Body mass index throughout the life-course and blood pressure in mid-adult life: a birth cohort study

Li, Leah; Law, Catherine; Power, Chris

doi:10.1097/hjh.0b013e3280f3c01a

Cited by 95 publications

(142 citation statements)

References 34 publications

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“…Of the eight studies considering the relationship between childhood BMI and adult blood pressure (27)(28)(29)(30)(31)(32)(33)(34) , six showed positive associations (27)(28)(29)(32)(33)(34) . However, when adjusted for adult BMI, only two associations remained positive (32,33) and four studies demonstrated significant negative associations (i.e.…”

Section: Independent Effects Of Childhood Obesity On Adult Disease Riskmentioning

confidence: 99%

Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable

McMullen

2014

Proc. Nutr. Soc.

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The worldwide prevalence of overweight and obesity in the adult population is estimated to be 35 %. These trends are reflected in childhood obesity prevalence, and the potential impact of early-onset obesity is of great concern. The aim of this review was to investigate the long-term implications of childhood obesity for metabolic and cardiovascular health, focusing on the independent contribution of childhood obesity to adult disease risk, as distinct from associations mediated by tracking of obesity across the lifespan. The data systematically reviewed provide little evidence to suggest that childhood overweight and obesity are independent risk factors for metabolic and cardiovascular risk during adulthood. Instead, the data demonstrate that the relationships observed are dependent on tracking of BMI between childhood and adulthood, alongside persistence of dietary patterns and physical activity. Adjustment for adult BMI uncovers unexpected negative associations between childhood BMI and adult disease, suggesting a protective effect of childhood obesity at any given level of adult BMI. Further work is required to explain these findings, both in terms of pathways and statistical artefacts. To conclude, it must be stressed that it is not suggested that childhood obesity is without negative consequence. Childhood obesity is clearly associated with a range of adverse physical and psychological outcomes. However, the data are important in supporting a positive message that the long-term consequences of childhood obesity are avoidable; and that there remains opportunity for intervention across the lifespan. This nuance in understanding long-term risk is important when considering the effectiveness of interventions at different stages of the lifespan. Childhood: Obesity: Metabolic syndrome: Cardiovascular disease: Blood pressureThe worldwide prevalence of overweight and obesity in the adult population is currently estimated to be 35 %, rising to over 70 % in some population groups, with rates of obesity nearly doubling between 1980 and 2008 (1) . This is a global phenomenon, with the prevalence of overweight and obesity in low-and middleincome countries on the rise, mirroring their transition to the obesogenic environments more commonly associated with 'Western' living. The relationship between obesity and risk of non-communicable disease in adulthood has long been established, with a wealth of evidence demonstrating the considerable impact of excess adiposity on the health and wellbeing of populations (2) . The trends in adult overweight and obesity are reflected in childhood obesity prevalence, and the potential impact of early-onset obesity is of great concern. It has been estimated that 200 million school-aged children were overweight or obese in 2010 worldwide, with a prevalence of >20 % in European states and >30 % in regions of North America (3) . In the UK, the 2007 Foresight report showed that about 8-10 % of girls and boys were obese in 2004, and this was projected to rise to an estimated 25 % by 2050 (4)...

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Section: Independent Effects Of Childhood Obesity On Adult Disease Riskmentioning

confidence: 99%

Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable

McMullen

2014

Proc. Nutr. Soc.

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“…19,20 Possible reasons for this contrasting pattern of higher blood pressures in less urbanized and socioeconomically deprived populations could be the role of in utero as well as early life nutritional influences as suggested by earlier studies. 11,21 When the cohort as a whole was analysed, PBSG children showed significantly higher SBP and DBP than NBSG children. Subgroup analysis revealed that the difference in SBPs between PBSG and NBSG children were significant in all the subgroups.…”

Section: Urban Ruralmentioning

confidence: 99%

“…10 Excessive BMI gain at any life stage is known to be associated with higher blood pressure in later life. 11 Thinner children are more vulnerable to BMI gain and increased blood pressure in adulthood. 11 The positive influence of adiposity on blood pressure is evident even in normal weight children, suggesting that this problem is not restricted to the overweight children.…”

