The Utility of Childhood and Adolescent Obesity Assessment in Relation to Adult Health. (February 2013)

• Record Type: Journal Article
• Authors: Goldhaber-Fiebert, Jeremy D.; Rubinfeld, Rachel E.; Bhattacharya, Jay; Robinson, Thomas N.; Wise, Paul H.
• Is Part Of: Medical decision making. Volume 33:Number 2(2013)
• Page Start: 163
• Page End: 175
• Publication Date: 2013-02
• Subjects: child -- adolescent -- adult -- obesity -- risk assessment -- type 2 diabetes mellitus -- hypertension -- forecasting; Medical policy -- Periodicals; Clinical medicine -- Decision making -- Periodicals; Medicine -- Periodicals; Médecine clinique -- Prise de décision -- Périodiques; 362.1
• DOI: 10.1177/0272989X12447240
• Languages: English
• ISSNs: 0272-989X

Abstract

Background: High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children.Objective: To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults.Design: Longitudinal statistical analyses; microsimulations combining multiple data sets.Data Sources: National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys.Methods: The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race.Results: Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6.Limitation: Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future.Conclusion: Early childhood obesity assessment adds limited information to later childhood assessment. Targeted later childhood approaches or universal strategies to prevent unhealthy weight gain should be considered.