Abstract
OBJECTIVE: Although obese children are at increased risk for coronary heart disease in later life, it is not clear if this association results from the persistence of childhood obesity into adulthood. We examined the relation of adiposity at various ages to the carotid intima-media thickness (IMT) at age 35ây.
DESIGN: Prior to the determination of IMT by B-mode ultrasound, subjects (203 men, 310 women) had, on average, six measurements of body mass index (BMI) and triceps skinfold thickness (TSF) between the ages of 4 and 35ây. Mixed regression models for longitudinal data were used to assess the relation of these characteristics to adult IMT.
RESULTS: Overall, adult IMT was associated with levels of both BMI and TSF (P<0.001), with the magnitudes of the associations with childhood adiposity comparable to those with adult levels of BMI and TSF. Furthermore, adult obesity modified the association between childhood adiposity and IMT: high IMT levels were seen only among overweight (BMI â¥95th percentile) children who became obese (BMI â¥30âkg/m2) adults (P<0.01 for linear trend). In contrast, IMT levels were not elevated among (1) overweight children who were not obese in adulthood, or among (2) thinner children who became obese adults.
CONCLUSIONS: These results emphasize the adverse, cumulative effects of childhood-onset obesity that persists into adulthood. Since many overweight children become obese adults, the prevention of childhood obesity should be emphasized.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Napoli C, D'Armiento FP, Mancini FP, Postiglione A, Witztum JL, Palumbo G, Palinski W . Fatty streak formation occurs in human fetal aortas and is greatly enhanced by maternal hypercholesterolemia. Intimal accumulation of low density lipoprotein and its oxidation precede monocyte recruitment into early atherosclerotic lesions. J Clin Invest 1997; 100: 2680â2690.
Berenson GS, Srinivasan SR, Bao W, Newman III WP, Tracy RE, Wattigney WA . Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998; 338: 1650â1656.
Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt JD, Rost CA, Lauer RM . Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996; 27: 277â284.
Abraham S, Collins G, Nordsieck M . Relationship of childhood weight status to morbidity in adults. HSMHA Health Rep 1971; 86: 273â284.
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH . Long term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. New Engl J Med 1992; 327: 1350â1355.
Gunnell DJ, Frankel SJ, Nanchahal K, Peters TJ, Davey Smith G . Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. Am J Clin Nutr 1998; 67: 1111â1118.
Ogden CL, Flegal KM, Carroll MD, Johnson CL . Prevalence and trends in overweight among US children and adolescents, 1999â2000. JAMA 2002; 288: 1728â1732.
Bots ML, Hofman A, Grobbee DE . Increased common carotid intima-media thickness. Adaptive response or a reflection of atherosclerosis? Findings from the Rotterdam Study. Stroke 1997; 28: 2442â2447.
Spence JD . Ultrasound measurement of carotid plaque as a surrogate outcome for coronary artery disease. Am J Cardiol 2002; 89: 10Bâ15B.
Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M, Alzola C . Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC Study. Am J Epidemiol 1991; 134: 250â256.
Temelkova-Kurktschiev T, Koehler C, Schaper F, Henkel E, Hahnfeld A, Fuecker K, Siegert G, Hanefeld M . Relationship between fasting plasma glucose, atherosclerosis risk factors and carotid intima media thickness in non-diabetic individuals. Diabetologia 1998; 41: 706â712.
Espeland MA, Tang R, Terry JG, Davis DH, Mercuri M, Crouse III JR . Associations of risk factors with segment-specific intimal-medial thickness of the extracranial carotid artery. Stroke 1999; 30: 1047â1055.
Ciccone M, Vettor R, Pannacciulli N, Minenna A, Bellacicco M, Rizzon P, Giorgino R, De Pergola G . Plasma leptin is independently associated with the intima-media thickness of the common carotid artery. Int J Obes Relat Metab Disord 2001; 25: 805â810.
