Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta‐analysis

Obese children are at higher risk of being obese as adults, and adult obesity is associated with an increased risk of morbidity. This systematic review and meta‐analysis investigates the ability of childhood body mass index (BMI) to predict obesity‐related morbidities in adulthood. Thirty‐seven studies were included. High childhood BMI was associated with an increased incidence of adult diabetes (OR 1.70; 95% CI 1.30–2.22), coronary heart disease (CHD) (OR 1.20; 95% CI 1.10–1.31) and a range of cancers, but not stroke or breast cancer. The accuracy of childhood BMI when predicting any adult morbidity was low. Only 31% of future diabetes and 22% of future hypertension and CHD occurred in children aged 12 or over classified as being overweight or obese. Only 20% of all adult cancers occurred in children classified as being overweight or obese. Childhood obesity is associated with moderately increased risks of adult obesity‐related morbidity, but the increase in risk is not large enough for childhood BMI to be a good predictor of the incidence of adult morbidities. This is because the majority of adult obesity‐related morbidity occurs in adults who were of healthy weight in childhood. Therefore, targeting obesity reduction solely at obese or overweight children may not substantially reduce the overall burden of obesity‐related disease in adulthood.

[1]  R. Feinstein,et al.  Childhood Overweight and Obesity. , 2016, Gastroenterology clinics of North America.

[2]  M. Simmonds,et al.  The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. , 2015, Health technology assessment.

[3]  D. Cook,et al.  Adiposity in Early, Middle and Later Adult Life and Cardiometabolic Risk Markers in Later Life; Findings from the British Regional Heart Study , 2014, PloS one.

[4]  T. Sørensen,et al.  Body mass index in childhood and adult risk of primary liver cancer. , 2014, Journal of hepatology.

[5]  C. Bombardier,et al.  Assessing Bias in Studies of Prognostic Factors , 2013, Annals of Internal Medicine.

[6]  K. Goel,et al.  Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of "normal weight central obesity". , 2013, Journal of the American College of Cardiology.

[7]  T. Robinson,et al.  The Utility of Childhood and Adolescent Obesity Assessment in Relation to Adult Health , 2013, Medical decision making : an international journal of the Society for Medical Decision Making.

[8]  A. Leiba,et al.  Overweight in Adolescence Is Related to Increased Risk of Future Urothelial Cancer , 2012, Obesity.

[9]  R. Viner,et al.  The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[10]  Ivana Vucenik,et al.  Annals of the New York Academy of Sciences Obesity and Cancer Risk: Evidence, Mechanisms, and Recommendations , 2022 .

[11]  L. Oliver,et al.  Unintentional injury hospitalizations among children and youth in areas with a high percentage of Aboriginal identity residents: 2001/2002 to 2005/2006. , 2012, Health reports.

[12]  J. Reilly Evidence-based obesity prevention in childhood and adolescence: critique of recent etiological studies, preventive interventions, and policies. , 2012, Advances in nutrition.

[13]  Mark S Tremblay,et al.  Abdominal obesity and cardiovascular disease risk factors within body mass index categories. , 2012, Health reports.

[14]  L. Mccargar,et al.  Early markers of adult obesity: a review , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[15]  M. Ashwell,et al.  Waist‐to‐height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta‐analysis , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[16]  M. Barchana,et al.  Measured body mass index in adolescence and the incidence of pancreatic cancer in a cohort of 720,000 Jewish men , 2012, Cancer Causes & Control.

[17]  M. Barchana,et al.  Measured Body Mass Index in Adolescence and the Incidence of Colorectal Cancer in a Cohort of 1.1 Million Males , 2011, Cancer Epidemiology, Biomarkers & Prevention.

[18]  L. Lloyd,et al.  Childhood obesity and risk of the adult metabolic syndrome: a systematic review , 2011, International Journal of Obesity.

[19]  J. Mi,et al.  [Association between obesity in childhood and hypertension incidence: a prospective cohort study]. , 2011, Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine].

[20]  T. Dwyer,et al.  Predictive associations between alternative measures of childhood adiposity and adult cardio-metabolic health , 2011, International Journal of Obesity.

[21]  J. Reilly,et al.  Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review , 2011, International Journal of Obesity.

[22]  Chris Power,et al.  Predicting cardiovascular disease risk factors in midadulthood from childhood body mass index: utility of different cutoffs for childhood body mass index. , 2011, The American journal of clinical nutrition.

[23]  Joan K. Morris,et al.  Screening for Future Cardiovascular Disease Using Age Alone Compared with Multiple Risk Factors and Age , 2011, BDJ.

[24]  A. Rudich,et al.  Adolescent BMI trajectory and risk of diabetes versus coronary disease. , 2011, The New England journal of medicine.

[25]  Nicholas J Wald,et al.  Assessing risk factors as potential screening tests: a simple assessment tool. , 2011, Archives of internal medicine.

[26]  T. Laitinen,et al.  Pediatric Metabolic Syndrome Predicts Adulthood Metabolic Syndrome, Subclinical Atherosclerosis, and Type 2 Diabetes Mellitus but Is No Better Than Body Mass Index Alone: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study , 2010, Circulation.

[27]  Michael J. Merten Weight Status Continuity and Change From Adolescence to Young Adulthood: Examining Disease and Health Risk Conditions , 2010, Obesity.

[28]  P. Horn,et al.  Childhood predictors of adult type 2 diabetes at 9- and 26-year follow-ups. , 2010, Archives of pediatrics & adolescent medicine.

