Obesity, metabolic syndrome and type 2 diabetes

Atherosclerotic cardiovascular disease (ASCVD) begins within the first two decades of life, and the process is accelerated in the presence of risk factors. Obesity, metabolic syndrome (MetS), and type 2 diabetes mellitus (T2DM) are among the most prominent risk factors associated with ASCVD in childhood and adolescence. The dramatic increase in pediatric obesity over the last 40 years has been accompanied by more frequent reports of the MetS and its component cardiometabolic risk factors in children. Moreover, the increased prevalence of T2DM has occurred in parallel with the rapid rise in the prevalence of childhood obesity rates, suggesting that adiposity may be a primary culprit. The strong association of childhood obesity with cardiometabolic risk factor clustering and its tracking into adulthood is among the reasons that the current obesity epidemic with its relationship to future ASCVD and T2DM is considered to be one of the most important public health challenges in modern-day society. Emerging evidence suggests that the proper identification of at-risk youth and appropriate intervention early in life may reduce the risk of developing premature ASCVD and T2DM. Although the field of pediatric preventive medicine is still in its infancy, research in this area will be critically important to the future health of generations to come.