Tracking of overweight status from childhood to young adulthood: the Bogalusa Heart Study

Objective: To understand tracking of overweight status from childhood to young adulthood in a biracial sample. Design: A longitudinal sample was created from cross-sectional surveys at two time points, childhood ( baseline) and young adulthood ( follow-up). Setting: Bogalusa Heart Study, Louisiana, United States of America. Subjects: A total of 841 young adults, 19 - 35 years (68% Euro-Americans ( EA), 32% African-Americans ( AA)) were studied. The same subjects had also participated in one of the five cross-sectional surveys at childhood ( 9 - 11 years). Methods: Body mass index (BMI) was used to determine overweight status as per the Centers for Disease Control and Prevention standards. Change in the BMI status from childhood to young adulthood was used to group the participants into the following categories: normal weight to normal weight (NW-NW); normal weight to overweight (NW-OW); overweight to normal weight (OW-NW); and overweight to overweight (OW-OW). Tracking of overweight was defined by ( 1) correlations between baseline and follow-up BMI, ( 2) Cohen's kappa concordance test to determine the strength of tracking in BMI quartiles and ( 3) the percentage of individuals who remained in the same overweight status group from baseline to follow-up. Results: From baseline to follow-up, the percentage of participants who were overweight increased from 24.7 to 57.7%. A total of 35.2% of the children shifted from normal weight in childhood to overweight in young adulthood (P<0.0005). Baseline BMI was positively correlated with follow-up BMI (r = 0.66, P<0.0005). A total of 61.9% of the participants in the highest BMI quartile in childhood remained in the highest BMI quartile in young adulthood. The strength of tracking in BMI quartiles was 27% for EA men (P<0.0005), 23% for EA women (P<0.0005), 27% for AA men (P<0.0005) and 35% for AA women (P<0.0005). A total of 53.7% of the EA women remained in the NW-NW category and 31.2% of the AA women remained in the OW-OW category. The percentage tracking ( NW-NW and OW-OW) was 72.8% in EA women, 59.6% in AA men, 59.5% in AA women and 48.8% in EA men (P<0.0001). Conclusion: Childhood overweight tracked into young adulthood in this sample and the tracking of NW-NW and OW-OW was the most prominent among the EA women.