Home and Community Care Digest

Home and Community Care Digest 7(2) November -0001

High BMI in Childhood Creates Risk for Heart Disease Among Adults

Abstract

This study investigated whether or not excess weight in childhood increased the risk of coronary heart disease in adulthood. Having a higher body mass index in childhood was found to be associated with a higher risk of developing or dying from coronary heart disease in adulthood. Moreover, this risk increased with the child's age and was found to be stronger in boys than in girls. The overall rise in the rate of childhood obesity is expected to continue, and from a policy perspective these findings suggest that a growing number of children will face an increased risk of coronary heart disease in adulthood. High BMI is a modifiable risk factor and intervention during childhood may reduce the risk of future coronary heart disease, and ultimately the burden on health system in the future.
Background: This study investigated whether or not excess weight in childhood increased the risk of developing coronary heart disease (CHD) in adulthood. Children are becoming overweight at progressively younger ages, making them at risk for weight-related problems and social stigmatization. In addition, excess weight in childhood may adversely affect health in adulthood, specifically the risk of developing or dying from CHD. The severity of the long-term effects of excess childhood weight on CHD should be examined.

Methods: A large sample of Danish population was followed from childhood to adulthood. Information on their body mass index (BMI) in childhood (7 through 13 years of age) and CHD events (both nonfatal and fatal) in adulthood (25 years of age or older) were collected. To examine the association between childhood BMI and any CHD event in adulthood, the risk of an event in adulthood was calculated for each 1-unit increase in BMI at each age. In the analysis, the amount of weight equivalent to a 1-unit increase in BMI at each age was calculated.

Findings: Childhood BMI (at 7 to 13 years of age for boys, and 10 to 13 years of age for girls) was found to be associated with a higher risk of developing or dying from CHD in adulthood. The risk of any CHD event increased as the age of the child increased, meaning that the risk of a one-unit increase in a boy's BMI at age 13 was substantially greater that for a 7-year old boy. Similar but weaker associations were found for girls. Controlling for birth weight, which could affect the relationship observed between BMI and the risk of adulthood CHD, strengthened the results.

Conclusions: The study found that having higher childhood BMI elevates the risk of a CHD event (nonfatal and fatal) in adulthood, particularly among boys. Boys aged 7-13 and girls aged 10-13 with higher than average BMI face a greater risk of developing CHD in adulthood. Typically, children are classified as being at risk if their BMI is above certain cutoff points such as the 85th percentile on growth charts. However, a linear association between childhood BMI and adulthood CHD found in this study suggested that even a small amount of weight gain can increase the risk of CHD. The finding suggests that a large number of children (perhaps more than realized by policy makers) are facing increased risks of future CHD. Overall, the study provides a rationale for targeted interventions during certain period of childhood (i.e., 7 to 13 for boys and 10 to 13 for girls) to help children attain and maintain healthy weight and reduce the risk of future CHD. Ultimately, this strategy may also reduce the burden on health system in the future.

Reference: Baker JL, Olsen LW, Sorensen TIA. Childhood Body-Mass Index and the risk of coronary heart disease in adulthood. The New England Journal of Medicine. 2007; 357(23): 2329-2337.

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