¹Cardiology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia

Correspondence: Professor DS Celermajer, Cardiology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia. E-mail: david.celermajer@email.cs.nsw.gov.au

Received 14 March 2006; Revised 11 April 2006; Accepted 21 April 2006.

Abstract

Rates of overweight and obesity in both adults and children have risen sharply during the past 20 years. The reasons for this escalation in obesity are not fully determined, however, sedentary lifestyle and dietary changes in combination with genetic predisposition are probably involved.

Clinical cardiovascular disease, including myocardial infarction and stroke, are usually only manifest in the fifth decade of life or beyond. However, the earliest physical signs of atherosclerosis, the underlying disease process that leads to these events, may be present from early childhood.

There are now a variety of noninvasive tests used to assess both the structural and functional properties of the vasculature and in vivo changes suggestive of 'early atherosclerosis' have now been characterised. These have allowed not only an increased understanding of the atherosclerotic changes to the vasculature that accompany overweight and obesity in children, but have also allowed serial study of the effects of diet and exercise interventions on early atherosclerosis changes, in childhood obesity.