Response to the letter sent by Dr. Viroj Wiwanitkit entitled "Body mass index and screening for cardiovascular disease risk"

Abstract

Infancy is the period of life that ranges from conception to about 12 years old, and it is divided in first infancy (birth to 2 years old), second infancy (2 to 6 years old) and late infancy (6 to 12 years old) (1). Thus, we consider that, although the term encompasses more than the ages 7 to 12, these ages are within the period of life called infancy.Although the second and third points raised by Dr. Wiwanitkit are extremely relevant, we believe they set us away for the objective of the study. Thus, these two questions will be answered together. The authors, as Dr. Wiwanitkit, are aware of the information available in literature indicating that the body mass index (BMI) is mediated by different elements including feeding habits, and that excess weight is influenced by different risk factors, including sleep habits (2).However, the intention of the article was to provide BMI cutoff values obtained from cardiovascular risk factor references, rather than carry out a study on associated factors of excess weight, although this kind of study is essential, as evidenced by Must and cols. (2). Therefore, our objective was to provide an empirically validated instrument for the screening of school children and adolescents with increased probability of presenting cardiovascular risk factors, to professionals who work with this age group. In order to reach this objective, we used information about blood pressure (systolic and diastolic) and total cholesterol. These factors were chosen to compose the cardiovascular risk factor reference because, together with smoking and diabetes mellitus, they are the main modifiable cardiovascular risk factors (3). RefeRences1. Gabbard C. Lifelong motor development (5th ed.

Sitting-height measures are related to body mass index and blood pressure levels in children

“…Until recently, the risk of high blood pressure in children was neglected in pediatric clinical practice. Currently, growing evidence shows that hypertension in adults has antecedents in childhood (8), and that risk detection in that period can impact the occurrence of adverse events in young adults (9)(10)(11)(12). The first highlight of this study is the prevalence of 7% of children with high blood pressure levels, showing that hypertension is not rare in that age.…”

“…In adults, relatively long members have been associated with increased risk of cancer (2), while relatively short members have been associated to higher rates of diabetes, dyslipidemia (8,9), hypertension (9,10) and adverse cardiovascular outcomes (3,11). In children, few studies were directed to those associations.…”