A longitudinal study of pediatric body mass index values predicted health in middle age

Background and objective: To characterize the use of pediatric body mass index (BMI) to predict obesity, overweight, and diseases in middle age. Methods: A longitudinal study of people born in a week in 1958 (n = 12,327). The main outcome measures are obesity (BMI greater than or equal to 30) and overweight (BMI greater than or equal to 25) at age 33 and disease history self-reported at age 42. Receiver operating characteristic (ROC) analysis was performed using BMI measured at ages 7, 11, and 16 years as predictors. Results: BMI values measured at age 11 could predict obesity at age 33 with areas under ROC curve (AUC) of 0.78 for males and 0.80 for females (each P <.001). BMI values at age 11 predicted overweight with slightly smaller AUC (each P <.001). They could also predict history of diabetes and hypertension (AUC = 0.60 and 0.56, respectively, each P <.01), both sexes pooled. Prediction based on BMI at age 7 was less satisfactory; that at 16 gave limited improvement. Cutoff points based on ROC curves. the international reference. and the 85th and 95th percentiles gave very different profiles of diagnostic features. Conclusion: Pediatric BMI may predict adult obesity and overweight with a reasonable profile of sensitivity and specificity. (C) 2004 Elsevier Inc. All rights reserved.