title: Variability and rapid increase in body mass index during childhood are associated with adult obesity.
abstract: BACKGROUND
  Body mass index (BMI) in childhood predicts obesity in adults, but it is unknown whether rapid increase and variability in BMI during childhood are independent predictors of adult obesity.
  
  
  METHODS
  The study cohort consisted of 1622 Bogalusa Heart Study participants (aged 20 to 51 years at follow-up) who had been screened at least four times during childhood (aged 4-19 years). BMI rate of change during childhood for each individual was assessed by mixed models; BMI residual standard deviation (RSD) during childhoodwas used as a measure of variability. The average follow-up period was 20.9 years.
  
  
  RESULTS
  One standard deviation increase in rate of change in BMI during childhood was associated with 1.39 [95% confidence interval (CI): 1.17-1.61] kg/m(2) increase in adult BMI and 2.98 (95% CI: 2.42-3.56) cm increase in adult waist circumference, independently of childhood mean BMI. Similarly, one standard deviation increase in RSD in BMI during childhood was associated with 0.46 (95% CI: 0.23-0.69) kg/m(2) increase in adult BMI and 1.42 (95% CI: 0.82-2.02) cm increase in adult waist circumference. Odds ratio for adult obesity progressively increased from the lowest to the highest quartile of BMI rate of change or RSD during childhood (P for trend < 0.05 for both).
  
  
  CONCLUSIONS
  Rapid increase and greater variability in BMI during childhood appear to be independent risk factors for adult obesity. Our findings have implications for understanding body weight regulation and obesity development from childhood to adulthood.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA, sli10@tulane.edu.
authors.forename: Shengxu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA, Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Dianjianyi
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Camilo
authors.initials: C
authors.lastname: Fernandez
authors.affiliation: Department of Biostatistics and Bioinformatics.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Tanika
authors.initials: T
authors.lastname: Kelly
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA and Ochsner Health System, New Orleans, LA, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Krousel-Wood
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D055105:Waist Circumference; D015430:Weight Gain; D044465:White People; D055815:Young Adult
keywords: Obesity; longitudinal analysis; rate of change; variability