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Published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC), the study found that compared to children who keep a healthy weight between ages four and six, those with new or persistent excess weight as measured by BMI (body mass index) were two and a half times more likely to run the risk of high blood pressure.

In those with 'new or persistent abdominal obesity', the risks for high blood pressure were up to three and a half times greater, though those children who lost weight did not have an increased risk of high blood pressure. The findings applied to all children, regardless of sex or socioeconomic status.

“The myth that excess weight in children has no consequences hampers the prevention and control of this health problem,” said study author Dr Iñaki Galán, of Carlos III Health Institute, Madrid, Spain.

“Parents need to be more physically active with young children and provide a healthy diet. Women should shed extra pounds before becoming pregnant, avoid gaining excess weight during pregnancy, and quit smoking, as these are all established risk factors for childhood obesity.”

According to the World Health Organization, childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and the prevalence has increased at an ‘alarming’ rate. In 2016, it was reported that more than 41 million children under the age of five were overweight.

This study, based on the ELOIN cohort, examined the link between excess weight and high blood pressure in 1,796 four-year-olds who were followed up two years later. Blood pressure was measured at both time points, as was body mass index and waist circumference.

“There is a chain of risk, whereby overweight and obesity lead to high blood pressure, which heightens the chance of cardiovascular disease if allowed to track into adulthood,” said Galán.

“But the results show that children who return to a normal weight also regain a healthy blood pressure.”

"The best way to maintain a healthy weight and lose excess kilos is to exercise and eat a healthy diet", said Galán.

In addition to the central role of parents, the study recommended that the school curriculum needed to include three to four hours of physical activity every week.

Teachers should supervise activities during breaks, while schools can offer games and sports after classes and provide nutritionally balanced meals and snacks.

Galán noted that overweight in children is most accurately assessed using both BMI and waist circumference. In the study, using either measurement alone would have missed 15% to 20% of cases.