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. 2020 May;44(5):1164-1172.
doi: 10.1038/s41366-019-0461-6. Epub 2019 Oct 9.

Prediction of adult class II/III obesity from childhood BMI: the i3C consortium

Jessica G Woo  1   2   3 , Nanhua Zhang  4   5 , Matthew Fenchel  4 , David R Jacobs Jr  6 , Tian Hu  6 , Elaine M Urbina  7   5 , Trudy L Burns  8 , Olli Raitakari  9   10   11 , Julia Steinberger  6 , Lydia Bazzano  12 , Ronald J Prineas  13 , Cashell Jaquish  14 , Markus Juonala  15   16 , Justin R Ryder  6 , Stephen R Daniels  17 , Alan Sinaiko  6 , Terence Dwyer  18   19 , Alison Venn  19
Affiliations

Prediction of adult class II/III obesity from childhood BMI: the i3C consortium

Jessica G Woo et al. Int J Obes (Lond). 2020 May.

Abstract

Background and objectives: Adult class II/III obesity (BMI ≥ 35 kg/m2) has significant adverse health outcomes. Early prevention and treatment are critical, but prospective childhood risk estimates are lacking. This study aimed to define the prospective risk of adult class II/III obesity, using childhood BMI.

Methods: Children ages 3-19 years enrolled in cohorts of the International Childhood Cardiovascular Cohort (i3C) consortium with measured BMI assessments in childhood and adulthood were included. Prospective risk of adult class II/III obesity was modeled based on childhood age, sex, race, and BMI.

Results: A total of 12,142 individuals (44% male, 85% white) were assessed at median age 14 [Interquartile range, IQR: 11, 16] and 33 [28, 39] years. Class II/III adult obesity developed in 6% of children with normal weight; 29% of children with overweight; 56% of children with obesity; and 80% of children with severe obesity. However, 38% of the 1440 adults with class II/III obesity (553/1440) were normal weight as children. Prospective risk of adult class II/III obesity varied by age, sex, and race within childhood weight status classifications, and is notably higher for girls, black participants, and those in the United States. The risk of class II/III obesity increased with older adult age.

Conclusions: Children with obesity or severe obesity have a substantial risk of adult class II/III obesity, and observed prospective risk estimates are now presented by age, sex, race, and childhood BMI. Clinical monitoring of children's BMI for adult class II/III obesity risk may be especially important for females and black Americans.

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Conflict of interest statement

Conflicts of Interest: None of the authors has indicated any potential conflicts of interest

Figures

Figure 1:
Figure 1:. Risk of Adult Class II/III Obesity at age 35 by Childhood Age and BMI.
Contour lines represent risk of developing class II/III obesity by age 35; adult risk level is indicated by the number on the contour (e.g., 0.9=90% risk). Shaded areas, presented for reference only, represent (from top to bottom): childhood severe obesity (darkest gray), obesity (dark gray), overweight (medium gray) and normal weight (light gray), according to the CDC 2000 growth charts. Results are presented by race (white or black only) and sex groups, with the country fixed as United States. A) White males; B) Black males; C) White females; D) White males.
Figure 2:
Figure 2:. Risk of Adult Class II/III Obesity at age 45 by Childhood Age and BMI.
Contour lines represent risk of developing class II/III obesity by age 45; adult risk level is indicated by the number on the contour (e.g., 0.9=90% risk). Shaded areas, presented for reference only, represent (from top to bottom): childhood severe obesity (darkest gray), obesity (dark gray), overweight (medium gray) and normal weight (light gray), according to the CDC 2000 growth charts. Results are presented by race (white or black only) and sex groups, with the country fixed as United States. A) White males; B) Black males; C) White females; D) White males.
See this image and copyright information in PMC

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