Cardiometabolic Risk in Children Improves Over Decades - EMJ

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Cardiometabolic Risk and Rising Insulin Levels in Children

cardiometabolic

THE LATEST study from Cuenca, Spain, reveals that while childhood obesity remains a pressing challenge, children’s cardiometabolic risk profiles have improved over the last thirty years. Favourable changes in cholesterol and blood pressure are offset by a troubling rise in insulin levels, signalling nuanced shifts in paediatric health. 

Thirty Years of Cardiometabolic Trends 

Cardiometabolic health, a measure encompassing weight status and cardiovascular risk factors, has been central to public health monitoring in children. This investigation tracked more than 4,200 children aged 8 to 11 from 1992 to 2022. Findings show the prevalence of obesity rose until 2010 but then plateaued, suggesting prevention efforts may be paying off. However, excess weight remains concerning, highlighting the need for ongoing attention to lifestyle and nutrition. 

Results: Lipids, Blood Pressure, and Insulin 

Statistical analysis across seven time points revealed significant improvements in lipid profiles for children, with mean total cholesterol dropping from 185 mg/dL to 160 mg/dL, and low-density lipoprotein cholesterol decreasing from 114 mg/dL to 90 mg/dL. Non-high-density lipoprotein cholesterol also declined, while resting blood pressure showed marked reductions (SBP: 113.5 to 101.0 mm Hg; DBP: 70.4 to 60.7 mm Hg). However, mean insulin concentrations rose from 6.3 to 8.7 μIU/mL since 2004, indicating emerging concerns about metabolic health despite progress in cardiovascular markers. 

Cardiometabolic Risk in Perspective 

This extensive cross-sectional evidence highlights advances in the management of paediatric blood pressure and lipid levels, crucial elements of cardiometabolic health. Nonetheless, persistent rates of excess weight and elevated insulin point to potential future risks for diabetes or chronic metabolic conditions. Public health initiatives must remain vigilant, leveraging these insights to fine-tune strategies that support holistic childhood health and address evolving cardiometabolic risks. 

Reference 

Sequí-Domínguez I et al. Body composition and cardiometabolic risk in children. JAMA Netw Open. 2025;8(10):e2535004. 

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