Objective:

To investigate the relationship between childhood and young adult BMI changes and the risk of coronary heart disease (CHD).

Approach:

• Study Design: Population-based cohort study following 103,232 patients born between 1945 and 1968 for nearly 40 years.
• Data Collection: Weight measurements taken in childhood and young adulthood, linked with health records and death registries.
• Analysis: Statistical models used to assess the association between BMI changes and CHD events.

Key Findings:

• Among the 4,091 patients with childhood overweight who achieved normal weight by young adulthood, coronary heart disease (CHD) risk matched that of the participants who never had overweight.
• Patients with pubertal onset overweight demonstrated 23% higher risk compared with those who had persistent overweight.
• Patients with pubertal onset overweight and persistent overweight showed a respective 83% and 53% increased likelihood of adult CHD events compared with those maintaining normal weight.
• Patients with high childhood BMI who achieved normal young adulthood BMI showed no increased CHD risk vs those with normal BMI at both timepoints.
• The highest CHD risk emerged among patients with low childhood BMI and high young adulthood BMI, showing more than twice the risk compared with those maintaining normal BMI.

Interpretation:

Limitations:

• Inability to adjust for smoking status and other lifestyle factors.
• Predominantly White cohort may limit generalizability.
• 28% of eligible patients excluded due to missing data or events prior to age 22.

Conclusion:

Sources:

• JAMA Pediatrics