Predicting obesity in early adulthood from childhood and parental obesity

Objective: To determine the degree of tracking of adiposity from childhood to early adulthood, and the risk of overweight in early adulthood associated with overweight in childhood and parental weight status in a cohort of children born in the mid 1970s. Design: Longitudinal observational study. Subjects: Approximately 155 healthy boys and girls born in Adelaide, South Australia 1975-6 and their parents. Measurements: Height and weight of subjects at 2 years, annually from 4 to 8 years, biennially from 11 to 15 years and at 20 years, and of parents when subjects were aged 8 years. BMI of subjects converted to standard deviation scores and prevalence of overweight and obesity determined using worldwide definitions. Parents classified as overweight if BMI > 25kg/m2. Tracking estimated as Pearson correlation coefficient. Risk ratio used to describe the association between weight status at each age and parental weight status and weight status at 20 years and weight status at each earlier age, both unadjusted and adjusted for parental weight status. Results: The prevalence of overweight/obesity increased with age and was higher than that reported in international reference populations. Tracking of BMI was established from 6 years onwards to 20 years at r values > 0.6 suggesting that BMI from 6 years is a good indicator of later BMI. Tracking was stronger for shorter intervals and for those subjects with both parents overweight compared with those with only one or neither parent overweight. Weight status at an earlier age was a more important predictor of weight status at 20 years than parental weight status, and risk of overweight at 20 years increased further with increasing weight status of parents. Conclusion: Strategies for prevention of overweight and targeted interventions for prevention of the progression of overweight to obesity are urgently required in school aged children in order to stem the epidemic of overweight in the adult population

Does fat intake predict adiposity in healthy children and adolescents aged 2-15y? A longitudinal analysis

ObjectiveTo investigate the relationship between food energy and macronutrient intake and body fatness assessed up to seven times between 2 and 15 y of age.DesignProspective, observational study. Generalised linear estimating equations were used to evaluate the longitudinal relationship between body fatness and macronutrient intake. Regression analysis was used to assess whether body fatness at a particular age was predicted by intake at any of the previous ages.SettingCommunity-based project in Adelaide, South Australia.SubjectsIn all 143--243 subjects from a representative birth cohort of healthy children recruited in 1975 and followed over 15 y.Main outcome measuresThe dependent variables were body mass index (BMI), triceps (TC) and subscapular (SS) skinfolds, expressed as standard deviation (s.d.) scores at each age. The predictor variables were energy-adjusted macronutrient intake and total energy intake, estimated from a 3--4 day diet diary, the previous corresponding measure of body fatness, sex and parental BMI, TC or SS.ResultsAcross 2--15 y energy-adjusted fat and carbohydrate intakes were respectively directly and inversely related to SS skinfold measures but not to either BMI or TC skinfold. The best predictor of fatness was previous adiposity, with the effect strengthening as the age interval shortened. Parental BMI, maternal SS and paternal TC contributed to the variance of the corresponding measure in children at some but not all ages.ConclusionsThe current level of body fatness of the child and parental adiposity are more important predictors than dietary intake variables of risk of children becoming or remaining overweight as they grow