High normal weight status in childhood as a predictor of being overweight or hypertensive in early adulthood

• Published in: Journal of adolescent health Vol. 32; no. 2; p. 125
• Main Authors: Field, Alison E., Cook, Nancy, Gillman, Matthew W.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.02.2003
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/S1054-139X(02)00619-5

Purpose: To assess the extent to which weight status in childhood or adolescence predicts weight status and blood pressure in young adulthood. Methods: Prospective study (The East Boston Blood Pressure Study) of 315 children from an urban community in Massachusetts, who were 8 to 15 years at time of enrollment (1978 to 1981), and were followed up again in 1989-1990 (young adult visit). At baseline subjects were evaluated at up to four weekly visits per year for four years, and at follow-up at three weekly visits. Weight, height, and blood pressure were measured by trained research staff. Overweight and obesity were defined as being at or above the 85th percentile (overweight) or above the 95th percentile (obesity) of body mass index (BMI) for age and sex. High blood pressure was defined as having systolic blood pressure at or above 140 mm/Hg and/or diastolic blood pressure at or above 90 mm/Hg and/or reporting the use of anti-hypertensive medication. Results: More males (55%) than females (30%) were overweight or obese at the young adult follow-up (p < .001). Weight status in childhood was a good predictor of being overweight or obese as a young adult. Children with a BMI between the 50th to 75th age- and gender-percentile were approximately five times (girls: odds ratio [OR] = 5.3, 95% confidence interval [CI] 0.8-23.5; boys: OR = 5.3, 95% CI 1.9-15.1) more likely than their leaner peers to become overweight or obese during the 8 to 12 years of follow-up. Those between the 75th and 85th percentiles were at least nine times more likely than their peers below the 50th percentile to become overweight or obese (girls: OR = 35.9, 95% CI 7.5-171.2; boys: OR = 9.2, 95% CI 3.2-26.1) during the follow-up. High blood pressure was more common among the males (11%) than the females (0.6%). Boys between the 75th and 84th percentile of BMI were 3 times more likely (OR = 3.6, 95% CI 0.7-18.0) and those at above the 85th percentile were 5 times more likely (OR = 4.9, 95% CI 1.4-17.1) than their leaner peers below the 50th percentile to become hypertensive. There were too few cases of high blood pressure among the girls to assess the relationship with BMI. Conclusions: Our findings suggest that although the risk of excessive weight and elevated blood pressure are highest among overweight youth, those in the upper end of the healthy weight range are also at elevated risk. Boys in the upper end of the healthy weight range (e.g., 50th-84th percentiles) were at a significantly increased risk of becoming hypertensive by adulthood. These findings suggest that future interventions to prevent adult obesity and its complications should include children and adolescents in the high normal weight range.