title: Associations between severity of obesity in childhood and adolescence, obesity onset and parental BMI: a longitudinal cohort study.
abstract: OBJECTIVE
  To explore the relationship between severity of obesity at age 7 and age 15, age at onset of obesity, and parental body mass index (BMI) in obese children and adolescents.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Obese children (n = 231) and their parents (n = 462) from the Swedish National Childhood Obesity Centre.
  
  
  METHODS
  Multivariate regression analyses were applied with severity of obesity (BMI standard deviation score (BMI SDS)) and onset of obesity as dependent variables. The effect of parental BMI was evaluated and in the final models adjusted for gender, parental education, age at onset of obesity, severity of obesity at age 7 and obesity treatment.
  
  
  RESULTS
  For severity of obesity at age 7, a positive correlation with maternal BMI was indicated (P = 0.05). Severity of obesity at this age also showed a strong negative correlation with the age at onset of obesity. Severity of obesity at age 15 was significantly correlated with both maternal and paternal BMI (P < 0.01). In addition, BMI SDS at age 15 differed by gender (higher for boys) and was positively correlated with severity of obesity at age 7 and negatively correlated with treatment. Also, a negative correlation was indicated at this age for parental education. No correlation with age at onset was found at age 15. For age at onset of obesity there was no relevant correlation with parental BMI. Children within the highest tertile of the BMI SDS range were more likely to have two obese parents.
  
  
  CONCLUSIONS
  The impact of parental BMI on the severity of obesity in children is strengthened as the child grows into adolescence, whereas the age at onset is probably of less importance than previously thought. The influence of parental relative weight primarily affects the severity of childhood obesity and not the timing.
authors.affiliation: Department of Clinical Science, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden. viktoria.svensson@karolinska.se
authors.forename: V
authors.initials: V
authors.lastname: Svensson
authors.forename: J A
authors.initials: JA
authors.lastname: Jacobsson
authors.forename: R
authors.initials: R
authors.lastname: Fredriksson
authors.forename: P
authors.initials: P
authors.lastname: Danielsson
authors.forename: T
authors.initials: T
authors.lastname: Sobko
authors.forename: H B
authors.initials: HB
authors.lastname: Schiöth
authors.forename: C
authors.initials: C
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D010290:Parents; D011336:Probability; D012720:Severity of Illness Index; D012923:Social Class; D013548:Sweden / Q000453:epidemiology