Relative contributions of adiposity in childhood and adulthood to vascular health of young adults



      Vascular damage is suggested to have origins in childhood adiposity, but it is not clear whether this is a direct consequence of being obese in childhood. We aimed to estimate the associations of childhood body size or adiposity with adult vascular health, and to investigate whether these associations were independent of adult body size or adiposity.

      Design and methods

      Subjects were 2328 participants aged 7–15 years at baseline in 1985 with follow-up during 2004–2006 when aged 26–36 years. Anthropometric measures were taken at both baseline and follow-up. Carotid intima-media thickness (IMT) and three measures of large artery stiffness (LAS) were measured by ultrasound at follow-up.


      Childhood body size or adiposity was positively associated with both adult IMT and LAS. Participants who were obese in adulthood had the greatest LAS, particularly those who were normal weight in childhood. Adjustment for adult body size or adiposity eliminated effects of childhood body size or adiposity on LAS. For IMT, adjustment for adult body size or adiposity reduced estimated effects of child height by 44% (male) and 27% (female), of child weight by 46% (male) and 70% (female) and, after adjusting for sex, of child body mass index and body surface area by 60% and 53% respectively.


      Whereas IMT appeared to be influenced by body size or adiposity during childhood and early adulthood, LAS depended primarily on current adiposity and magnitude of adiposity gain between childhood and adulthood.


      • Body size was measured in both childhood (7–15 years) and adulthood (26–36 years).
      • We examined their relationships with adult vascular health.
      • Large artery stiffness primarily depended on adult obesity.
      • Large artery stiffness was worst for normal weight children who became obese as adults.
      • Intima-media thickness was influenced by obesity in both childhood and adulthood.



