Which Children Will be Overweight or Obese As Adults?

Reprinted from Eating Disorders Review
November/December 2003 Volume 13, Number 6
©2002 Gürze Books

The Centers for Disease Control and Prevention (CDC) recently published revised growth charts for children and teens in the U.S. Results of a recent study indicate that higher-than-normal body mass index (BMI, kg/m2) values during childhood and adolescence are important risk factors for adult obesity and overweight (Am J Clin Nutr 2002;76:497).

Dr. Shumei Sun Guo and colleagues at Wright State University School of Medicine, Kettering, OH, used logistical models fitted to relate adult overweight and obesity to childhood and teen BMI values at each age for 166 males and 181 females in the Fels Longitudinal Study. The Fels study is a follow-up study of children who grew up in the years around World War II.

Relationship between high BMI in youth and obesity in adulthood

The researchers found that a child or adolescent with a high BMI percentile on the CDC growth charts had an increased risk of being overweight or obese by 35 years of age, and that this risk increases with age. For example, the probability of adult obesity at the 85th percentile for young males was ≤20% for young males to 17 years of age and 20% to 60% afterward; the corresponding probability for young females was 20% to 40% up to 18 years of age and 40% to 60% afterward.

Some additional points to ponder

In an editorial accompanying the article, George A. Bray, MD, a world authority on obesity, pointed out some limitations of Dr. Guo’s study. First, the children who participated in the Fels Longitudinal Study grew up during World War II, before obesity had become a major epidemic. Thus, the data might underestimate or overestimate the risk of obesity later in life. In addition, all the children in the Fels study were white; and Dr. Bray pointed out that today obesity affects more minorities than whites in the U.S. In addition, environmental factors should be factored in because they probably play a predominant role in the current epidemic of overweight and obesity. He suggests adding the weight status of parents to the approach used by Dr. Guo because children from families in which one or both parents are overweight have a much higher risk of becoming obese as adults than do children whose parents are not overweight.

Finally, he adds, certain genetic conditions have to be factored in. For example, gestational diabetes can also play an important role in development of obesity, as seen in the Pima Indians of the Southwest. As a group, the Pima have the highest rate of obesity and diabetes mellitus in the country. In the 1920s, they were lean and had one of the lowest rates of diabetes in the world. A diet that changed from native foods to fast foods and automation with labor-saving devices brought on the epidemic of obesity and diabetes that plagues the Pima today.

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