Marie-Jeanne Buscot1, Russell J Thomson2, Markus Juonala3,4,5, Matthew A Sabin6,7, David P Burgner6,7,8, Terho Lehtimäki9,10, Nina Hutri-Kähönen11, Jorma S A Viikari4, Eero Jokinen12, Paivi Tossavainen13, Tomi Laitinen14, Olli T Raitakari3,5,15, Costan G Magnussen16,3. 1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; m.buscot@utas.edu.au. 2. Centre for Research in Mathematics, School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, New South Wales, Australia. 3. Research Centre of Applied and Preventive Cardiovascular Medicine and. 4. Departments of Medicine and. 5. Division of Medicine, Turku University Hospital, Turku, Finland. 6. Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia. 7. Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia. 8. Department of Paediatrics, Monash Medical Centre, Clayton, Victoria, Australia. 9. Fimlab Laboratories Ltd, Tampere, Finland. 10. Departments of Clinical Chemistry and. 11. Pediatrics, Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Tampere, Finland. 12. Department of Pediatric Cardiology, Hospital for Children and Adolescents and University of Helsinki, Helsinki, Finland. 13. Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; and. 14. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. 15. Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland. 16. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Abstract
BACKGROUND AND OBJECTIVES: Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood. METHODS: Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years). RESULTS: Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years. CONCLUSIONS: Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention.
BACKGROUND AND OBJECTIVES: Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood. METHODS: Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years). RESULTS: Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years. CONCLUSIONS: Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention.
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