. 2022 Feb;46(2):393-399.

doi: 10.1038/s41366-021-01000-3. Epub 2021 Nov 2.

Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium

Joel Nuotio^#^{1

2

3

4}, Tomi T Laitinen^#^{5

6

7

8}, Alan R Sinaiko⁹, Jessica G Woo^{10

11}, Elaine M Urbina^{10

12}, David R Jacobs Jr¹³, Julia Steinberger⁹, Ronald J Prineas¹⁴, Matthew A Sabin^{6

15

16}, David P Burgner^{6

15}, Heikki Minn¹⁷, Trudy L Burns¹⁸, Lydia A Bazzano¹⁹, Alison J Venn²⁰, Jorma S A Viikari^{21

22}, Nina Hutri-Kähönen²³, Stephen R Daniels¹⁸, Olli T Raitakari^{5

7

24}, Costan G Magnussen^{5

7

20}, Markus Juonala^{6

21

22}, Terence Dwyer²⁵

Affiliations

¹ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. joel.nuotio@utu.fi.
² Heart Center, Turku University Hospital and University of Turku, Turku, Finland. joel.nuotio@utu.fi.
³ Murdoch Children's Research Institute, Melbourne, VIC, Australia. joel.nuotio@utu.fi.
⁴ Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. joel.nuotio@utu.fi.
⁵ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
⁶ Murdoch Children's Research Institute, Melbourne, VIC, Australia.
⁷ Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
⁸ Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
⁹ Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA.
¹⁰ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹¹ Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹² The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹³ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
¹⁴ Division of Public Health Science, Wake Forest University, Winston-Salem, NC, USA.
¹⁵ Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
¹⁶ Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia.
¹⁷ Department of Oncology, Turku University Hospital, Turku, Finland.
¹⁸ Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
¹⁹ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
²⁰ Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
²¹ Department of Internal Medicine, University of Turku, Turku, Finland.
²² Division of Medicine, Turku University Hospital, Turku, Finland.
²³ Department of Pediatrics, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
²⁴ Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
²⁵ Oxford Martin School, Oxford University, Oxford, UK.

^# Contributed equally.

PMID: 34728776
PMCID: PMC8794778
DOI: 10.1038/s41366-021-01000-3

Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium

Joel Nuotio et al. Int J Obes (Lond). 2022 Feb.

. 2022 Feb;46(2):393-399.

doi: 10.1038/s41366-021-01000-3. Epub 2021 Nov 2.

Authors

Affiliations

¹ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. joel.nuotio@utu.fi.
² Heart Center, Turku University Hospital and University of Turku, Turku, Finland. joel.nuotio@utu.fi.
³ Murdoch Children's Research Institute, Melbourne, VIC, Australia. joel.nuotio@utu.fi.
⁴ Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. joel.nuotio@utu.fi.
⁵ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
⁶ Murdoch Children's Research Institute, Melbourne, VIC, Australia.
⁷ Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
⁸ Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
⁹ Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA.
¹⁰ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹¹ Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹² The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹³ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
¹⁴ Division of Public Health Science, Wake Forest University, Winston-Salem, NC, USA.
¹⁵ Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
¹⁶ Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia.
¹⁷ Department of Oncology, Turku University Hospital, Turku, Finland.
¹⁸ Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
¹⁹ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
²⁰ Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
²¹ Department of Internal Medicine, University of Turku, Turku, Finland.
²² Division of Medicine, Turku University Hospital, Turku, Finland.
²³ Department of Pediatrics, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
²⁴ Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
²⁵ Oxford Martin School, Oxford University, Oxford, UK.

^# Contributed equally.

PMID: 34728776
PMCID: PMC8794778
DOI: 10.1038/s41366-021-01000-3

Abstract

Background: In high-income countries, cancer is the leading cause of death among middle-aged adults. Prospective data on the effects of childhood risk exposures on subsequent cancer mortality are scarce.

Methods: We examined whether childhood body mass index (BMI), blood pressure, glucose and lipid levels were associated with adult cancer mortality, using data from 21,012 children enrolled aged 3-19 years in seven prospective cohort studies from the U.S., Australia, and Finland that have followed participants from childhood into adulthood. Cancer mortality (cancer as a primary or secondary cause of death) was captured using registries.

Results: 354 cancer deaths occurred over the follow-up. In age-, sex, and cohort-adjusted analyses, childhood BMI (Hazard ratio [HR], 1.13; 95% confidence interval [CI] 1.03-1.24 per 1-SD increase) and childhood glucose (HR 1.22; 95%CI 1.01-1.47 per 1-SD increase), were associated with subsequent cancer mortality. In a multivariable analysis adjusted for age, sex, cohort, and childhood measures of fasting glucose, total cholesterol, triglycerides, and systolic blood pressure, childhood BMI remained as an independent predictor of subsequent cancer mortality (HR, 1.24; 95%CI, 1.03-1.49). The association of childhood BMI and subsequent cancer mortality persisted after adjustment for adulthood BMI (HR for childhood BMI, 1.35; 95%CI 1.12-1.63).

Conclusions: Higher childhood BMI was independently associated with increased overall cancer mortality.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1**
Flow diagram of the 42,185 i3C Consortium participants with any childhood risk factor measurement prior to age 20 and participants with data available on outcomes (analyzed sample).

**Fig. 2. Risk of cancer mortality according to childhood risk points.**
Childhood risk points: BMI and/or glucose >75th age, sex, and study-specific percentile point. Analysis adjusted for age, sex, and study cohort. Cohorts included in this analysis were BHS, NGHS, Minnesota, PLRS, and YFS that had glucose data available.

See this image and copyright information in PMC

References

1. Dagenais GR, Leong DP, Rangarajan S, Lanas F, Lopez-Jaramillo P, Gupta R, et al. Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study. Lancet. 2020;395:785–94. doi: 10.1016/S0140-6736(19)32007-0. - DOI - PubMed
1. Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. International Agency for Research on Cancer Handbook Working Group. Body Fatness and Cancer-Viewpoint of the IARC Working Group. N Engl J Med. 2016;375:794–8. doi: 10.1056/NEJMsr1606602. - DOI - PMC - PubMed
1. K Hidayat K, Du X, Shi B-M. Body fatness at a young age and risks of eight types of cancer: systematic review and meta-analysis of observational studies. Obes Rev. 2018;19:1385–94. - PubMed
1. Clarke MA, Joshu CE. Early life exposures and adult cancer risk. Epidemiol Rev. 2017;39:11–27. doi: 10.1093/epirev/mxx004. - DOI - PMC - PubMed
1. Weihrauch-Blüher S, Schwarz P, Klusmann JH. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism. 2019;92:147–52. doi: 10.1016/j.metabol.2018.12.001. - DOI - PubMed

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Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium

Affiliations

Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical