That is the sobering conclusion of a study presented at the American Heart Association's annual conference.

Researchers found about 13 percent of the schoolchildren studied have three or more of the risk factors for what physicians call metabolic syndrome, a precursor of cardiovascular disease.

Girls had a 1.6 times higher risk than boys, says Dr. Joanne S. Harrell, a professor of nursing and director of University of North Carolina at Chapel Hill's Center for Research on Chronic Illness.

Metabolic syndrome includes risk factors such as high blood pressure, elevated triglycerides (a fatty substance found in the blood), obesity, and low levels of the so-called "good" HDL cholesterol. If someone has metabolic syndrome, he or she is at early risk of heart disease as well as at risk for diabetes.

If nothing is done, Dr. Harrell says, there is a good chance the children could develop both heart disease and type 2 diabetes.

Researchers Look at Lifestyle Behaviors

Her team followed more than 3,200 students, about half boys and half girls between the ages of eight and 17, in a rural North Carolina county with no cities of more than 50,000 people.

The researchers decided to study students in rural areas with high minority populations because they knew such children have slightly higher obesity rates, and that type 2 diabetes is more common in minorities.

They evaluated each student's body mass index (BMI) - a ratio of weight to height - to determine if it was high enough to be labeled obese, as well as other risk factors such as blood pressure, blood fats, and how well their body utilized glucose. A BMI of 30 and above is considered obese; 25 and higher is overweight.

More than half of the children had a least one of the six risk factors for metabolic syndrome, 27 percent had two or more, and more than 13 percent had three or more risk factors. Some children who had three or more factors were only eight or nine years old.

The most common risk factor, found in more than 43 percent of the children, was a low HDL cholesterol level. More than one in four of the students were classified as overweight.

In all, slightly more than 16 percent of the girls and about 11 percent of the boys had three or more risk factors for metabolic syndrome. That was due, Dr. Harrell says, to the higher levels of excess weight in the girls.

Experts Point to Mounting Evidence

Dr. Henry C. McGill, a senior scientist emeritus at the Southwest Biomedical Research Institute in San Antonio, says, "There's no surprise in this study. The evidence [of heart-disease risk factors in children] just keeps piling up."

Recently, Dr. McGill wrote an editorial in the Journal of the American Medical Association, commenting on two other new studies linking risk factors found in children that help predict heart problems later.

One, the so-called Bogalusa Heart Study, followed Louisiana children into young adulthood and found high levels of the "bad" LDL cholesterol was the best predictor later in life of a condition called increased carotid artery thickness.

In the second study, Finnish researchers followed more than 2,000 children and teens and measured blood pressure, cholesterol, weight levels, and smoking habits. They found if the subjects had several risk factors earlier in life, they were at increased risk of hardening of the arteries that can lead to heart problems later.

Dr. McGill says the studies should definitely be a wake-up call for parents and pediatricians.

"My message is, we have got to start early to stop heart disease in middle age," Dr. McGill says.

"Start with smoking," he urges. "Get them to quit."

Then, work on the weight.

"The epidemic of obesity at all ages, especially in children, is a time bomb that will soon explode to cause a renewal of the epidemic of coronary heart disease and wipe out the gains of the last 30 years, during which time the mortality rate of CHD [coronary heart disease] has decreased by more than 50 percent," Dr. McGill says.

Always consult your child's physician for more information.

Online Resources

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American Academy of Pediatrics

American Heart Association

Centers for Disease Control and Prevention (CDC)

National Heart, Lung, and Blood Institute

National Institutes of Health (NIH)

National Library of Medicine, at NIH

Some Children On Fast Track To Heart Disease

Researchers Look at Lifestyle Behaviors

Experts Point to Mounting Evidence

Cholesterol Testing for Children and Teens

Online Resources

Cholesterol Testing for Children and Teens

Cholesterol is a waxy substance that can be found in all parts of your adolescent's body. It aids in the production of cell membranes, some hormones, and vitamin D.

The cholesterol in blood comes from two sources: the foods your adolescent eats and his/her liver. However, a child's liver makes all of the cholesterol your adolescent's body needs.

Cholesterol and other fats are transported through the blood stream in the form of round particles called lipoproteins.

The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL cholesterol is commonly called "bad" cholesterol. It can contribute to the formation of plaque build up in the arteries, known as atherosclerosis.

HDL cholesterol is known as "good" cholesterol, and is a type of fat in the blood that helps to remove cholesterol from the blood, preventing the fatty build up and formation of plaque.

The National Heart, Lung, and Blood Institute (NHLBI), recommends that cholesterol testing begin at age two for any child who has the following:

• at least one parent who has been found to have high blood cholesterol (240 milligrams or greater)
  
  
• a family history of early heart disease (before age 55 in a parent or grandparent)
  

The NHLBI also recommends that children and adolescents who have demonstrated risk factors, such as obesity, should have cholesterol and other lipids tested periodically by their physicians.

A full lipid profile shows the actual levels of each type of fat in the blood: LDL, HDL, triglycerides, and others.

Consult your adolescent's physician regarding this test.

A cholesterol screening is an overall look at, or profile of, the fats in the blood.

Physicians in the past felt that children and adolescents were at little risk for developing high cholesterol levels and other risk factors for heart diseases affecting the coronary arteries and blood vessels until later in life.

However, many physicians now realize that children and adolescents are increasingly at risk for having high blood cholesterol levels as a result of one, or more of the following:

• sedentary lifestyles (playing video games, watching TV instead of participating in vigorous exercise)
  
  
• high-fat junk food and fast food diets
  
  
• obesity
  
  
• family history of high cholesterol levels
  

Children and adolescents with high cholesterol are at higher risk for developing heart disease as adults.

Many physicians are recognizing that keeping blood cholesterol levels in normal ranges throughout one's lifetime may be of great benefit in reducing the likelihood of developing coronary artery disease and high blood pressure.

Always consult your child's physician for more information.