|SSM Cardinal Glennon Children's Medical Center|
As a parent, you know that life is full of cause-and-effect scenarios: If you don't go to work, then you can't pay the bills. If you ignore that sound the car is making, then you could end up on the side of the road with engine trouble.
Unfortunately, this concept is often a little harder for kids to grasp. They tend to live in the present and don't think too much about long-term consequences. Usually this works out just fine because you are there to offer support and, when necessary, a safety net.
But when it comes to your kids' health, there are some long-term consequences you may not even realize they're up against. One of the best examples of this is a condition called metabolic syndrome.
About Metabolic Syndrome
Not to be confused with metabolic disease (which occurs when hormones and other chemicals in the body fail to interact properly), metabolic syndrome describes a cluster of risk factors that put kids on the road to heart disease and type 2 diabetes.
Kids with metabolic syndrome have at least three of these risk factors:
You might be surprised to learn that these are problems kids can have. After all, high blood pressure and high cholesterol are usually things older people grumble about.
Not so anymore. Thanks to the rising obesity epidemic in young people, kids and teens are getting these conditions — and they're getting them earlier than ever before. Some estimates say that nearly 1 in 10 teens — and over a third of obese teens — have metabolic syndrome. And a study of 375 second- and third-graders found that 5% had metabolic syndrome and 45% had one or two risk factors for it.
This is something parents should know about, especially because they can take steps to lessen their kids' chances of developing metabolic syndrome or the risk factors that lead to it.
Because it's a precursor to heart disease and type 2 diabetes, metabolic syndrome (also called dysmetabolic syndrome or syndrome X) is brought on by the same problems that cause those diseases. So, having a diet that's high in calories and low in nutrients and consuming lots of fast food and sweetened beverages can put kids at risk.
Playing video games for most of the day or sitting in front of the computer and not getting enough (or any) exercise also can increase a child's chance of developing factors like obesity, high LDL ("bad") cholesterol, hypertension, and high blood sugar that define metabolic syndrome.
The risk of developing the condition appears to be highest around puberty. That may be because body fat, blood pressure, and lipids are all affected by the hormones that bring about the many changes of puberty.
Kids who have a family history of heart disease or diabetes are at greater risk for metabolic syndrome. But, as with many things in life, the lifestyle habits a child adopts can push things in one direction or another. So kids who are active, fit, and eat a lot of fruits and vegetables may drastically decrease their chances of developing metabolic syndrome — even if a close relative already has it.
Metabolic syndrome itself often has no noticeable symptoms early on. But when its risk factors are left to snowball for too long, major changes may start to develop in the body, such as:
For a diagnosis of metabolic syndrome, a child must have at least three of the four risk factors. The most common risk factors in teens are hypertension and high LDL cholesterol. However, even when just one risk factor is present, a doctor will likely check for the others. This is especially true if a child is overweight, has a family member with type 2 diabetes, or has acanthosis nigricans.
These exams and tests can help doctors make a diagnosis of metabolic syndrome:
Diagnosing metabolic syndrome in kids and teens can be a little bit like trying to hit a moving target. That's because as kids' bodies change and grow, the cutoff numbers for many of these tests change too. To standardize some of this information, doctors use special charts (a lot like growth charts) to plot where a child's numbers fall according to his or her age, sex, weight, and height. This also helps them follow the child's progression over time.
Treating Risk Factors
If your child is diagnosed with metabolic syndrome, it does not necessarily mean that he or she will develop heart disease or diabetes, but the chances are increased — especially if the risk factors involved aren't improved or eliminated.
For some kids, a lifestyle change may be enough to reduce the risk for serious disease. A doctor may recommend:
When lifestyle changes aren't enough, a child may be prescribed medications to treat individual risk factors. So, kids with high blood pressure might be put on antihypertension drugs. Others with high LDL cholesterol might be prescribed statins or other lipid-lowering drugs. Children with high blood sugar, who are on the brink of developing diabetes, may be given medication to decrease insulin resistance.
Although weight-loss drugs that are helpful to adults are still investigational in children, some kids who are morbidly obese (double or more the healthy weight for kids their sex, age, and height) might benefit from these medications.
While bariatric surgery for weight loss is not yet approved by the U.S. Food and Drug Administration (FDA) in kids, some teens with morbid obesity or those who are obese and have developed heart disease or diabetes may be candidates for the procedure.
Here's a great thing kids can learn about cause-and-effect: they have the power to positively influence many health outcomes. Eating right and staying active are two ways they can help ensure a healthier tomorrow.
Of course, it's easier for kids to make better choices if they see their parents doing the same. So make a plan to help your entire family choose a new, healthier direction. After all, getting a late start on the right path beats staying on the wrong one.
Reviewed by: Steven Dowshen, MD