Predictive associations between alternative measures of childhood adiposity and adult cardio-metabolic health

Objective: To estimate associations between alternative measures of childhood adiposity and indicators of cardio-metabolic health in adulthood, both unadjusted and adjusted for changes in adiposity from childhood to adulthood. Design and Methods: The study consisted of a 20-year follow-up of 2188 adults who had participated in the 1985 Australian Schools Health and Fitness Survey when they were between 7 and 15 years of age. Baseline and follow-up measures of body composition included height and weight, waist and hip circumferences and skinfold thicknesses at four sites. At follow-up, participants attended study clinics where component indicators of the metabolic syndrome (MetS) (waist circumference, blood pressure, fasting blood glucose and lipids) were measured. Results: Waist circumference and skinfold measures were the strongest predictors of subsequent MetS (2009 Joint Scientific Statement definition) in early adulthood. For example, relative risks (RRs) for children in the highest (vs lowest) quarter of waist circumference were 4.8 (95% confidence interval (CI): 2.5-9.2) for males and 5.8 (95% CI: 2.4-14.2) for females. After adjusting for change in waist circumference from childhood to adulthood, each 10cm increase in childhood waist circumference was associated with an approximate twofold increase in risk for adult MetS (RR=2.1 (95% CI: 1.7-2.7) among males and RR=2.3 (95% CI: 1.6-3.4) among females). Conclusion: Elevated waist circumference and skinfold thickness measures in childhood appear to be the strongest predictors of subsequent MetS in early adulthood. The increased risk associated with higher waist circumference in childhood appears to be independent of changes in waist circumference from childhood to adulthood. International Journal of Obesity (2011) 35, 38-45; doi:10.1038/ijo.2010.205; published online 28 September 2010