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Pediatrics

Prediction of adult class II/III obesity from childhood BMI: the i3C consortium

International Journal of Obesity volume 44, pages 1164–1172 (2020)Cite this article

Subjects

Abstract

Background and objectives

Adult class II/III obesity (BMI ≥ 35 kg/m2) has significant adverse health outcomes. Early prevention and treatment are critical, but prospective childhood risk estimates are lacking. This study aimed to define the prospective risk of adult class II/III obesity, using childhood BMI.

Methods

Children ages 3–19 years enrolled in cohorts of the International Childhood Cardiovascular Cohort (i3C) consortium with measured BMI assessments in childhood and adulthood were included. Prospective risk of adult class II/III obesity was modeled based on childhood age, sex, race, and BMI.

Results

A total of 12,142 individuals (44% male, 85% white) were assessed at median age 14 [Interquartile range, IQR: 11, 16] and 33 [28, 39] years. Class II/III adult obesity developed in 6% of children with normal weight; 29% of children with overweight; 56% of children with obesity; and 80% of children with severe obesity. However, 38% of the 1440 adults with class II/III obesity (553/1440) were normal weight as children. Prospective risk of adult class II/III obesity varied by age, sex, and race within childhood weight status classifications, and is notably higher for girls, black participants, and those in the United States. The risk of class II/III obesity increased with older adult age.

Conclusions

Children with obesity or severe obesity have a substantial risk of adult class II/III obesity, and observed prospective risk estimates are now presented by age, sex, race, and childhood BMI. Clinical monitoring of children’s BMI for adult class II/III obesity risk may be especially important for females and black Americans.

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Funding

Funded by the National Institutes of Health, National Heart, Lung and Blood Institute, grant number R01 HL121230.

Author information

Authors and Affiliations

  1. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Jessica G. Woo, Nanhua Zhang & Matthew Fenchel

  2. The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Jessica G. Woo & Elaine M. Urbina

  3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Jessica G. Woo, Nanhua Zhang & Elaine M. Urbina

  4. University of Minnesota, Minneapolis, MN, USA

    David R. Jacobs Jr., Tian Hu, Julia Steinberger, Justin R. Ryder & Alan Sinaiko

  5. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA

    Trudy L. Burns

  6. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

    Olli Raitakari

  7. Centre for Population Health Research, University of Turku, Turku, Finland

    Olli Raitakari

  8. Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland

    Olli Raitakari

  9. Tulane University, New Orleans, LA, USA

    Lydia Bazzano

  10. Wake Forest School of Medicine, Division of Public Health Sciences, Winston-Salem, NC, USA

    Ronald J. Prineas

  11. National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    Cashell Jaquish

  12. Department of Internal Medicine, University of Turku, Turku, Finland

    Markus Juonala

  13. Division of Medicine, Turku University Hospital, Turku, Finland

    Markus Juonala

  14. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA

    Stephen R. Daniels

  15. The George Institute, Oxford University, Oxford, England

    Terence Dwyer

  16. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia

    Terence Dwyer & Alison Venn

Authors
  1. Jessica G. Woo
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  2. Nanhua Zhang
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  4. David R. Jacobs Jr.
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  5. Tian Hu
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  6. Elaine M. Urbina
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  8. Olli Raitakari
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  9. Julia Steinberger
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  16. Alan Sinaiko
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  17. Terence Dwyer
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  18. Alison Venn
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Contributions

JGW conceptualized and designed the study and analysis, contributed to the interpretation of data, drafted the initial manuscript, and revised the manuscript for important intellectual content. NZ and MF carried out the analyses, contributed to drafting the initial manuscript, and revised the manuscript for important intellectual content. DRJ, TH, and JRR made substantial contributions to the analysis and interpretation of data, and revised the manuscript for important intellectual content. OR, TD, and AS contributed to the acquisition and interpretation of data, and revised the manuscript for important intellectual content. JS, EMU, TLB, LB, and SRD coordinated and supervised data collection and reviewed and revised the manuscript. RJP, CJ, and MJ contributed to the interpretation of data and reviewed and revised the manuscript. AV conceptualized the study, coordinated, and supervised data collection, contributed to the interpretation of the data, and critically revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jessica G. Woo.

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Woo, J.G., Zhang, N., Fenchel, M. et al. Prediction of adult class II/III obesity from childhood BMI: the i3C consortium. Int J Obes 44, 1164–1172 (2020). https://doi.org/10.1038/s41366-019-0461-6

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  • DOI: https://doi.org/10.1038/s41366-019-0461-6

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