Submitted to: European Journal of Clinical Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 7/8/2005
Publication Date: 1/1/2006
Citation: Deshmukh-Taskar, P., Nicklas, T., Morales, M., Yang, S., Zakeri, I., Berenson, G.S. 2006. Tracking of overweight status from childhood to young adulthood: the Bogalusa Heart Study. European Journal of Clinical Nutrition. 60(1):48-57. Interpretive Summary: Eight hundred forty-one young adults surveyed in the Bogalusa Heart Study had also been surveyed when they were children. In the present study, the African-American (AA) women and the Euro-American (EA) men had increased occurrence of overweight at childhood and young adulthood more than the other ethnicity-by-gender groups. More importantly, overweight children tended to become overweight young adults in this Bogalusa sample. In view of these results, one can conclude that overweight prevention programs should be initiated early in life, particularly for those at risk of overweight and overweight children, in order to change the BMI status from overweight to normal weight, and to prevent the occurrence of several chronic diseases (such as cardiovascular disease) that may result from overweight and obesity later in life. Also, in view of the alarming shift from normal weight status to overweight status from childhood to young adulthood in the AA group, ethnic minority groups (especially AA girls/AA women) should be monitored more closely in their growing ages to assist in the early detection of their overweight/obese status. Extension of this study to other ethnic groups, such as Hispanic-American children and Asian-American children is also warranted.
Technical Abstract: The objective of this study was to determine if childhood overweight tracks into young adulthood in a biracial sample. A longitudinal sample was created from cross-sectional surveys at two time points, childhood (baseline) and young adulthood (follow-up). The setting is Bogalusa Heart Study, Louisiana, United States of America. A total of 841 young adults, 19–35 years (68% Euro-Americans (EA), 32% African-Americans (AA)) were studied. The same subjects had also participated in one of five cross-sectional surveys at childhood (9–11 years). Body mass index (BMI) was used to determine overweight status as per the Centers for Disease Control and Prevention standards. Change in the BMI status from childhood to young adulthood was used to group the participants into the following categories: normal weight to normal weight (NW-NW); normal weight to overweight (NW-OW); overweight to normal weight (OW-NW); and overweight to overweight (OW-OW). Tracking of overweight was defined by (1) correlations between baseline and follow-up BMI, (2) Cohen's kappa concordance test to determine the strength of tracking in BMI quartiles and (3) the percentage of individuals who remained in the same overweight status group from baseline to follow-up. From baseline to follow-up, the percentage of participants who were overweight increased from 24.7 to 57.7%. A total of 35.2% of the children shifted from normal weight in childhood to overweight in young adulthood (P<0.0005). Baseline BMI was positively correlated with follow-up BMI (r=0.66, P<0.0005). A total of 61.9% of the participants in the highest BMI quartile in childhood remained in the highest BMI quartile in young adulthood. The strength of tracking in BMI quartiles was 27% for EA men (P<0.0005), 23% for EA women (P<0.0005), 27% for AA men (P<0.0005), and 35% for AA women (P<0.0005). A total of 53.7% of the EA women remained in the NW-NW category, and 31.2% of the AA women remained in the OW-OW category. The percentage tracking (NW-NW and OW-OW) was 72.8% in EA women, 59.6% in AA men, 59.5% in AA women, and 48.8% in EA men (P<0.0001). Childhood overweight tracked into young adulthood in this sample, and the tracking of NW-NW and OW-OW was the most prominent among the EA women.