Obesity in adolescence and adulthood and the risk of adult mortality.
BACKGROUND There are few long-term follow-up data on the relation between body mass index (BMI) in adolescence and in adulthood, and between adolescent BMI and adult mortality. The present study explores these relations.


METHODS
In Norwegian health surveys during 1963-1999, height and weight were measured for 128,121 persons in a standardized way both in adolescence (age 14-19 years) and 10 or more years later. Persons were followed for an average of 9.7 years after the adult measurement. Cox proportional hazard regression models were used to study the association between adolescent and adult BMI and mortality.


RESULTS
The odds ratio of obesity (BMI >/=30) in adulthood increased steadily with BMI in adolescence, from 0.2 for low BMI up to 16 for very high BMI. Very high adolescent BMI was associated with 30-40% higher adult mortality compared with medium BMI. Adjusting for adult BMI explained most of the association of adolescent obesity and mortality, especially among men. Adjustment for smoking did not change the results.


CONCLUSIONS
Obesity in adolescence tends to persist into adulthood. Adolescent obesity is also connected to excess mortality, but this excess seems to be explained mostly by obesity in adulthood. High BMI in adolescence seems to be predictive of both adult obesity and mortality.
Engeland
Anders
A
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. anders.engeland@fhi.no
Bjørge
Tone
T
Tverdal
Aage
A
Søgaard
Anne Johanne
AJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009765:Obesity / Q000150:complications* / Q000401:mortality* / Q000473:pathology; D016017:Odds Ratio; D012307:Risk Factors