Teen girls catching up to boys in prevalence of metabolic syndrome

There appears to be an increased awareness of the need to get our nation's youth moving and eating well-schools are taking a critical look at the meal options provided to students, and with the emergence of interactive exercise video games, game-loving teens don't necessarily equal couch potatoes.

So have things improved in recent years?

Yes and no, says Kenn Daratha, an assistant professor at the Washington State University (WSU) College of Nursing and the lead author on a paper, "Effects of Individual Components, Time, and Sex on Prevalence of Metabolic Syndrome in Adolescents," published in the April 2009 issue of the Archives of Pediatrics & Adolescent Medicine.

Daratha and co-author Ruth Bindler, a professor in the WSU College of Nursing, looked for changes in the prevalence of metabolic syndrome among teenagers and analyzed the percentage of teens who exceeded cutoff points for individual components of the syndrome.

Metabolic syndrome predicts an increased risk for cardiovascular disease and type 2 diabetes and is generally diagnosed when individuals exceed cutoff points for at least three out of the five components, or risk factors: elevated glucose levels, high blood pressure, central obesity or elevated waist circumference, decreased levels of HDL ('good') cholesterol and elevated triglycerides.

The authors analyzed Centers for Disease Control and Prevention data on more than 3,000 adolescents between the ages of 12 and 19. The data was gathered in mobile examination centers between 1999 and 2006 as part of the National Health and Nutrition Examination Study (NHANES).

The new findings show that, while metabolic syndrome was on the rise among teens throughout the 1990s, the prevalence of metabolic syndrome in this group has remained stable over the period studied. They observed, however, gender-based differences in certain individual risk factors. The waist circumference in teen girls has increased, while the level of HDL cholesterol has improved slightly in boys. Of particular concern is the fact that the fasting glucose level has nearly doubled in both boys and girls, indicating an elevated risk of early-onset diabetes in this population.

"Historically, rates of metabolic syndrome have been higher for adolescent males," Daratha said. "But based on the latest data used for this study, there are no statistical differences between boys and girls…Girls have 'joined the club,' if you will, partly based on their increases in waist circumference."

The outcome of this investigation will serve as baseline data for a study that Daratha and Bindler are currently conducting. Funded by a $1.3 million grant from the U.S. Department of Agriculture, the two researchers are evaluating the impact on obesity rates of school-based, family-based and individual interventions in nearly 5,000 students at six middle schools within Spokane Public Schools in Washington State. Interventions focus on diet, physical activity, sedentary behavior, and environmental design.

"Many of our children eat too much, and a large percentage of youth exceed their daily recommendation of extracurricular screen time, which is two hours," said Daratha. "As a result, only a small percentage of our children are meeting the recommended 60 minutes a day of moderate to vigorous physical activity."

The motivation to study metabolic syndrome in adolescents came to Daratha after a project with Spokane area cardiologists to study adult health outcomes following percutaneous coronary intervention (PCI), a non-surgical procedure that relieves narrowing and obstruction of the coronary arteries.

"I saw people in their forties who were having coronary interventions, and I realized that to help solve the problem of cardiovascular disease we need to start much earlier in life." said Daratha. "If we can work with youth at a time when they are starting to make their own decisions about healthy eating and increased physical activity, we expect we can really make a difference in their lives."