title: The influence of adolescent body mass index, physical activity, and tobacco use on blood pressure and cholesterol in young adulthood.
abstract: OBJECTIVE
  To test the independent influences of adolescent tobacco use, physical activity/inactivity, and body mass index (BMI) on young adult cardiovascular risk factors.
  
  
  METHODS
  This is a prospective cohort study using data from Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) (N = 14,322). We tested whether Wave I tobacco use, physical activity/inactivity, and BMI predicted self-report of being diagnosed with high blood pressure (BP) or high cholesterol by Wave III, while controlling for gender, age, race/ethnicity, use of healthcare, and Wave III tobacco use, physical activity/inactivity, BMI.
  
  
  RESULTS
  Among young adults aged 18-26, 5.37% report high BP and 4.28% high cholesterol. Obese adolescents are more likely to report high BP by young adulthood than normal-weight adolescents, independent of all control variables including BMI in young adulthood (adjusted odds ratio [aOR] = 1.96; 95% confidence interval = [1.50-2.57]). Overweight and obese adolescents are more likely to report high cholesterol by young adulthood than normal-weight adolescents, independent of all control variables including BMI in young adulthood (aOR = 1.47 [1.14-1.90] and 2.05 [1.44-2.91], respectively). Adolescent tobacco use and physical activity/inactivity do not independently predict reported high BP or cholesterol.
  
  
  CONCLUSIONS
  The odds of overweight and obese adolescents reporting a diagnosis for two cardiovascular risk factors by young adulthood are 1.5 to two times higher than normal-weight adolescents, regardless of BMI in young adulthood. The impact of transient and sustained increases in adolescent BMI on the evolution of cardiovascular risk warrants further investigation.
authors.affiliation: Pediatrics and Medicine, University of North Carolina, Chapel Hill, North Carolina 27599-7225, USA. caf@med.unc.edu
authors.forename: Carol A
authors.initials: CA
authors.lastname: Ford
authors.forename: James M
authors.initials: JM
authors.lastname: Nonnemaker
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Wirth
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015438:Health Behavior; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D009043:Motor Activity; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult