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40-year follow-up of overweight children
1Department of Pediatrics, Faculty of Health Sciences, University Hospital, Linköping, Sweden.
Insights
Childhood obesity often persists into adulthood, with severe childhood overweight predicting adult obesity. Early weight management is crucial for improving long-term health outcomes in obese children.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Longitudinal Studies
Background:
- Childhood obesity is a growing public health concern with potential long-term consequences.
- Understanding the trajectory of childhood obesity into adulthood is critical for effective intervention.
Purpose of the Study:
- To investigate the long-term outcomes of childhood overweight and obesity.
- To identify factors influencing the persistence of obesity into adulthood.
- To assess the impact of severe childhood obesity on adult morbidity and mortality.
Main Methods:
- A retrospective cohort study of 504 overweight children admitted to hospital between 1921 and 1947.
- Follow-up for 40 years using questionnaires at 10-year intervals.
- Analysis of weight for height (W/H) standard deviation scores (SDS) and correlation with family history and pubertal weight status.
Main Results:
- The mean W/H SDS peaked in puberty (+3.5) and decreased to approximately +1 in adulthood.
- 47% of participants remained obese (SDS > +1) in adulthood, with 84.6% having SDS > +2 in childhood.
- Family obesity and pubertal overweight were key predictors of adult weight status.
- Excessive pubertal overweight (SDS > +3) correlated with increased adult morbidity and mortality.
Conclusions:
- Childhood obesity has a significant tendency to persist into adulthood.
- Early identification and intervention for childhood obesity are essential for mitigating long-term health risks.
- Genetic and early-life factors play a crucial role in the development and persistence of obesity.
Abstract:
504 overweight children admitted to hospital between 1921 and 1947 were followed up for 40 years by questionnaires at 10 year intervals. The mean weight for height (W/H) standard deviation score (SDS) reached a maximum in puberty (+3.5). The SDS fell to about +1 in adulthood. 47% patients were still obese (SDS greater than +1) in adulthood; 84.6% of these had SDS more than +2 in childhood. The degree of obesity in the family (parents and grandparents) and the degree of overweight in puberty were the most important factors for weight level in adulthood. Even when their food intake was in accordance with recommended levels, obese children had higher than normal weight as adults. Excessive overweight in puberty (SDS greater than +3) was associated with higher than expected morbidity and mortality in adult life. Weight-reducing measures should be started early in life to improve the unfavourable long-term prognosis for very obese children.