Abstract 046: Excessive Gain in BMI Between Age 7-16 is Related to Cardiovascular Disease Risk in Adulthood: A Longitudinal Study
Obesity in childhood has been shown to promote adult obesity and the development of cardiovascular disease (CVD) risk. However, little longitudinal information exists on the rate of progression of adiposity during childhood as a predictor of adult insulin resistance and markers of CVD risk. We hypothesize that excessive adiposity in childhood and adolescence predicts adult individual CV risk factors, insulin resistance and vascular changes.
Children (n=383 mean age 7 yrs), were measured periodically for height, weight and blood pressure through adolescence. As adults (n=383, mean age 39 y, 50% female), height, weight, lipids, insulin resistance and carotid intima-media thickness (cIMT) were measured. Body mass index (BMI) categories (normal, overweight, and obese) were created by standard criteria. According to the CDC BMI growth charts, the normal mean change in BMI from age 7-16 at the 50th percentile is 5 kg/m2. Linear regression evaluated the influence of excessive weight gain in childhood on the development of adverse CVD risk factors in adulthood stratifying by 50 percentile change in BMI (≤5kg/m2 vs >5kg/m2) between childhood and adolescence, adjusting for confounding factors.
Of 313 normal weight children, 32% stayed normal weight, 68% became overweight and obese in adulthood. Of 45 overweight children 90% stayed overweight or became obese in adulthood. Of 25 obese children 100% became overweight and stayed obese in adulthood. Compared to ≤5kg/m2, a BMI gain of >5 kg/m2 between childhood and adolescence was more common in blacks than in whites and was associated with greater CV risk in adulthood: greater % obesity; higher blood pressure, lipids, insulin resistance (M/lbm=insulin sensitivity) and cIMT (Table).
These findings show that: 1) childhood adiposity is a strong predictor of adult overweight and obesity, and 2) excessive BMI gain between childhood and adolescence is a major determinant of obesity and CVD risk in adulthood.
- © 2013 by American Heart Association, Inc.