Childhood BMI May Influence Poorer Health Outcomes in Adulthood

Adults who had a high BMI in adolescence were at highest risk for Type 2 diabetes and early heart attack

Contact: Sam Roth,,

WASHINGTON (Jun 21, 2021) -

A high body mass index (BMI) during adolescence is a significant risk factor for Type 2 diabetes, early heart attack and overall poorer health for young adults, regardless of BMI in adulthood, according to a research letter published today in the Journal of the American College of Cardiology.

BMI is calculated based on weight and height. According to the National Heart, Lung, and Blood Institute, BMI categories are defined as: less than 18.5 kg/m2 is underweight; 18.5 to 24.9 is normal weight; 25 to 29.9 is overweight; and 30 or greater is obese.

Researchers analyzed the BMI z-scores, which is relative weight adjusted for a child’s age and sex, of 12,300 adolescents with 24 years of follow-up data through the National Longitudinal Study of Adolescent to Adult Health. Patients in the study were between 11 to 18 years of age and 51.4% were female. The researchers adjusted analyses to control for race/ethnicity, sex, age, education, household income, and tobacco and alcohol use. All results were self-reported. The average baseline BMI in this study was 22.4 kg/m2. Each one-unit higher BMI z-score in adolescence was associated with a 4.17 kg/m2 higher BMI in adulthood at the 24-year follow-up.

A higher BMI in adolescence was associated with a 2.6% increase in overall poor health, as well as an 8.8% increased risk for Type 2 diabetes and 0.8% increased risk for early heart attack in adults in their 30s and 40s, independent of what their adult BMI was. This study is the first of its kind to demonstrate the adverse relationship in younger adults.

“The finding that adolescent BMI is a risk factor for poor health outcomes in adulthood, regardless of adult BMI, has significant implications for our understanding of cardiovascular disease onset,” said Jason M. Nagata, MD, MSc, assistant professor of pediatrics in the Division of Adolescent and Young Adult Medicine at the University of California, San Francisco, and lead author of the study. “Considering these findings, health care providers should consider BMI history when assessing for cardiovascular and chronic disease risk.”

The researchers said the findings support the hypothesis that both age of obesity onset and cumulative obesity exposure contribute to insulin resistance and atherosclerosis. To combat poor health outcomes, the researchers recommend more guidance and support from pediatricians to patients. “Our study suggests that adolescence is an important time period to optimize health and prevent early heart attacks. Pediatricians should encourage teens to develop healthy behaviors including physical activity and balanced meals,” Nagata said.

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit

The Journal of the American College of Cardiology ranks among the top cardiovascular journals in the world for its scientific impact. JACC is the flagship for a family of journals—JACC: Cardiovascular Interventions, JACC: Cardiovascular Imaging, JACC: Heart Failure, JACC: Clinical Electrophysiology, JACC: Basic to Translational Science, JACC: Case Reports, JACC: CardioOncology and JACC: Asia—that prides themselves in publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at


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