This paper reviews child and adolescent adiposity measures and associated long-term health risks. The ®rst section argues that anthropometric measures are practical for large scale epidemiological studies, particularly the body mass index. Limitations of this and other measures are presented. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This is based on a search for relevant literature in the following computerised databases: Medline (1985±96), BIDS (EMBASE and Science Citation Index 1985±96). The literature search revealed that the child to adult adiposity relationship is now well-documented, although methodological differences hinder comparisons. Nonetheless, consistently elevated risks of adult obesity are evident for fatter children, although the prediction of adult obesity from child and adolescent adiposity measures is only moderate. Fewer studies could be identi®ed in relation to long-term health risks of child and adolescent adiposity. It is therefore dif®cult to specify categories of risk associated with childhood adiposity without more information from long-term studies. Further evidence is also required to con®rm the suggestion from some studies that adult disease risks are associated with a change in adiposity from normal weight in childhood to obesity in adulthood. However, on the basis of the evidence available, it is argued that population-based approaches to the prevention of obesity are likely to be more effective than approaches targeted at fat children. Population-based approaches are desirable, ®rst because of the poor prediction of adult obesity from child and adolescent measures, and second, because risks of adult mortality and morbidity may be elevated for individuals who become overweight after adolescence.Keywords: body mass index; obesity; measures; childhood; adolescence; tracking; morbidity; mortality; review IntroductionPrevention of obesity is a public health priority, 1 with much of the concern focusing on childhood and adolescence. 2 Child and adolescent adiposity is of particular interest because of possible long-term associations with adult disease, but evidence on long-term relationships is fragmentary and an overview is needed that clari®es how they might occur.There are three main sections to this review. The ®rst provides a summary of the basic methods used to assess child and adolescent adiposity. This key issue is included here because it is essential that appropriate measures are used, for example, to investigate trends over time and over the life course. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This relationship is studied because of the concern that child and adolescent adiposity in¯uences adult disease primarily through its association with adiposity in adult life. Evidence is now available from several prospective and retrospective samples following subjects from childhood to adulthood. The speci®c questions of interest in this se...

Objectives-To assess relations between the adiposity of children and their parents and to establish whether tracking of adiposity from childhood to adulthood varies according to the parental body mass index (BMI). Methods-Longitudinal data from the 1958 British birth cohort study were used (6540 men and 6207 women). The height and weight of the study subjects were measured at 7, 11, 16, 23 (self reported), and 33 years. Parental height and weight were self reported when their children were 11 years old. The children were classified into six parental BMI (weight/height 2 ) groups. Results-At each age of follow up the mean BMI of the children increased as the parental BMI increased. Higher risks of adult (33 year) obesity were evident among children with overweight or obese parents: the odds for sons and daughters with two obese parents (compared with those with both parents of normal BMI) were 8.4 and 6.8, respectively. The children of two obese parents also showed the strongest child to adult tracking of BMI as indicated by the correlation between ages 7 and 33 (r = 0.46, 0.54, sons and daughters, respectively). Conclusions-The children of obese and overweight parents have an increased risk of obesity. Subjects with two obese parents are fatter in childhood and also show a stronger pattern of tracking from childhood to adulthood. As the prevalence of parental obesity increases in the general population the extent of child to adult tracking of BMI is likely to strengthen.

The purpose of this study was to assess relations among height, weight, and body mass index (BMI) at different ages from childhood to adulthood, and to examine long-term relations among timing of puberty, height, and BMI. Longitudinal data from the 1958 British birth cohort (all children born between March 3rd and 9th, 1958) were used. Height and weight were measured at ages 7, 11, 16, 23 (self-reported), and 33 y; pubertal status was assessed at ages 11 and 16 y. Data for 5700 females and 5512 males were analyzed. Adult height was well predicted from childhood, with strong correlations (r = 0.7 for both sexes) between height at ages 7 and 33 y. Correlations for BMI were weaker, especially between childhood and early adulthood (r = 0.33 for males and 0.37 for females, ages 7 and 33 y), although they increased with increasing age. Although the fattest children had the highest risks of adult obesity, most obese adults had not been fat at earlier ages: only 17% and 18% of obese 33-y-old men and women, respectively, had been fat at age 7 y. A strong and evenly graded association was found between timing of puberty and BMI, with higher mean BMIs for the earlier maturers at ages 7-33 y. The moderate prediction of adult BMI in this large and unselected sample suggests that although the prevention of childhood fatness may be desirable, most obese adults could not be identified from their childhood BMI, and hence, preventive strategies need to be population-based.

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