Section: Introductionmentioning

confidence: 99%

“…11 Thinner children are more vulnerable to BMI gain and increased blood pressure in adulthood. 11 The positive influence of adiposity on blood pressure is evident even in normal weight children, suggesting that this problem is not restricted to the overweight children. 12 Sociodemographic factors like socioeconomic levels and urbanization strongly influence the adiposity levels in populations.…”

Section: Introductionmentioning

confidence: 99%

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Body mass index trend and its association with blood pressure distribution in children

et al. 2010

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The aim of the study was to examine the association of a trend in body mass index (BMI) status with current blood pressure in a cohort of school children from South India. A population of 25 228 children was selected using stratified random sampling method. Height and weight were measured in [2003][2004]. Height, weight and blood pressure were measured in [2005][2006]. A total of 12 129 children aged 5-16 years having paired data were analysed. Blood pressure and BMI values were converted to Z scores using International paediatric reference values. An increase in Z BMI meant that the child is moving to a higher BMI level with respect to his or her age and sex. In the cohort, 62.4% children had a higher Z BMI at follow-up than at baseline. Children with higher Z BMI at follow-up were labelled as positive BMI status group (PBSG) and the remaining as negative BMI status group (NBSG). The positive trend in BMI was more in rural areas, government schools and girls. In all subgroups, PBSG showed significantly higher systolic blood pressures (SBPs) than NBSG. PBSG showed significantly higher diastolic blood pressures (DBPs) in urban area, government schools and girls when compared with NBSG. Prevalence of first instance systolic hypertension was more in PBSG in all the subgroups except in rural children. Prevalence of diastolic hypertension was significantly higher in PBSG in urban subgroup only. BMI status trends are associated with blood pressure distribution in children.

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“…Three studies showed positive correlations between childhood BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP), 10,32,33 and a further three studies showed a positive association with SBP only. 9,21,23 All but two of these studies 23,28 observed significant tracking of childhood BMI into adulthood, yet two studies did not adjust for adult BMI 9,10 meaning that the independent effects of childhood BMI were not tested.…”

Section: Blood Pressurementioning

confidence: 99%

Childhood obesity and adult cardiovascular disease risk: a systematic review

2009

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Background: Although the relationship between adult obesity and cardiovascular disease (CVD) has been shown, the relationship with childhood obesity remains unclear. Given the evidence of tracking of body mass index (BMI) from childhood to adulthood, this systematic review investigated the independent relationship between childhood BMI and adult CVD risk. Objective: To investigate the association between childhood BMI and adult CVD risk, and whether the associations observed are independent of adult BMI. Design: Electronic databases were searched from inception until July 2008 for studies investigating the association between childhood BMI and adult CVD risk. Two investigators independently reviewed studies for eligibility according to inclusion/ exclusion criteria, extracted the data and assessed study quality using the Newcastle-Ottawa Scale. Results: Positive associations between childhood BMI and adult blood pressure or carotid intima-media thickness were generally attenuated once adjusted for adult BMI. Associations between childhood BMI and CVD morbidity/mortality had not been adjusted and do not provide evidence of an independent relationship. Negative associations between childhood BMI and blood pressure were observed in several adjusted data sets. Conclusions: Little evidence was found to suggest that childhood obesity is an independent risk factor for CVD risk. Instead, the data suggest that relationships observed are dependent on the tracking of BMI from childhood to adulthood. Importantly, evidence suggests that risk of raised blood pressure is highest in those who are at the lower end of the BMI scale in childhood and overweight in adulthood. The findings challenge the widely accepted view that the presence of childhood obesity is an independent risk factor for CVD and that this period should be a priority for public health intervention. Although interventions during childhood may be important in prevention of adult obesity, it is important to avoid the potential for negative consequences when the timing coincides with critical stages of neurological, behavioural and physical development.

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Body mass index throughout the life-course and blood pressure in mid-adult life: a birth cohort study

Abstract: High BMI and excessive BMI gain at any life stage, particularly recently, is associated with increased adult BP. Relatively thin children were vulnerable to BMI gain and increased BP in adulthood. Elevated BP associated with low birthweight was not caused by 'catch-up' growth.

Cited by 95 publications

References 34 publications

Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable

Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable

Body mass index trend and its association with blood pressure distribution in children

Childhood obesity and adult cardiovascular disease risk: a systematic review

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