Skip to main content
×
Home
    • Aa
    • Aa

Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable

  • Sarah McMullen (a1)
Abstract

The worldwide prevalence of overweight and obesity in the adult population is estimated to be 35 %. These trends are reflected in childhood obesity prevalence, and the potential impact of early-onset obesity is of great concern. The aim of this review was to investigate the long-term implications of childhood obesity for metabolic and cardiovascular health, focusing on the independent contribution of childhood obesity to adult disease risk, as distinct from associations mediated by tracking of obesity across the lifespan. The data systematically reviewed provide little evidence to suggest that childhood overweight and obesity are independent risk factors for metabolic and cardiovascular risk during adulthood. Instead, the data demonstrate that the relationships observed are dependent on tracking of BMI between childhood and adulthood, alongside persistence of dietary patterns and physical activity. Adjustment for adult BMI uncovers unexpected negative associations between childhood BMI and adult disease, suggesting a protective effect of childhood obesity at any given level of adult BMI. Further work is required to explain these findings, both in terms of pathways and statistical artefacts. To conclude, it must be stressed that it is not suggested that childhood obesity is without negative consequence. Childhood obesity is clearly associated with a range of adverse physical and psychological outcomes. However, the data are important in supporting a positive message that the long-term consequences of childhood obesity are avoidable; and that there remains opportunity for intervention across the lifespan. This nuance in understanding long-term risk is important when considering the effectiveness of interventions at different stages of the lifespan.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable
      Available formats
      ×
Copyright
Corresponding author
Corresponding author: S. McMullen, fax 0844 243 6001, email sarah.mcmullen@nct.org.uk
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. TLS Visscher & JC Seidell (2001) The public health impact of obesity. Annu. Rev Public Health 22, 355375.

5. CG Owen , PH Whincup , L Orfei (2009) Is body mass index before middle age related to coronary heart disease risk in later life? Evidence from observational studies. Int J Obes 33, 866877.

6. JJ Reilly & J Kelly (2011) Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes 35, 891898.

7. MH Park , C Falconer , RM Viner (2012) The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obes Rev 13, 9851000.

8. AS Singh , C Mulder , JWR Twisk (2008) Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 9, 474488.

9. T Lobstein (2008) Child obesity: what can be done and who will do it? Proc Nutr Soc 67, 301306.

10. K Silventoinen , M Bartels , D Posthuma (2007) Genetic regulation of growth in height and weight from 3 to 12 years of age: a longitudinal study of Dutch twin children. Twin Res Hum Genet 10, 354363.

11. CMA Haworth , S Carnell , EL Meaburn (2008) Increasing heritability of BMI and stronger associations with the FTO gene over childhood. Obesity 16, 26632668.

13. K Silventoinen & J Kaprio (2009) Genetics of tracking of body mass index from birth to late middle age: evidence from Twin and Family Studies. Obes Facts 2, 196202.

14. AM Craigie , AA Lake , SA Kelly (2011) Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas 70, 266284.

15. GL Ambrosini , PM Emmett , K Northstone (2012) Identification of a dietary pattern prospectively associated with increased adiposity during childhood and adolescence. Int J Obes 36, 12991305.

16. RM van Dam (2005) New approaches to the study of dietary patterns. Br J Nutr 93, 573574.

18. V Mikkila , L Rasanen , OT Raitakari (2005) Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in young Finns study. Br J Nutr 93, 923931.

19. OT Raitakari , KVK Porkka , S Taimela (1994) Effects of persistent physical activity and inactivity on coronary risk-factors in children and young adults – the cardiovascular risk in young Finns study. Am J Epidemiol 140, 195205.

20. X Chen & Y Wang (2008) Tracking of blood pressure from childhood to adulthood – a systematic review and meta-regression analysis. Circulation 117, 31713180.

21. SC Langley-Evans & S McMullen (2010) Developmental origins of adult disease. Med Princ Pract 19, 8798.

22. LJ Lloyd , SC Langley-Evans & S McMullen (2010) Childhood obesity and adult cardiovascular disease risk: a systematic review. Int J Obes 34, 1828.

23. LJ Lloyd , SC Langley-Evans & S McMullen (2012) Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obes 36, 111.

25. TJ Cole , MC Bellizzi , KM Flegal (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 12401243.

28. AR Sinaiko , RP Donahue , DR Jacobs (1999) Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults – the Minneapolis Children's Blood Pressure Study. Circulation 99, 14711476.

29. DS Freedman , LK Khan , WH Dietz (2001) Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics 108, 712718.

30. CM Wright , L Parker , D Lamont (2001) Implications of childhood obesity for adult health: findings from thousand families cohort study. BMJ 323, 12801284.

31. V Burke , LJ Beilin , D Dunbar (2004) Associations between blood pressure and overweight defined by new standards for body mass index in childhood. Prev Med 38, 558564.

32. R Hardy , ME Wadsworth , C Langenberg (2004) Birthweight, childhood growth, and blood pressure at 43 years in a British birth cohort. Int J Epidemiol 33, 121129.

