Focus on childhood fitness, not just fatness.

摘要

The seeds of adult-onset morbidity, such as cardiovascular disease and altered metabolism of glucose, are sown in utero, infancy, and childhood. Because atherogenesis begins early and can occur in children and young adults,modifiable risk factors that might promote a pathological response need to be addressed early. The rising prevalence of obesity in childhood caused the lay media to focus on eating habits, food marketing, and on lifestyle (eg, exercise), all factors that are modifiable to prevent the developrnent of obesity. Less emphasis has been placed on the independent importance of physical activity, regardless of other habits, not solely as a preventive measure against obesity but as an overall protective measure against cardiovascular risk factors in childhood.Insulin resistance is considered to be the driving force of a cluster of adverse cardiovascular risk factors, including dyslipidaemia, hypertension, and alterations in glucose metabolism, known as the metabolic syndrome. The main cause of insulin resistance in childhood is obesity. Indeed, as the prevalence of overweight and obesity in children and adolescents is increasing substantially in developed and developing countries, more and more reports have shown the high prevalence of clustered cardiovascular risk factors in obese youth.The rising prevalence of obesity in youth demands preventive interventions focused on behavioural changes, modification of dietary habits, and encouragement of physical activity. Physical activity improves insulin sensitivity and independently has other beneficial effects on overall health, as Maimonides found out 800 years ago.