Urbina EM, Srinivasan SR, Tang R, Bond MG, Kieltyka L, Berenson GS . Impact of multiple coronary risk factors on the intima-media thickness of different segments of carotid artery in healthy young adults (The Bogalusa Heart Study). Am J Cardiol 2002; 90: 953â958.
Hodis HN, Mack WJ . Atherosclerosis imaging methods: assessing cardiovascular disease and evaluating the role of estrogen in the prevention of atherosclerosis. Am J Cardiol 2002; 89 (Suppl): 19Eâ27E.
Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE . Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 1997; 96: 1432â1437.
Chambless LE, Heiss G, Folsom AR, Rosamond W, Szklo M, Sharrett AR, Clegg LX . Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987â1993. Am J Epidemiol 1997; 146: 483â494.
O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson Jr SK . Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med 1999; 340: 14â22.
Chambless LE, Folsom AR, Clegg LX, Sharrett AR, Shahar E, Nieto FJ, Rosamond WD, Evans G . Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 2000; 151: 478â487.
Lavrencic A, Kosmina B, Keber I, Videcnik V, Keber D . Carotid intima-media thickness in young patients with familial hypercholesterolaemia. Heart 1996; 76: 321â325.
Tonstad S, Joakimsen O, Stensland-Bugge E, Leren TP, Ose L, Rusell D, Bonaa KH . Risk factors related to carotid intima-media thickness and plaque in children with familial hypercholesterolemia and control subjects. Arterioscler Thromb Vasc Biol 1996; 16: 984â991.
Sanchez A, Barth JD, Zhang L . The carotid artery wall thickness in teenagers is related to their diet and the typical risk factors of heart disease among adults. Atherosclerosis 2000; 152: 265â266.
Jarvisalo MJ, Putto-Laurila A, Jartti L, Lehtimaki T, Solakivi T, Ronnemaa T, Raitakari OT . Carotid artery intima-media thickness in children with type 1 diabetes. Diabetes 2002; 51: 493â498.
Davis PH, Dawson JD, Riley WA, Lauer RM . Carotid intimal-medial thickness is related to cardiovascular risk factors measured from childhood through middle age: The Muscatine Study. Circulation 2001; 104: 2815â2819.
Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T . Do obese children become obese adults? A review of the literature. Prev Med 1993; 22: 167â177.
Berenson GS (ed). Cardiovascular risk factors in children. Oxford University Press: New York; 1980.
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL . CDC growth charts: United States. Adv Data 2000; 314: 1â27, http://www.cdc.gov/nccdphp/dnpa/growthcharts/sas.htm.
Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL . Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 2002; 109: 45â60.
Kuczmarski RJ, Flegal KM . Criteria for definition of overweight in transition: background and recommendations for the United States. Am J Clin Nutr 2000; 72: 1074â1081.
Srinivasan SR, Berenson GS . Serum lipoprotein in children and methods for study. In: Lewis LA (ed). CRC handbook of electrophoresis. Vol III: Lipoprotein methodology and human studies. CRC Press: Boca Raton, FL; 1983. pp 185â204.
Tang R, Hennig M, Thomasson B, Scherz R, Ravinetto R, Catalini R, Rubba P, Zanchetti A, Bond MG . Baseline reproducibility of B-mode ultrasonic measurement of carotid artery intima-media thickness: the European Lacidipine Study on Atherosclerosis (ELSA). J Hypertens 2000; 18: 197â201.
Touboul PJ, Mearis SP . Carotid artery intima-media thickness. In: Hennerici MG, Meairs SP (eds). Cerebrovascular ultrasound. Cambridge University Press: Cambridge, UK; 2001. pp 152â161.
Verbeke G, Molenberghs G . Linear mixed models for longitudinal data. Springer-Verlag: New York; 2000. pp 57â62.
Cleveland WS . The elements of graphing data. Wadsworth advanced books and software: Monterey, CA; 1985. pp 170â178.
Littell RC, Milliken GA, Stroup WW, Wolfinger RD . SAS system for mixed models. SAS Institute Inc.: Cary, NC; 1996.
