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Updated: Dec 15, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
The Longitudinal Relation of Childhood Height to Subsequent Obesity in a Large Electronic Health Record Database
David S Freedman1, Alyson B Goodman1, Raymond J King1
1Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Childhood height is linked to later obesity risk, especially before age 12. Greater height-for-age in children may signal an increased likelihood of developing obesity later in life.
Area of Science:
- Pediatric Health
- Obesity Research
- Growth and Development
Background:
- Childhood height correlates with Body Mass Index (BMI) and body fatness.
- Previous studies suggest a link between childhood height and adult BMI.
- Longitudinal data on this association in large pediatric populations is limited.
Purpose of the Study:
- To investigate the longitudinal association between childhood height and subsequent BMI and obesity.
- To analyze this relationship using a large electronic health record database.
Main Methods:
- Utilized an electronic health record database of 2.8 million children.
- Children were initially examined between 2 and 13.9 years old and reexamined approximately 4 years later.
- Analyzed the correlation between height-for-age z score and BMI, and the association of initial height-for-age with subsequent BMI and obesity.
Main Results:
- A cross-sectional correlation between height-for-age z score and BMI increased with age.
- Childhood height-for-age was associated with subsequent BMI and obesity, with a fourfold increase in obesity prevalence across height categories.
- Approximately 40% of this association was independent of initial BMI, diminishing with increasing initial age.
Conclusions:
- Greater childhood height-for-age before 12 years of age may serve as a marker for increased risk of subsequent obesity.
- Healthcare professionals should consider childhood height as a potential indicator for future obesity risk.
- The predictive value of height-for-age for later obesity decreases in older children (12+ years).
Objective:
Several cross-sectional studies have shown that height in childhood is correlated with BMI and with body fatness, and two longitudinal studies have reported that childhood height is associated with adult BMI. This study explored this longitudinal association in an electronic health record database of 2.8 million children.
Methods:
Children were initially examined between the ages of 2 and 13.9 years and, on average, were reexamined 4 years later.
Results:
As expected, there was a cross-sectional correlation between height-for-age z score and BMI that increased from r = -0.06 (age of 2 years) to r = 0.37 (age of 9-10 years). In addition, height-for-age at the first visit was related to subsequent BMI and obesity, with the prevalence of subsequent obesity increasing about fourfold over six categories of height-for-age at the first visit. About 40% of this longitudinal association was independent of initial BMI, but its magnitude decreased with initial age. For example, the initial height-for-age of children who were 12 years of age or older was only weakly associated with subsequent BMI.
Conclusions:
Health professionals should recognize that greater childhood height-for-age before 12 years of age may be a marker for increased risk of subsequent obesity.
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