The severity and frequency of childhood obesity has increased significantly over the past three to four decades. The health effects of increased body mass index as a child may significantly impact obese youth as they age. However, many of the long-term outcomes of childhood obesity have yet to be studied. This article examines the currently available longitudinal data evaluating the effects of childhood obesity on adult outcomes. Consequences of obesity include an increased risk of developing the metabolic syndrome, cardiovascular disease, type 2 diabetes and its associated retinal and renal complications, nonalcoholic fatty liver disease, obstructive sleep apnea, polycystic ovarian syndrome, infertility, asthma, orthopedic complications, psychiatric disease, and increased rates of cancer, among others. These disorders can start as early as childhood, and such early onset increases the likelihood of early morbidity and mortality. Being obese as a child also increases the likelihood of being obese as an adult, and obesity in adulthood also leads to obesity-related complications. This review outlines the evidence for childhood obesity as a predictor of adult obesity and obesity-related disorders, thereby emphasizing the importance of early intervention to prevent the onset of obesity in childhood.

1.
Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL: Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 2002;109:45-60.
2.
Magarey AM, Daniels LA, Boulton TJ: Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust 2001;174:561-564.
3.
Lobstein T, Baur L, Uauy R: Obesity in children and young people: a crisis in public health. Obes Rev 2004;5(suppl 1):4-104.
4.
Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA 2012;307:483-490.
5.
de Onis M, Blossner M, Borghi E: Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010;92:1257-1264.
6.
Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ: Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 2008;9:474-488.
7.
Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, Robinson TN, Scott BJ, St Jeor S, Williams CL: Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999-2012.
8.
Li J, Motsko SP, Goehring EL Jr, Tave A, Pezzullo JC, Jones JK: Prevalence of pediatric dyslipidemia: comparison of a population-based claims database to national surveys. Pharmacoepidemiol Drug Saf 2010;19:1031-1040.
9.
Copeland KC, Zeitler P, Geffner M, Guandalini C, Higgins J, Hirst K, Kaufman FR, Linder B, Marcovina S, McGuigan P, Pyle L, Tamborlane W, Willi S, TODAY Study Group: Characteristics of adolescents and youth with recent-onset type 2 diabetes: the TODAY cohort at baseline. J Clin Endocrinol Metab 2011;96:159-167.
10.
Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, Hayflick L, Butler RN, Allison DB, Ludwig DS: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005;352:1138-1145.
11.
Keiller SM, Colley JR, Carpenter RG: Obesity in schoolchildren and their parents. Ann Hum Biol 1979;6:443-455.
12.
Elks CE, den Hoed M, Zhao JH, Sharp SJ, Wareham NJ, Loos RJ, Ong KK: Variability in the heritability of body mass index: a systematic review and meta-regression. Front Endocrinol (Lausanne) 2012;3:29.
13.
Llewellyn CH, Trzaskowski M, Plomin R, Wardle J: Finding the missing heritability in pediatric obesity: the contribution of genome-wide complex trait analysis. Int J Obes (Lond) 2013;37:1506-1509.
14.
Whitaker KL, Jarvis MJ, Beeken RJ, Boniface D, Wardle J: Comparing maternal and paternal intergenerational transmission of obesity risk in a large population-based sample. Am J Clin Nutr 2010;91:1560-1567.
15.
Roberts MD, Company JM, Brown JD, Toedebusch RG, Padilla J, Jenkins NT, Laughlin MH, Booth FW: Potential clinical translation of juvenile rodent inactivity models to study the onset of childhood obesity. Am J Physiol Regul Integr Comp Physiol 2012;303:R247-R258.
16.
Jorgensen MJ, Aycock ST, Clarkson TB, Kaplan JR: Effects of a Western-type diet on plasma lipids and other cardiometabolic risk factors in African green monkeys (Chlorocebus aethiops sabaeus). J Am Assoc Lab Anim Sci 2013;52:448-453.
17.
Heerwagen MJ, Miller MR, Barbour LA, Friedman JE: Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol 2010;299:R711-R722.
18.
Wisniewski AB, Chernausek SD: Gender in childhood obesity: family environment, hormones, and genes. Gend Med 2009;6(suppl 1): 76-85.
19.
Lerret SM, Garcia-Rodriguez L, Skelton J, Biank V, Kilway D, Telega G: Predictors of nonalcoholic steatohepatitis in obese children. Gastroenterol Nurs 2011;34:434-437.
20.