33. AE Field , NR Cook & MW Gillman (2005) Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res 13, 163169.

34. L Li , C Law & C Power (2007) Body mass index throughout the life-course and blood pressure in mid-adult life: a birth cohort study. J Hypertens 25, 12151223.

35. A Oren , LE Vos , CS Uiterwaal (2003) Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: the Atherosclerosis Risk in Young Adults study. Int J Obes Relat Metab Disord 27, 13831390.

37. DS Freedman , WH Dietz , R Tang (2004) The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 28, 159166.

38. M Juonala , M Raitakari , J SAV (2006) Obesity in youth is not an independent predictor of carotid IMT in adulthood. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 185, 388393.

39. DS Freedman , DA Patel , SR Srinivasan (2008) The contribution of childhood obesity to adult carotid intima-media thickness: the Bogalusa Heart Study. Int J Obes 32, 749756.

41. MK Salonen , E Kajantie , C Osmond (2009) Role of childhood growth on the risk of metabolic syndrome in obese men and women. Diabetes Metab 35, 94100.

42. DS Freedman , LK Khan , MK Serdula (2004) Inter-relationships among childhood BMI, childhood height, and adult obesity: the Bogalusa Heart Study. Int J Obes 28, 1016.

43. RM Martin , JMP Holly , GD Smith (2006) Associations of adiposity from childhood into adulthood with insulin resistance and the insulin-like growth factor system: 65-year follow-up of the Boyd Orr cohort. J Clin Endocrinol Metab 91, 32873295.

44. MSBJC Thearle , WC Knowler & J Krakoff (2009) Childhood predictors of adult acute insulin response and insulin action. Diab Care 32, 938943.

45. JG Eriksson , T Forsen , J Tuomilehto (1999) Catch-up growth in childhood and death from coronary heart disease: longitudinal study. BMJ 318, 427431.

46. DA Lawlor & DA Leon (2005) Association of body mass index and obesity measured in early childhood with risk of coronary heart disease and stroke in middle age – findings from the Aberdeen children of the 1950s prospective cohort study. Circulation 111, 18911896.

48. T Bjorge , A Engeland , A Tverdal (2008) Body mass index in adolescence in relation to cause-specific mortality: a follow-up of 230,000 Norwegian adolescents. Am J Epidemiol 168, 3037.

50. JS Kaufman , RF Maclehose & S Kaufman (2004) A further critique of the analytic strategy of adjusting for covariates to identify biologic mediation. Epidemiol Perspect Innov 1, 4.

51. YK Tu , R West , GTH Ellison (2005) Why evidence for the fetal origins of adult disease might be a statistical artifact: the “reversal paradox” for the relation between birth weight and blood pressure in later life. Am J Epidemiol 161, 2732.

52. E Bonora , S Kiechl , J Willeit (1998) Prevalence of insulin resistance in metabolic disorders – The Bruneck Study. Diabetes 47, 16431649.

53. RP Wildman , P Muntner , K Reynolds (2008) The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004). Arch Intern Med 168, 16171624.

54. M Brochu , A Tchernof , IJ Dionne (2001) What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocrinol Metab 86, 10201025.

55. E Muscelli , S Camastra , A Gastaldelli (1998) Influence of duration of obesity on the insulin resistance of obese non-diabetic patients. Int J Obes Relat Metab Disord 22, 262267.

56. M Lundgren , M Svensson , S Lindmark (2007) Fat cell enlargement is an independent marker of insulin resistance and ‘hyperleptinaemia’. Diabetologia 50, 625633.

57. C Weyer , JE Foley , C Bogardus (2000) Enlarged subcutaneous abdominal adipocyte size, but not obesity itself, predicts type II diabetes independent of insulin resistance. Diabetologia 43, 14981506.

58. LB Salans , SW Cushman & RE Weismann (1973) Studies of human adipose tissue. Adipose cell size and number in nonobese and obese patients. J Clin Invest 52, 929941.

59. ES Ford (2003) C-reactive protein concentration and cardiovascular disease risk factors in children: findings from the National Health and Nutrition Examination Survey 1999–2000. Circulation 108, 10531058.

60. R Weiss , J Dziura , TS Burgert (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350, 23622374.

61. LM Bell , S Byrne , A Thompson (2007) Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range. J Clin Endocrinol Metab 92, 517522.

62. R Weiss , SE Taksali , S Dufour (2005) The ‘obese insulin-sensitive’ adolescent: importance of adiponectin and lipid partitioning. J Clin Endocrinol Metab 90, 37313737.

63. JE Galgani , C Moro & E Ravussin (2008) Metabolic flexibility and insulin resistance. Am J Physiol Endocrinol Metab 295, E10091017.

65. RM Puhl & JD Latner (2007) Stigma, obesity, and the health of the nation's children. Psychol Bull 133, 557580.

66. SK Lhachimi , WJ Nusselder , TJ Lobstein (2013) Modelling obesity outcomes: reducing obesity risk in adulthood may have greater impact than reducing obesity prevalence in childhood. Obes Rev 14, 523531.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 47
Total number of PDF views: 112 *
Loading metrics...

Abstract views

Total abstract views: 244 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd May 2017. This data will be updated every 24 hours.