturally competent nutritional support that emphasizes local diets, cultural norms but stresses the importance of diversity of energy sources in meals such as complex carbohydrates, protein, and fat without an emphasis on processed or fast food is going to be vital.”

“In addition, countries that have had nutrition scarcity and caloric scarcity are now in many circumstances having to deal with caloric overabundance and obesity, so provider education is paramount,” Dr. Cioe-Pena concluded.

SOURCE: https://bit.ly/3Hdtwvx The Lancet Child and Adolescent Health, online January 17, 2022.

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