[29]  D. Cook,et al.  Is body mass index before middle age related to coronary heart disease risk in later life? Evidence from observational studies , 2009, International Journal of Obesity.

[30]  R. Collins,et al.  Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies , 2009, The Lancet.

[31]  R. Collins,et al.  Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies , 2009, Lancet.

[32]  D. Prabhakaran,et al.  Predicting adult metabolic syndrome from childhood body mass index: follow-up of the New Delhi birth cohort , 2008, Archives of Disease in Childhood.

[33]  T. Bjørge,et al.  Body mass index in adolescence in relation to cause-specific mortality: a follow-up of 230,000 Norwegian adolescents. , 2008, American journal of epidemiology.

[34]  A. S. Singh,et al.  Tracking of childhood overweight into adulthood: a systematic review of the literature , 2008, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[35]  J. Viikari,et al.  Childhood predictors of the metabolic syndrome in adulthood. The Cardiovascular Risk in Young Finns Study , 2008, Annals of medicine.

[36]  T. Sørensen,et al.  [Childhood body mass index and the risk of coronary heart disease in adulthood]. , 2007, Ugeskrift for laeger.

[37]  H. Sweeting,et al.  Measurement and Definitions of Obesity In Childhood and Adolescence: A field guide for the uninitiated , 2007, Nutrition journal.

[38]  A. Tirosh,et al.  Blood-pressure categories in adolescence predict development of hypertension in accordance with the European guidelines. , 2007, American journal of hypertension.

[39]  C. Power,et al.  Body mass index throughout the life-course and blood pressure in mid-adult life: a birth cohort study , 2007, Journal of hypertension.

[40]  J. Eriksson,et al.  Infant Growth and Stroke in Adult Life: The Helsinki Birth Cohort Study , 2007, Stroke.

[41]  T. Sørensen,et al.  Growth patterns and the risk of breast cancer in women. , 2006, International journal of gynecological cancer : official journal of the International Gynecological Cancer Society.

[42]  D. Lawlor,et al.  The associations of birthweight, gestational age and childhood BMI with type 2 diabetes: findings from the Aberdeen Children of the 1950s cohort , 2006, Diabetologia.

[43]  Jill Hayden,et al.  Evaluation of the Quality of Prognosis Studies in Systematic Reviews , 2006, Annals of Internal Medicine.

[44]  J. Eriksson,et al.  Trajectories of growth among children who have coronary events as adults. , 2005, The New England journal of medicine.

[45]  John P A Ioannidis,et al.  Selective reporting biases in cancer prognostic factor studies. , 2005, Journal of the National Cancer Institute.

[46]  C. Bouchard,et al.  Utility of childhood BMI in the prediction of adulthood disease: comparison of national and international references. , 2005, Obesity research.

[47]  Debbie A Lawlor,et al.  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 , 2005, Circulation.

[48]  Walter C Willett,et al.  Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. , 2005, The American journal of clinical nutrition.

[49]  T. Bjørge,et al.  Relation of height and body mass index to renal cell carcinoma in two million Norwegian men and women. , 2004, American journal of epidemiology.

[50]  D. Machin,et al.  A longitudinal study of pediatric body mass index values predicted health in middle age. , 2004, Journal of clinical epidemiology.

[51]  G. Davey Smith,et al.  Childhood body mass index and later cancer risk: A 50‐year follow‐up of the Boyd Orr study , 2004, International journal of cancer.

[52]  V. McCormack,et al.  Childhood growth and breast cancer. , 2004, American journal of epidemiology.

[53]  J. Eriksson,et al.  Extreme hypertrophic cardiomyopathy , 2003, Heart.

[54]  E. Hyppönen,et al.  Prenatal growth, BMI, and risk of type 2 diabetes by early midlife. , 2003, Diabetes care.

[55]  B. Hacking,et al.  Health consequences of obesity , 2003, Archives of disease in childhood.

[56]  Anders Engeland,et al.  Height, body mass index, and ovarian cancer: a follow-up of 1.1 million Norwegian women. , 2003, Journal of the National Cancer Institute.

[57]  Clive Osmond,et al.  Growth and living conditions in childhood and hypertension in adult life: a longitudinal study , 2002, Journal of hypertension.

[58]  C Osmond,et al.  Tallness and overweight during childhood have opposing effects on breast cancer risk , 2001, British Journal of Cancer.

[59]  J. Eriksson,et al.  Early growth and coronary heart disease in later life: longitudinal study , 2001, BMJ : British Medical Journal.

[60]  Clive Osmond,et al.  The Fetal and Childhood Growth of Persons Who Develop Type 2 Diabetes , 2000, Annals of Internal Medicine.

[61]  I. Olkin,et al.  Meta-analysis of observational studies in epidemiology - A proposal for reporting , 2000 .

[62]  N. Wald,et al.  When can a risk factor be used as a worthwhile screening test? , 1999, BMJ.

[63]  T. Peters,et al.  Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. , 1998, The American journal of clinical nutrition.

[64]  A. Leiba,et al.  Adolescent obesity and paternal country of origin predict renal cell carcinoma: a cohort study of 1.1 million 16 to 19-year-old males. , 2013, The Journal of urology.

[65]  L. Lloyd,et al.  Childhood obesity and adult cardiovascular disease risk: a systematic review , 2010, International Journal of Obesity.

[66]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[67]  Yang Gao,et al.  Interventions for preventing obesity in children. , 2005, The Cochrane database of systematic reviews.

[68]  E. Waters,et al.  Interventions for preventing obesity in children. , 2001, The Cochrane database of systematic reviews.