Morrison JA, Friedman LA, Gray-McGuire C: Metabolic Syndrome in Childhood Predicts Adult Cardiovascular Disease 25 Years Later: The Princeton Lipid Research Clinics Follow-Up Study. Pediatrics 2007;120:340-345.
21.
Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, Srinivasan SR, Daniels SR, Davis PH, Chen W, Sun C, Cheung M, Viikari JS, Dwyer T, Raitakari OT: Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011;365:1876-1885.
22.
Tirosh A, Shai I, Afek A, Dubnov-Raz G, Ayalon N, Gordon B, Derazne E, Tzur D, Shamis A, Vinker S, Rudich A: Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med 2011;364:1315-1325.
23.
Lloyd LJ, Langley-Evans SC, McMullen S: Childhood obesity and adult cardiovascular disease risk: a systematic review. Int J Obes (Lond) 2010;34:18-28.
24.
Mattsson N, Rönnemaa T, Juonala M, Viikari JS, Raitakari OT: Childhood predictors of the metabolic syndrome in adulthood. The Cardiovascular Risk in Young Finns Study. Ann Med 2008;40:542-552.
25.
Chen X, Wang Y: Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation 2008;117:3171-3180.
26.
Davis PH, Dawson JD, Riley WA, Lauer RM: Carotid intimal-medial thickness is related to cardiovascular risk factors measured from childhood through middle age: The Muscatine Study. Circulation 2001;104:2815-2819.
27.
Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt JD, Rost CA, Lauer RM: Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996;27:277-284.
28.
Raitakari OT, Juonala M, Viikari JS: Obesity in childhood and vascular changes in adulthood: insights into the Cardiovascular Risk in Young Finns Study. Int J Obes (Lond) 2005;29(suppl 2):S101-S104.
29.
Reinehr T, Wunsch R: Intima media thickness-related risk factors in childhood obesity. Int J Pediatr Obes 2011;6(suppl 1):46-52.
30.
Baker JL, Olsen LW, Sorensen TI: Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med 2007;357:2329-2337.
31.
Franks PW, Hanson RL, Knowler WC, Sievers ML, Bennett PH, Looker HC: Childhood obesity, other cardiovascular risk factors, and premature death. New Engl J Med 2010;362:485-493.
32.
Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 2009;338:1650-1656.
33.
Lee JM, Gebremariam A, Vijan S, Gurney JG: Excess body mass index-years, a measure of degree and duration of excess weight, and risk for incident diabetes. Arch Pediatr Adolesc Med 2012;166:42-48.
34.
Morrison JA, Glueck CJ, Horn PS, Wang P: Childhood predictors of adult type 2 diabetes at 9- and 26-year follow-ups. Arch Pediatr Adolesc Med 2010;164:53-60.
35.
TODAY Study Group, Zeitler P, Hirst K, Pyle L, Linder B, Copeland K, Arslanian S, Cuttler L, Nathan DM, Tollefsen S, Wilfley D, Kaufman F: A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med 2012;366:2247-2256.
36.
Rhodes ET, Prosser LA, Hoerger TJ, Lieu T, Ludwig DS, Laffel LM: Estimated morbidity and mortality in adolescents and young adults diagnosed with Type 2 diabetes mellitus. Diabet Med 2012;29:453-463.
37.
Fagherazzi G, Guillas G, Boutron-Ruault MC, Clavel-Chapelon F, Mesrine S: Body shape throughout life and the risk for breast cancer at adulthood in the French E3N cohort. Eur J Cancer Prev 2013;22:29-37.
38.
Hardiman P, Pillay OC, Atiomo W: Polycystic ovary syndrome and endometrial carcinoma. Lancet 2003;361:1810-1812.
39.
Chromecki TF, Cha EK, Fajkovic H, Rink M, Ehdaie B, Svatek RS, Karakiewicz PI, Lotan Y, Tilki D, Bastian PJ, Daneshmand S, Kassouf W, Durand M, Novara G, Fritsche HM, Burger M, Izawa JI, Brisuda A, Babjuk M, Pummer K, Shariat SF: Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy. BJU Int 2013;111:249-255.
40.
Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr: Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999;341:1097-1105.
41.
Bibbins-Domingo K, Coxson P, Pletcher MJ, Lightwood J, Goldman L: Adolescent overweight and future adult coronary heart disease. N Engl J Med 2007;357:2371-2379.
42.
Brotman LM, Dawson-McClure S, Huang KY, Theise R, Kamboukos D, Wang J, Petkova E, Ogedegbe G: Early childhood family intervention and long-term obesity prevention among high-risk minority youth. Pediatrics 2012;129:e621-e628.
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