Childhood Obesity Dynamics and Risk of Heart Disease and Diabetes in Adulthood: Evidence from a U.S. Synthetic Cohort

Sarah Qabazard , Emory University
Natalia E Poveda Rey, Department of Nutrition and Biochemistry, Faculty of Sciences, Pontificia Universidad Javeriana, Bogota
Solveig A Cunningham, Netherlands Interdisciplinary Demographic Institute and Emory University

Background: Childhood obesity, which is rising across middle- and upper-income countries, has long-term health consequences. This study examines how the timing, duration, and intensity of obesity in childhood and adolescence are associated with adult heart disease and diabetes using a longitudinal synthetic cohort spanning two decade of follow-up. Methods: We used synthetic cohort methods to follow a nationally representative group of U.S. children who were in kindergarten in 1998-1999 (born in 1991-1994 ) from ages 4 to 42. Data were from the Early Childhood Longitudinal Study, linked with the National Longitudinal Survey of Youth, after matching individuals of same sex and similar weight trajectories at overlapping ages. BMI trajectories were tracked across mid-childhood (4-9 years), early-adolescence (10-14), and late adolescence (15-19 years). Obesity dynamics were defined using indicators of age of onset, obesity duration, and excess BMI-years (composite measure of intensity and duration). Physician-diagnosed heart disease and diabetes were measured at ages 30-40. Survey-weighted logistic regression models estimated associations, adjusting for sex, race/ethnicity, and urbanicity. Results: Longer duration of obesity in mid-childhood was associated with higher odds of adult heart disease (AOR = 1.33; 95% CI: 1.11-1.59), while duration in adolescence (15-19 years), was linked to greater diabetes risk, with each additional year of obesity increasing odds by 29% (AOR = 1.29; 95% CI: 1.09-1.53). Excess BMI was positively associated with diabetes during early adolescence. Conclusion: Early and sustained obesity, particularly during adolescence, confers elevated risk for adult cardiometabolic disease. Preventing prolonged obesity exposure in youth may reduce future diabetes and heart disease.

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 Presented in Session 29. Flash Session Child and Adolescent Health and Development