      LAS (large artery stiffness), IMT (intima-media thickness), CD (carotid distensibility), SI (stiffness index), YEM (Young's elastic modulus)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Berenson G.S.
        • Srinivasan S.R.
        • Bao W.
        • Newman 3rd, W.P.
        • Tracy R.E.
        • Wattigney W.A.
        Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study.
        N Engl J Med. 1998 Jun 4; 338: 1650-1656
        • Celermajer D.S.
        • Ayer J.G.
        Childhood risk factors for adult cardiovascular disease and primary prevention in childhood.
        Heart. 2006 Nov; 92: 1701-1706
        • Iannuzzi A.
        • Licenziati M.R.
        • Acampora C.
        • et al.
        Increased carotid intima-media thickness and stiffness in obese children.
        Diabetes Care. 2004 Oct; 27: 2506-2508
        • Woo K.S.
        • Chook P.
        • Yu C.W.
        • et al.
        Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening.
        Int J Obes Relat Metab Disord. 2004 Jul; 28: 852-857
        • Hirai T.
        • Sasayama S.
        • Kawasaki T.
        • Yagi S.
        Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis.
        Circulation. 1989 Jul; 80: 78-86
        • Salomaa V.
        • Riley W.
        • Kark J.D.
        • Nardo C.
        • Folsom A.R.
        Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC Study. Atherosclerosis Risk in Communities Study.
        Circulation. 1995 Mar 1; 91: 1432-1443
        • Lorenz M.W.
        • Markus H.S.
        • Bots M.L.
        • Rosvall M.
        • Sitzer M.
        Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis.
        Circulation. 2007 Jan 30; 115: 459-467
        • Wright C.M.
        • Parker L.
        • Lamont D.
        • Craft A.W.
        Implications of childhood obesity for adult health: findings from thousand families cohort study.
        BMJ. 2001 Dec 1; 323: 1280-1284
        • Oren A.
        • Vos L.E.
        • Uiterwaal C.S.
        • Gorissen W.H.
        • Grobbee D.E.
        • Bots M.L.
        Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: the Atherosclerosis Risk in Young Adults study.
        Int J Obes Relat Metab Disord. 2003 Nov; 27: 1383-1390
        • Raitakari O.T.
        • Juonala M.
        • Kahonen M.
        • et al.
        Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study.
        JAMA. 2003 Nov 5; 290: 2277-2283
        • Freedman D.S.
        • Dietz W.H.
        • Tang R.
        • et al.
        The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study.
        Int J Obes Relat Metab Disord. 2004 Jan; 28: 159-166
        • Juonala M.
        • Raitakari M.
        • Viikari S.A.
        • Raitakari O.T.
        Obesity in youth is not an independent predictor of carotid IMT in adulthood. The Cardiovascular Risk in Young Finns Study.
        Atherosclerosis. 2006 Apr; 185: 388-393
        • Freedman D.S.
        • Patel D.A.
        • Srinivasan S.R.
        • et al.
        The contribution of childhood obesity to adult carotid intima-media thickness: The Bogalusa Heart Study.
        Int J Obes (Lond). 2008 May; 32: 749-756
        • Juonala M.
        • Jarvisalo M.J.
        • Maki-Torkko N.
        • Kahonen M.
        • Viikari J.S.
        • Raitakari O.T.
        Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular Risk in Young Finns Study.
        Circulation. 2005 Sep 6; 112: 1486-1493
        • Savva S.C.
        • Tornaritis M.
        • Savva M.E.
        • et al.
        Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index.
        Int J Obes Relat Metab Disord. 2000 Nov; 24: 1453-1458
        • Schmidt M.D.
        • Dwyer T.
        • Magnussen C.G.
        • Venn A.J.
        Predictive associations between alternative measures of childhood adiposity and adult cardio-metabolic health.
        Int J Obes (Lond). 2011 Jan; 35: 38-45
        • Dwyer T.
        • Gibbons L.E.
        The Australian Schools Health and Fitness Survey. Physical fitness related to blood pressure but not lipoproteins.
        Circulation. 1994 Apr; 89: 1539-1544
        • Magnussen C.G.
        • Fryer J.
        • Venn A.
        • Laakkonen M.
        • Raitakari O.T.
        Evaluating the use of a portable ultrasound machine to quantify intima-media thickness and flow-mediated dilation: agreement between measurements from two ultrasound machines.
        Ultrasound Med Biol. 2006 Sep; 32: 1323-1329
        • Hosmer D.
        • Blizzard L.
        Estimating effects for non-linearly scaled covariates in regression models Part I – linear link function models.
        Australasian Epidemiologist. 2004; 11: 40-47
        • Cole T.J.
        • Bellizzi M.C.
        • Flegal K.M.
        • Dietz W.H.
        Establishing a standard definition for child overweight and obesity worldwide: international survey.
        BMJ. 2000 May 6; 320: 1240-1243
        • Cole T.J.
        Modeling postnatal exposures and their interactions with birth size.
        J Nutr. 2004 Jan; 134: 201-204
        • De Stavola B.L.
        • Nitsch D.
        • dos Santos Silva I.
        • et al.
        Statistical issues in life course epidemiology.
        Am J Epidemiol. 2006 Jan 1; 163: 84-96
        • Juonala M.
        • Magnussen C.G.
        • Berenson G.S.
        • et al.
        Childhood adiposity, adult adiposity, and cardiovascular risk factors.
        N Engl J Med. 2011 Nov 17; 365: 1876-1885
        • Daniels S.R.
        • Obarzanek E.
        • Barton B.A.
        • Kimm S.Y.
        • Similo S.L.
        • Morrison J.A.
        Sexual maturation and racial differences in blood pressure in girls: the National Heart, Lung, and Blood Institute Growth and Health Study.
        J Pediatr. 1996 Aug; 129: 208-213
        • Miettinen O.
        Theoretical epidemiology. Principles of occurrence research in medicine.
        Wiley, New York1985
        • Magarey A.M.
        • Daniels L.A.
        • Boulton T.J.
        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 Jun 4; 174: 561-564
        • Den Ruijter H.M.
        • Peters S.A.
        • Anderson T.J.
        • et al.
        Common carotid intima-media thickness measurements in cardiovascular risk prediction: a meta-analysis.
        JAMA. 2012 Aug 22; 308: 796-803
        • Laurent S.
        • Cockcroft J.
        • Van Bortel L.
        • et al.
        Expert consensus document on arterial stiffness: methodological issues and clinical applications.
        Eur Heart J. 2006 Nov; 27: 2588-2605
        • Sarkola T.
        • Slorach C.
        • Hui W.
        • Bradley T.J.
        • Redington A.N.
        • Jaeggi E.
        Transcutaneous very-high resolution ultrasound for the quantification of carotid arterial intima-media thickness in children – feasibility and comparison with conventional high resolution vascular ultrasound imaging.
        Atherosclerosis. 2012 Sep; 224: 102-107