Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study

Background. Childhood obesity is related to adult levels of lipids, lipopro teins, blood pressure, and insulin and to morbidity from coronary heart dis ease (CHD). However, the importance of the age at which obesity develops in these associations remains uncertain. Objective and Design. We assessed the longitudinal relationship of childhoo d body mass index (BMI, kg/m(2)) to adult levels of lipids, insulin, and bl ood pressure among 2617 participants. All participants were initially exami ned at ages 2 to 17 years and were reexamined at ages 18 to 37 years; the m ean follow-up was 17 years. Results. Of the overweight children (BMI greater than or equal to 95th perc entile), 77% remained obese (>30 kg/m(2)) as adults. Childhood overweight w as related to adverse risk factor levels among adults, but associations wer e weak (r similar to 0.1-0.3) and were attributable to the strong persisten ce of weight status between childhood and adulthood. Although obese adults had adverse levels of lipids, insulin, and blood pressure, levels of these risk factors did not vary with childhood weight status or with the age (les s than or equal to8 years, 12-17 years, or greater than or equal to 18 year s) of obesity onset. Conclusions. Additional data are needed to assess the independent relations hip of childhood weight status to CHD morbidity. Because normal-weight chil dren who become obese adults have adverse risk factor levels and probably w ill be at increased risk for adult morbidity, our results emphasize the nee d for both primary and secondary prevention.