D'Agostino Jr RB, Burke G, O'Leary D, Rerwers M, Selby J, Savage PL, Saad MF, Bergman RN, Howard G, Wagenknecht L, Haffner SM . Ethnic differences in carotid wall thickness. The Insulin Resistance Atherosclerosis Study. Stroke 196; 27: 1744â1749.
Karason K, Wikstrand J, Sjostrom L, Wendelhag I . Weight loss and progression of early atherosclerosis in the carotid artery: a four-year controlled study of obese subjects. Int J Obes Relat Metab Disord 1999; 23: 948â956.
Schmidt HH, Hill S, Makariou EV, Feuerstein IM, Dugi KA, Hoeg JM . Relation of cholesterol-year score to severity of calcific atherosclerosis and tissue deposition in homozygous familial hypercholesterolemia. Am J Cardiol 1996; 77: 575â580.
Wilson PWF, Hoeg JM, DâAgostino RB, Silbershatz H, Belanger AM, Poehlmann H, OâLeary D, Wolf PA . Cumulative effects of high cholesterol levels, high blood pressure, and cigarette smoking on carotid stenosis. N Engl J Med 1997; 337: 516â522.
Harrison GG . Height-weight tables. Ann Intern Med 1985; 103 (Part 2): 989â994.
Wannamethee SG, Shaper AG . Weight change and duration of overweight and obesity in the incidence of type 2 diabetes. Diabetes Care 1999; 22: 1266â1272.
Cuomo S, Guarini P, Gaeta G, De Michele M, Boeri F, Dorn J, Bond M, Trevisan M . Increased carotid intima-media thickness in childrenâadolescents, and young adults with a parental history of premature myocardial infarction. Eur Heart J 2002; 23: 1345â1350.
Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt JD, Rost CA, Lauer RM . Usefulness of the Framingham risk score and body mass index to predict early coronary artery calcium in young adults (Muscatine Study). Am J Cardiol 2001; 88: 509â515.
McGill Jr HC, McMahan CA, Herderick EE, Zieske AW, Malcom GT, Tracy RE, Strong JP . Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation 2002; 105: 2712â2718.
Riley WA, Barnes RW, Applegate WB, Dempsey R, Hartwell T, Davis VG, Bond MG, Furberg CD . Reproducibility of noninvasive ultrasonic measurement of carotid atherosclerosis: the Asymptomatic Carotid Artery Plaque Study. Stroke 1992; 23: 1062â1068.
Freedman DS, Dietz W, Srinivasan SR, Berenson GS . The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics 1999; 103: 1175â1182.
Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS . Relation of childhood obesity to coronary heart disease risk factors in adulthood. Pediatrics 2001; 108: 712â718.
Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH . Weight, weight change, and coronary heart disease in women. Risk within the ânormalâ weight range. JAMA 1995; 273: 461â465.
Acknowledgements
This work is supported by NIH Grants HL-38844 (National Heart, Blood and Lung Institute) and AG-16592 (National Institute on Aging), American Heart Association Grant 0160261B, and by funds from the Centers for Disease Control and Prevention.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Freedman, D., Dietz, W., Tang, R. et al. The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study. Int J Obes 28, 159â166 (2004). https://doi.org/10.1038/sj.ijo.0802515
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802515
Keywords
This article is cited by
-
Current applications for measuring pediatric intima-media thickness
Pediatric Radiology (2022)
-
The potential effect mechanism of high-fat and high-carbohydrate diet-induced obesity on anxiety and offspring of zebrafish
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity (2022)
-
The association between anthropometric measures of adiposity and the progression of carotid atherosclerosis
BMC Cardiovascular Disorders (2020)
-
Prediction of adult class II/III obesity from childhood BMI: the i3C consortium
International Journal of Obesity (2020)
-
Childhood obesity, cardiovascular and liver health: a growing epidemic with age
World Journal of Pediatrics (2020)