Children as young as 10 could display a key sign of a potentially deadly condition, experts have warned. New research has found that having belly fat at a young age is associated with a greater risk of heart disease.

The findings, which are set to be presented at this year’s European Congress on Obesity (ECO) in Spain, showed that adverse waist-to-height ratio trajectories (a marker for central obesity) during childhood may increase cardiometabolic and cardiovascular risk at 10 years old.

Within the research, children whose bellies gradually expanded relative to their height had elevated blood pressure, higher inflammation markers, and early signs of insulin resistance – the precursor to type 2 diabetes.

As part of the decade-long study, 700 children were monitored at 14 regular clinical visits from birth to age 10. Researchers used the waist-to-height ratio, which is calculated by dividing waist circumference by height.

Their cardiometabolic risk was evaluated using composite scores, adjusted for age and sex, which included high-density lipoprotein cholesterol (known as “good cholesterol”), triglycerides (blood fats), glucose, height-adjusted blood pressure, and HOMA-IR (insulin resistance). The study revealed three distinct patterns of waist-to-height ratio development from birth to age 10.

This included a stable “reference group” consisting of two-thirds of the children, a “rising then stabilising” group comprising around one in six, and a “slow-rising” group also accounting for roughly one in six. 

After accounting for factors such as sociodemographics, puberty status, and lifestyle habits including physical activity, sleep, and diet, the study found that children categorised as “slow-rising” had cardiometabolic risk scores 0.79 standard deviations higher, and cardiovascular disease risk scores 0.53 standard deviations higher than those in the reference group. This indicates a substantial deterioration in cardiometabolic health by age 10.

The “slow-rising” group also exhibited higher systolic blood pressure and increased levels of C-peptide, HOMA-IR, glycoprotein acetyls (GlycA), and high-sensitivity C-reactive protein (hs-CRP), all of which are indicators of chronic inflammation and potential precursors to cardiovascular disease.

Moreover, these children showed reduced levels of HDL cholesterol, commonly known as “good” cholesterol, signalling early markers for future heart and metabolic diseases. In contrast, the “rising then stabilising” group displayed significantly lower haemoglobin A1c (HbA1c) levels, suggesting better regulation of blood sugar, and marginally elevated apolipoprotein B (ApoB) levels, a separate risk factor for cardiovascular disease.

Upon considering the amount of belly fat the children had at age 10, researchers discovered that this accounted for the majority of health risk disparities among the groups. Lead study author Dr David Horner, from the University of Copenhagen in Denmark, explained:  “This means that the children’s current level of abdominal fat – not just how their fat developed over time – was the strongest predictor of their heart and metabolic health. 

“Once this factor was included in the analysis, the earlier pattern of gradual fat gain (“slow-rising” group) was no longer linked to higher risk on its own. This suggests that where a child ends up, how much belly fat they have at age 10, matters more than how they got there. In other words, it’s the amount of central fat at that age, not necessarily the pattern of gain over time, that plays the biggest role in determining their present-day risk for heart and metabolic problems.”

He added: “Our findings highlight that an elevated waist-to-height ratio at age 10 is a key clinical indicator of cardiometabolic risk in children. This reinforces the importance of monitoring central obesity in routine care, not only tracking weight, but specifically measures of central obesity as part of standard assessments. 

“As clinical focus shifts from weight alone to identifying children with early signs of metabolic risk, waist-to-height ratio offers a simple and effective tool for detecting central obesity with cardiometabolic relevance. Identifying children with elevated ratios can help clinicians target those at greater risk of metabolic dysfunction, supporting more personalised interventions and early prevention of long-term complications.”

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Belly fat in adults has already been linked to a number of health risks, with high levels of visceral fat, which is stored deep within the belly, associated with heart disease, diabetes, dementia, and even cancer. 

To check if your visceral fat levels are too high as an adult, experts from the Cleveland Clinic recommend a straightforward method involving a tape measure. Measure by positioning it around your waist just above your hip bones.

According to these specialists: “For women, 35 inches or more means you’re at risk for health problems stemming from visceral fat,” while, “for men, the number is 40 inches or more.”

In the UK it’s estimated that around one in every four adults and around one in every five children aged 10 to 11 are living with obesity. Anyone worried about their weight and potential health risks should think about speaking to their doctor.