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Predictive value of body mass index at age 18 on adulthood obesity: results of a prospective survey of an urban population.

ABSTRACT: Overweight children often become obese adults. The main purpose of this study was to define the risk of teenage obesity as a predictor of adulthood obesity in an under-studied and urban population. A secondary aim was to determine whether gender had an effect on the predictive value of teenage obesity. The final goal was to examine the influence of dietary habits on obesity.This cross-sectional survey was conducted using convenience sampling of an urban, primarily African American, community. Demographic questions were supplemented by a dietary history and measurement of body anthropometrics.Five hundred three subjects were interviewed; 86% were African American, and the mean age was 43 years. Body mass index (BMI) at age 18 was the strongest factor associated with current obesity status in univariate and multivariate analyses. Sixty-nine (13.7%) subjects were overweight at age 18, and 28 (5.6%) were obese. Of the 28 obese teenagers, 22 (78.6%) went on to become obese as adults. Only 2.1% of nonobese adults were obese as teenagers. For women, BMI at age 18 was more predictive of adult BMI than for men. Gain of ? 5 BMI units after age 18 was linked to a higher prevalence of diabetes and hypertension. No dietary differences were found between obese and nonobese adults.The results of this study provide evidence that high BMI at age 18 is strongly correlated with adulthood obesity, much more so with women than men. Eating habits did not have an impact, suggesting that obesity may be the result of a combination of factors yet to be clearly defined.

SUBMITTER: Friedenberg FK

PROVIDER: S-EPMC3166399 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Predictive value of body mass index at age 18 on adulthood obesity: results of a prospective survey of an urban population.

Friedenberg Frank K FK Tang Derek M DM Vanar Vishwas V Mendonca Thais T

The American journal of the medical sciences 20111101 5

<h4>Introduction</h4>Overweight children often become obese adults. The main purpose of this study was to define the risk of teenage obesity as a predictor of adulthood obesity in an under-studied and urban population. A secondary aim was to determine whether gender had an effect on the predictive value of teenage obesity. The final goal was to examine the influence of dietary habits on obesity.<h4>Methods</h4>This cross-sectional survey was conducted using convenience sampling of an urban, prim ...[more]

PMID: 21629040

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Project description:BackgroundAccurate obesity classification is important so that appropriate intervention can be instituted to modify metabolic risk factors. Commonly utilized body mass index (BMI) and percentage body fat (PBF) are influenced by lean mass whereas fat mass index (FMI) measures only body fat. This study compares the prevalence of obesity and metabolic risk factors with FMI, BMI and PBF using DXA (dual-energy x-ray absorptiometry).Methods489 women randomly recruited from the electoral roll were stratified into 4 age groups; 40-49, 50-59, 60-69 and 70-79 years from 2000 to 2001. Clinical data and DXA body composition were obtained. Statistical analyses were performed using Medcalc v15 (Ostend, Belgium) with significance level at p = 0.05 (two-tailed).ResultsThere was higher prevalence of obesity using PBF compared to BMI and FMI (p<0.001). This difference was greater from age 50-59 (p<0.05) which may be explained by age-related lean mass loss. PBF over-classified obesity in over 35% of normal and 95% of overweight categories compared to FMI and BMI. BMI has a sensitivity of 78.9% and specificity of 98.3% for obesity using FMI as the standard. BMI under-classified obesity in the overweight category by 14.9% compared to FMI. There was no difference in diabetes, dyslipidemia, hypertension and metabolic syndrome prevalence within the BMI-obesity and FMI-obesity categories (p>0.05).ConclusionPBF classified more obesity than BMI and FMI because of its low pre-determined threshold. The greater difference with PBF compared to BMI and FMI from the 50-59 decade onwards can be attributed to age-related lean mass loss. BMI had the lowest sensitivity for obesity diagnosis. BMI under-classified obesity in the overweight category compared to FMI due to its inability to differentiate lean mass. However, there was no significant difference in the prevalence of metabolic risk factors between BMI and FMI-obesity categories indicating that fat location may influence metabolic dysregulation.

Project description:BackgroundHistorically, cutoff points for childhood and adolescent overweight and obesity have been based on population-specific percentiles derived from cross-sectional data. To obtain cutoff points that might better predict overweight and obesity in young adulthood, we examined the association between childhood body-mass index (BMI) and young adulthood BMI status in a longitudinal cohort.MethodsIn this study, we used data from the International Childhood Cardiovascular Cohort (i3C) Consortium (which included seven childhood cohorts from the USA, Australia, and Finland) to establish childhood overweight and obesity cutoff points that best predict BMI status at the age of 18 years. We included 3779 children who were followed up from 1970 onwards, and had at least one childhood BMI measurement between ages 6 years and 17 years and a BMI measurement specifically at age 18 years. We used logistic regression to assess the association between BMI in childhood and young adulthood obesity. We used the area under the receiver operating characteristic curve (AUROC) to assess the ability of fitted models to discriminate between different BMI status groups in young adulthood. The cutoff points were then compared with those defined by the International Obesity Task Force (IOTF), which used cross-sectional data, and tested for sensitivity and specificity in a separate, independent, longitudinal sample (from the Special Turku Coronary Risk Factor Intervention Project [STRIP] study) with BMI measurements available from both childhood and adulthood.FindingsThe cutoff points derived from the longitudinal i3C Consortium data were lower than the IOTF cutoff points. Consequently, a larger proportion of participants in the STRIP study was classified as overweight or obese when using the i3C cutoff points than when using the IOTF cutoff points. Especially for obesity, i3C cutoff points were significantly better at identifying those who would become obese later in life. In the independent sample, the AUROC values for overweight ranged from 0·75 (95% CI 0·70-0·80) to 0·88 (0·84-0·93) for the i3C cutoff points, and the corresponding values for the IOTF cutoff points ranged from 0·69 (0·62-0·75) to 0·87 (0·82-0·92). For obesity, the AUROC values ranged from 0·84 (0·75-0·93) to 0·90 (0·82-0·98) for the i3C cutoff points and 0·57 (0·49-0·66) to 0·76 (0·65-0·88) for IOTF cutoff points.InterpretationThe childhood BMI cutoff points obtained from the i3C Consortium longitudinal data can better predict risk of overweight and obesity in young adulthood than can standards that are currently used based on cross-sectional data. Such cutoff points should help to more accurately identify children at risk of adult overweight or obesity.FundingNone.

Dataset Information

Predictive value of body mass index at age 18 on adulthood obesity: results of a prospective survey of an urban population.

Publications

Predictive value of body mass index at age 18 on adulthood obesity: results of a prospective survey of an urban population.

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