One-third of the adolescent population in Western countries is now considered to be overweight or obese. The implications of this epidemic remain unclear but may well lead to an increased prevalence of cardiovascular disease and an erosion in the mortality and morbidity gains that have been apparent in the last few decades. To further explore this question, records from an Israeli national database containing the BMIs of adolescents was analyzed. Data for a total of 2.3 million individuals (mean age 17 yrs.) was available between 1967 and 2010 compromising a total of over 42,000,000 years of person follow-up. Body mass index (BMI) was assessed by centiles and linked to mortality data for the population. 9.1% of deaths in this young cohort were attributable to cardiovascular causes with 1497 from coronary disease, 528 from stroke and 893 from sudden death. Using a multivariable model adjusting for factors including birth year, sex and socioeconomic class there was a clear and graded increase in the risk of death from cardiovascular causes starting in the group between the 50th and 74th centiles and increasing rapidly as BMI increased such that in the 95th centile, the relative risk of death from coronary disease was 4.9 and from stroke was 2.6.
This epidemiological study of adolescent BMI draws strong correlations between early life BMI and the risk of death in adulthood from cardiovascular causes. Whether adolescence is a particularly sensitive time when disease processes may initiate or whether adolescent BMI simply predicts adult BMI is unclear as no data were available on the adult characteristics of the study group. Regardless, the increasing prevalence of childhood and adolescent obesity portends a coming tidal wave of cardiovascular disease that is likely to seriously affect the health of future adult populations.
Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, Tzur D, Afek A, Shamiss A, Haklai Z, Kark JD. Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. N Engl J Med. 2016 Jun 23;374(25):2430-40.
Hussain Contractor and James M. McCabe