Abstract
Youth-onset metabolic diseases, including obesity and type 1 and type 2 diabetes, and their associated cardiometabolic complications represent a major global health challenge. The incidence and prevalence of these conditions vary across regions, with rising trends and a heavier burden observed in middle- and low-income countries. Diet, physical activity and lifestyle choices are key factors in the development and progression of metabolic diseases during childhood and adolescence, along with additional risk factors such as genetic predisposition, ancestry, ethnicity, lifetime events (i.e. puberty) and other environmental factors. Disparities in access to healthcare, diagnostic and management capabilities and treatment options across the world affect outcomes, contributing to high morbidity and mortality rates, particularly in low-resource settings. Compared with onset during adulthood, an early diagnosis of metabolic diseases is associated with a higher risk and severity of complications, including adverse vascular outcomes and premature mortality. Although clinical signs of cardiovascular complications typically appear in adulthood, they are the result of a long, subclinical disease process that can begin in childhood and adolescence. This underscores the need for early prevention strategies and effective treatments to reduce the short- and long-term health impacts of these conditions. Addressing the rising prevalence of metabolic diseases, especially among vulnerable populations, requires comprehensive, culturally tailored actions that consider the available resources in diverse settings.