Risk for obesity in adolescence starts in early childhood

S. Shankaran, C. Bann, A. Das, B. Lester, H. Bada, C. R. Bauer, L. La Gasse, R. D. Higgins

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective:The objective of this study was to assess the predictive value of body mass index (BMI) at earlier ages on risk of overweight/obesity at age of 11 years.Study Design:This is a longitudinal study of 907 children from birth to age of 11 years. Predictors include BMI at earlier ages and outcome is overweight/obesity status at age of 11 years. Analyses were adjusted for covariates known to affect BMI.Result:At 11 years, 17% were overweight and 25% were obese. Children whose BMI was measured as85th percentile once at preschool age had a twofold risk for overweight/obesity at 11 years of age. Risk increased by 11-fold if a child's BMI measured was noted more than once during this age. During early elementary years, if a child's BMI was85th percentile once, risk for overweight/obesity at 11 years was fivefold and increased by 72-fold if noted more than two times. During late elementary years, if a child's BMI was85th percentile once, risk for overweight/obesity was 26-fold and increased by 351-fold if noted more than two times. Risk of overweight/obesity at 11 years was noted with higher maternal prepregnancy weight, higher birth weight, female gender and increased television viewing.Conclusion:Children in higher BMI categories at young ages have a higher risk of overweight/obesity at 11 years of age. Effect size was greater for measurements taken closer to 11 years of age. Pediatricians need to identify children at-risk for adolescent obesity and initiate counseling and intervention at earlier ages.

Original languageEnglish
Pages (from-to)711-716
Number of pages6
JournalJournal of Perinatology
Issue number11
StatePublished - Nov 2011

Bibliographical note

Funding Information:
The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Institute on Drug Abuse (NIDA), the Administration on Children, Youth, and Families and the Center for Substance Abuse and Treatment provided grant support for recruiting subjects into the Maternal Lifestyle Study from 1993 to 1995. NIDA and NICHD provided funding to conduct follow-up examinations in three phases: at 1, 4, 8, 10, 12, 18, 24 and 36 months corrected age (Phase I); at 3½, 4, 4½, 5, 5½, 6, and 7 years of age (Phase II); and at 8, 9, 10 and 11 years of age (Phase III). The funding agencies provided overall oversight of study conduct, but all data analyses and interpretation were completed independent of the funding agencies. We are indebted to our medical and nursing colleagues, the infants and their parents who agreed to take part in this study. Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, Dr Abhik Das (DCC Principal Investigator) and Dr Sylvia Tan (DCC Statistician) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. The following investigators, in addition to those listed as authors, participated in this study: Steering Committee Chair: Barry M Lester, PhD, Brown University. Brown University Warren Alpert Medical School Women & Infants Hospital of Rhode Island (U10 HD27904, N01 HD23159): Barry M Lester, PhD, Cynthia Miller-Loncar, PhD; Linda L. LaGasse, PhD; Jean Twomey, PhD. Eunice Kennedy Shriver National Institute of Child Health and Human Development: Rosemary D Higgins, MD. National Institute on Drug Abuse: Vincent L Smeriglio, PhD; Nicolette Borek, PhD. RTI International (U10 HD36790): W Kenneth Poole, PhD; Abhik Das, PhD; Jane Hammond, PhD; Debra Fleischmann, BS. University of Miami Holtz Children’s Hospital (GCRC M01 RR16587, U10 HD21397): Charles R Bauer, MD; Ann L Graziotti, MSN, ARNP; Rafael Guzman, MSW; Carmel Azemar, MSW. University of Tennessee (U10 HD42638): Henrietta S Bada, MD; Toni Whitaker, MD; Charlotte Bursi, MSSW; Pamela Lenoue, RN Wayne State University Hutzel Women’s Hospital and Children’s Hospital of Michigan (U10 HD21385)FSeetha Shankaran, MD; Eunice Woldt, RN MSN; Jay Ann Nelson, BSN. Supported by the Eunice Kennedy Shriver. The National Institute of Child Health and Human Development. Grant Numbers: U10HD21385 (S Shankaran) 10HD36790( C Bann) U10HD27904 (B Lester), U10HD42638 (H Bada) and U10HD21397 (CR Bauer).


  • early elementary
  • late elementary
  • obesity
  • overweight
  • preschool

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this