Obesity-related cardiovascular risk in children and the role of lifestyle changes.

Overweight and obesity in children present significant public health concerns because of the link with numerous chronic health conditions, especially type 2 diabetes and cardiovascular disease. Perhaps obesity is only the visible pointer of other underlying risk factors for these disease conditions in childhood. Although an imbalance between energy consumed and expended appears to be the simplistic underlying problem for the increased prevalence of obesity, it is a complex condition, with various contributing factors, and may be considered the metabolic factory for various risk factors for cardiovascular disease, both modifiable and nonmodifiable. It has also been recognized that the risk factors emerge quite early in the clinical course of obesity. Physical activity-based lifestyle change appears to be the most variable component of energy expenditure and therefore has been the obvious choice and the target of behavioral interventions to modify body weight in children. This review focuses on the obesity-related nontraditional risk factors for cardiovascular disease in children and the role of lifestyle changes in modulating these risk factors.