Childhood Obesity, Glucose Intolerance, and Hypertension Increase Risk for Premature Adult Mortality

Whether childhood obesity, hypertension, glucose intolerance, and hypercholesterolemia are associated with premature adult mortality has not been clearly documented. Researchers examined whether these risk factors predicted premature death in a prospective longitudinal cohort of 4857 American Indian children from Arizona who were born between 1945 and 1984. At baseline, the children were aged 5–19 years (mean, 11 years) and did not have diabetes.

During an average follow-up of 24 years, 559 participants died before age 55. Of these, 166 deaths were considered endogenous (due to disease or self-inflicted injury), including 59 deaths attributed to alcoholic liver disease, 22 to cardiovascular disease, 21 to infections, 12 to cancer, and 10 to diabetes. Body-mass index (BMI) was positively associated with premature endogenous death but not with death from exogenous causes (e.g., accidents or homicide). Children in the highest BMI quartile had more than double the endogenous death rate as children in the lowest BMI quartile, and children in the highest quartile of glucose intolerance had significantly higher risk for endogenous death (incidence rate ratio, 1.73) than those in the lowest quartile. Childhood hypertension was also significantly associated with premature endogenous death (IRR, 1.57). Neither childhood blood pressure nor cholesterol levels were associated with premature adult death.