More than 10 percent of preschool children between the ages of two and five were overweight in 2002 -- up from 7 percent in 1994, according to the American Heart Association's Heart Disease and Stroke Statistics - 2005 Update released Friday.

Since 1991, the prevalence of obesity among American adults has increased 75 percent.

Risk Factors Present Early in Life

Cardiovascular disease (CVD) -- still the nation's No. 1 killer -- claimed 927,448 American lives in 2002, reports the AHA. The update includes a new section on the metabolic syndrome (MetS) in adolescents that indicates that rates of controllable risk factors for cardiovascular diseases are increasing among America's young people.

Cardiovascular diseases include high blood pressure, coronary heart disease (heart attack and angina), congestive heart failure, stroke and congenital heart defects, among others. The update includes recently published data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) showing that about 65 million Americans had high blood pressure in 2002, which represents a 30 percent increase over the previous survey from 1988-94.

"While heart attacks and stroke remain the leading causes of death in men and women, we see in the 2005 Update that many risk factors for these conditions are common, preventable and occur well before the onset of disease," said Christopher O'Donnell, M.D., associate director of the National Heart, Lung and Blood Institute's Framingham Heart Study, and chair of the American Heart Association's statistics committee.

"These risk factors, including abnormal blood lipids and high blood pressure, often present early in life even before middle age, when preventative measures might make a large difference," Dr. O'Donnell says.

Metabolic Syndrome in Adolescents

About 1 million 12-19-year-olds in the United States (or 4.2 percent overall) have MetS. Many controllable risk factors for heart disease are encompassed in the metabolic syndrome: abnormal blood lipids, high glucose (blood sugar), high blood pressure and overweight/obesity. MetS during adolescence was defined in the 1988-1994 NHANES data as three or more of these abnormalities:

• Blood triglyceride level of 110 milligrams per deciliter (mg/dL) or higher.

• High-density lipoprotein (HDL, the "good" cholesterol) levels of 40 mg/dL or lower.

• Elevated fasting glucose of 110 mg/dL or higher.

• Blood pressure above the 90th percentile for age, sex and height.

• Waist circumference at or above the 90th percentile for age and sex.

The most common risk factor found in adolescents with MetS is being overweight. Not all overweight adolescents will have MetS, which was present in just under 30 percent of overweight adolescents. However, of those with MetS, nearly two-thirds were overweight.

Overweight in this age group means that body mass index (BMI), a measure of body fatness, was at or above the 95th percentile according to the Centers for Disease Control growth charts for children of similar age and sex.

Epidemic Increases

"Childhood risk factors carry over into adulthood, and may eventually translate into heart disease and other medical problems, such as diabetes. Obesity is a major risk factor for heart disease that should be controlled early in life," said Robert H. Eckel, M.D., an endocrinologist at the University of Colorado Health Science Center, Division of Endocrinology, Metabolism and Diabetes, and president-elect of the American Heart Association.

"Intervention is urgently needed for high-risk people to reverse the alarming and epidemic increases in diabetes, obesity and metabolic syndrome, particularly in young people," Dr. O'Donnell warned.

The Fast-Food Factor

In related news, researchers have shown a correlation between fast food, weight gain, and insulin resistance in what appears to be the first long-term study on this subject.

The Coronary Artery Risk Development in Young Adults (CARDIA) study by Mark Pereira, Ph.D., assistant professor in epidemiology, University of Minnesota School of Public Health, and David Ludwig, M.D., Ph.D., director of the Obesity Program at Children's Hospital Boston, reported that fast food increases the risk of obesity and type 2 diabetes.

Participants who consumed fast food two or more times a week gained approximately 10 more pounds and had twice as great increase in insulin resistance in the 15-year period than participants who consumed fast food less than once per week.

Dieting May Exacerbate the Problem

Despite the alarming trend, Americans should not rush to put their children -- or themselves -- on the latest reducing diet, say experts. A common-sense approach to eating and physical activity is advised.

"Americans are obsessed with dieting and food." says University of Michigan Health System cardiovascular nutritionist Marilyn Migliore, M.S., R.D., C.S.W., a cardiovascular nutritionist/social worker. The South Beach Diet has consistently ranked as one of the top five advice books on the New York Times best seller list, she notes. The irony is that 64 percent of adults in the United States remain either overweight or obese -- the highest incidence on the planet.

"The food industry has spent $30 billion in advertising. It's overwhelming in amount, powerful in presentation and pernicious in outcome. It has conditioned us to become food eating machines," says Migliore, author of The Hunger Within.

The diet industry has also done its part to get Americans on the dieting bandwagon: from Atkins to South Beach; ‘low carb' to ‘no carb;' Anna Nicole Smith - before and after; and those ‘lose 10 pounds in 10 days' gimmicks. These "quick-fix" approaches amount to putting a band-aid on the symptoms but ultimately exacerbating the problem, says Migliore.

Healthier Choices

"We can shift away from that mindset by, rather than looking at food in terms of what you should and should not be eating, just make the decisions based on what the particular food is going to provide you," Migliore explains. "Learning to use the tools we have available to us, such as reading nutrition labels; and understanding how our internal and external environment can affect why, how much and when we eat, can ensure that we manipulate our own environments and keep it from manipulating us."

Some fast-food restaurants are responding to a call for healthier choices.

"Appropriate action would be to reduce portions to normal sizes, and to sell burgers of lean meat, whole-grain bread or buns, fat-reduced mayonnaise, more vegetables, lower-fat fried potatoes, and reduced-sugar soft drinks," says Arne Astrup of RVA University, Copenhagen, Denmark.