Brief report
Child Height and the Risk of Young-Adult Obesity

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Background

Childhood obesity is a major risk factor for adult obesity, and obese children tend to be taller than their normal-weight peers.

Purpose

The aim of this study is to evaluate whether childhood height influences the probability that normal or overweight children become overweight young adults.

Methods

The study involved a multicenter prospective cohort of subjects assessed in both third grade and 12th grade, n=2802. Main exposures were CDC childhood BMI categories and height quartiles from third-grade measurements. Main outcome measure was CDC adult BMI categories from 12th-grade measurements. Associations between childhood height quartiles, childhood BMI categories, and adult BMI categories were assessed using chi-square tests and logistic regression models.

Results

Overall, 79% of overweight children remained overweight as young adults. Among children who were overweight or obese, the probability of becoming an overweight or obese young adult was 85% for children in the top quartile of height and 67% for children in the bottom quartile of height (p=0.007). Among children who were normal weight, the probability of becoming an overweight or obese young adult was 25% for children in the top height quartile versus 17% for children in the bottom height quartile (p=0.003).

Conclusions

When clinicians classify children by BMI categories and counsel about the risk for future obesity, they should recognize that greater height may be a marker for increased risk of adult overweight and obesity.

Introduction

For the prevention and treatment of obesity, clinicians are instructed to categorize children according to BMI percentiles, and then counsel.1, 2, 3 BMI was derived as an index of adiposity that adjusts a subject's weight for his/her height, so there is minimal association between BMI and height. Although this has generally been true in adults, in children several studies4, 5, 6, 7, 8 have noted a positive association between BMI and height.

Previous analysis9 of this study's cohort examined the interrelationships between child height and BMI as continuous variables and found a statistical interaction in the prediction of young adult BMI. In children with a BMI below the 80th percentile, the association of child and adult BMI did not differ among children of different heights. However, among children with a BMI above the 80th percentile, those who were taller had significantly higher young adult BMI compared with those who were shorter.

There is longitudinal tracking of overweight categories from childhood into adulthood.10 The aim of this study is to evaluate whether childhood height influences the probability that normal or overweight children will become overweight young adults.

Section snippets

Study Population

Participants are from the Child and Adolescent Trial for Cardiovascular Health (CATCH), a multicenter, cluster-randomized field trial designed to evaluate the effectiveness of school- and home-based interventions to reduce cardiovascular risk factors. In Fall 1991, 5106 third-graders were assessed. As 12th-graders (Spring 2001), 2909 were reassessed, of which 2802 had complete data, and those data were used for this analysis. Details of the original study11 and this longitudinal cohort are

Results

Child height was positively associated with both child overweight status (r=0.29, p<0.0001) and adult overweight status (r=0.21, p<0.0001). In young adults, overweight status and height were uncorrelated (r=−0.005). Table 1 shows descriptive data.

As seen in Table 2, there was a strong positive association between childhood overweight and adult overweight. Among the 712 children who were overweight or obese in third grade, 566 (79%) remained overweight or obese as young adults. Among the 2090

Discussion

Consistent with previous analysis,9 this investigation found a positive association between child height and young adult overweight status among children who had an elevated BMI. Overweight children who were in the tallest quartile had an 18% higher probability of remaining overweight or obese as young adults compared with overweight children who were in the shortest quartile (85% vs 67%, respectively).

The current study has novel findings in children who had normal BMIs. Among children who were

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