The prevalence of overweight and obesity in children and adolescents in the US has increased significantly in the last three decades [1].
Overweight is defined as having excess body weight for height from
fat, muscle, bone, water, or a combination of these factors [2]. Obesity
is defined as having excess body fat [3]. Empirically, overweight is
defined as BMI above the 85% and below the 95% for age and obesity
as BMI above the 95th percentile for age.
The proportion of adolescents and adults with congenital heart disease (CHD) with overweight and obesity parallels that of the general
population. Exercise restrictions or concerns about capacity to exercise
in persons with CHD may lead to a higher prevalence of poor fitness.
Ferns et al. demonstrated reduced exercise capacity in boys and girls
who were obese compared with their peers over the age range 4 to 18
years. Obese participants had higher heart rates early in exercise than
those of normal weight [4]. Higher resting heart rates have been demonstrated in children who are obese compared to their lean peers [5].
Obesity in children, as well as adults, is associated with endothelial dysfunction and multiple markers of inflammation raising concern about
additional burden to people with structural heart disease [6].
The population of adolescents and adults with congenital heart
disease is increasing rapidly leading to interest in evaluating morbidity
associated with excess weight in this population.
2. Methods