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Simulation of Growth Trajectories of Childhood Obesity into Adulthood.

作者信息

Ward Zachary J, Long Michael W, Resch Stephen C, Giles Catherine M, Cradock Angie L, Gortmaker Steven L

机构信息

From the Center for Health Decision Science (Z.J.W., S.C.R.) and the Department of Social and Behavioral Sciences (C.M.G., A.L.C., S.L.G.), Harvard T.H. Chan School of Public Health, Boston; and the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC (M.W.L.).

出版信息

N Engl J Med. 2017 Nov 30;377(22):2145-2153. doi: 10.1056/NEJMoa1703860.


DOI:10.1056/NEJMoa1703860
PMID:29171811
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9036858/
Abstract

BACKGROUND: Although the current obesity epidemic has been well documented in children and adults, less is known about long-term risks of adult obesity for a given child at his or her present age and weight. We developed a simulation model to estimate the risk of adult obesity at the age of 35 years for the current population of children in the United States. METHODS: We pooled height and weight data from five nationally representative longitudinal studies totaling 176,720 observations from 41,567 children and adults. We simulated growth trajectories across the life course and adjusted for secular trends. We created 1000 virtual populations of 1 million children through the age of 19 years that were representative of the 2016 population of the United States and projected their trajectories in height and weight up to the age of 35 years. Severe obesity was defined as a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 35 or higher in adults and 120% or more of the 95th percentile in children. RESULTS: Given the current level of childhood obesity, the models predicted that a majority of today's children (57.3%; 95% uncertainly interval [UI], 55.2 to 60.0) will be obese at the age of 35 years, and roughly half of the projected prevalence will occur during childhood. Our simulations indicated that the relative risk of adult obesity increased with age and BMI, from 1.17 (95% UI, 1.09 to 1.29) for overweight 2-year-olds to 3.10 (95% UI, 2.43 to 3.65) for 19-year-olds with severe obesity. For children with severe obesity, the chance they will no longer be obese at the age of 35 years fell from 21.0% (95% UI, 7.3 to 47.3) at the age of 2 years to 6.1% (95% UI, 2.1 to 9.9) at the age of 19 years. CONCLUSIONS: On the basis of our simulation models, childhood obesity and overweight will continue to be a major health problem in the United States. Early development of obesity predicted obesity in adulthood, especially for children who were severely obese. (Funded by the JPB Foundation and others.).

摘要

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本文引用的文献

[1]
Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood.

Prev Med. 2017-2

[2]
State-level estimates of childhood obesity prevalence in the United States corrected for report bias.

Int J Obes (Lond). 2016-10

[3]
Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents.

Lancet. 2016-8-20

[4]
Diagnosis, Epidemiology, and Management of Hypertension in Children.

Pediatrics. 2016-8

[5]
A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence.

Int J Mol Sci. 2016-6-15

[6]
Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014.

JAMA. 2016-6-7

[7]
Trends in Obesity Among Adults in the United States, 2005 to 2014.

JAMA. 2016-6-7

[8]
An evidence-based resource for the management of comorbidities associated with childhood overweight and obesity.

J Am Assoc Nurse Pract. 2016-10

[9]
Tracking of overweight and obesity from early childhood to adolescence in a population-based cohort - the Tromsø Study, Fit Futures.

BMC Pediatr. 2016-5-10

[10]
Body Mass Transitions Through Childhood and Early Adolescence: A Multistate Life Table Approach.

Am J Epidemiol. 2016-4-1

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