The Coronary Artery Risk Detection in Appalachian Communities Program, or CARDIAC, is a unique program that has been ongoing in West Virginia since 1998. According to the program website, it is “a chronic disease risk surveillance and intervention initiative designed to combat the unacceptably high prevalence of heart disease and diabetes in West Virginia”. I learned about this program last year as I began to search for data about the health of children in the state, and was really excited to see the wealth of information that this project has generated.
To implement change and improve the health of our nation (or state, in this case), it is helpful to have starting measurements. This process of data collection is laborious and time-intensive, and requires commitment from both researchers and participants in the study. This project is exceptional, and received the US Department of Health and Human Services Innovation in Prevention Award in 2007.
In West Virginia, all 5th grade students are given the opportunity to participate in the free screening, which includes height and weight measurements to determine Body Mass Index (BMI), blood pressure, a fasting lipid profile, and recording the presence or absence of Acanthosis Nigricans. Acanthosis Nigricans is a skin disorder in which there is darker, thick velvety skin in body folds and creases, and is often a marker of insulin resistance, associated with hormonal problems and obesity. This simple visual test (typically done by examining the back of the neck) is included in screening in order to aid in identifying students who may have undiagnosed diabetes.
Since the inception of the program, 81,156 5th graders have been screened. Of these students, 5.2% had Acanthosis Nigricans. In total, 18.8% were overweight and an additional 28.3% were obese. In other words, 47.1% of all 5th grade students screened in West Virginia over the past 14 years were overweight or obese. That is a scary statistic, especially considering the fact that overweight children have a higher tendency of becoming overweight adults (1).
In addition to carrying excess body weight, over twenty-five percent (25.7%) of children screened had abnormal blood lipids, also increasing their risk of heart disease.
A modified version of the screening has also been conducted since 2003 in younger children. Of the kindergarten children, 16.4% were overweight and 17.5% were obese- a total of 33.9%. To read more about this project and see additional statistics, visit the website.
1. Guo SS, Wu W, Chumlea WC, Roche AF. Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. The American Journal of Clinical Nutrition. 2002;76(3):653-658.