A high body mass index (BMI) during adolescence may be a significant risk factor for Type 2 diabetes, early MI and overall poorer health for young adults, regardless of BMI in adulthood, according to a research letter published June 21 in the Journal of the American College of Cardiology.

Jason M. Nagata, MD, MSc, et al., analyzed the BMI z-scores – 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.

Results showed that 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 MI in adults in their 30s and 40s, independent of what their adult BMI was. According to the researchers, this study is one of the first 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 Nagata. "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 adds.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Exercise

Keywords: Young Adult, Child, Body Mass Index, Longitudinal Studies, Insulin Resistance, Diabetes Mellitus, Type 2, Exercise, Obesity, Pediatric Obesity, Body Weight, Health Behavior, Risk Factors, Atherosclerosis, Chronic Disease, Myocardial Infarction

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