Determinants of overweight and obesity and other cardiometabolic risks in adolescents: a Spanish longitudinal birth study.

BACKGROUND

To assess the prenatal, early postnatal and adolescent factors associated with overweight/obesity (OwO) and other cardiometabolic risk factors at age 15.

METHODS

Longitudinal study based on 241 participants from the INMA-Valencia cohort. Z-scores of body mass index (zBMI), waist circumference (zWC), and waist-to-height ratio (WHtR), systolic and diastolic BP (zSBP and zDBP) were evaluated at ages 4, 7, 9, 11 and 15. A cardiometabolic risk score was calculated. Covariates were collected at pregnancy, birth, and age 15.

RESULTS

At age 4, 30.7% presented overweight/obesity (zBMI > 1 SD), increasing to 46.1% at age 9, and decreasing to 29.3% at age 15 (29.3%). The proportion of high/excess central adiposity was lower than overweight/obesity at all ages. Adjusted models showed that pre-pregnancy obesity was positively associated with all cardiometabolic outcomes, except zSBP (i.e. β [95% CI]: 0.77 [0.25, 1.29] for zBMI, and 2.31 [0.94, 3.69] for CMR score). Smoking during pregnancy was directly related to zSBP and zBMI. Adolescent physical activity was inversely associated with WHtR, zFM, zWC, zDBP and cardiometabolic risk scores (β -0.65 [95% CI -0.95, -0.36]). Cereal intake and processed meat consumption were positively related to WHtR, zBMI and zWC.

CONCLUSION

Early modifiable factors impact adolescent cardiometabolic health. This information could improve preventive interventions and policies from very early.

IMPACT: This longitudinal study shows how sociodemographic, clinical, and lifestyle factors influence adolescents' cardiometabolic health from very early stages of life until adolescence. Maternal characteristics, such as pre-gestational obesity or tobacco consumption during pregnancy, were directly associated with cardiometabolic risk factors in adolescence, such as BMI, percentage of fat mass, and diastolic blood pressure. Adolescents' intake of cereals, and processed meats, and consumption of less than five dairy meals, were positively related to an increase in cardiometabolic risk factors. Findings from this longitudinal study provide valuable insights for designing early-life interventions in prevention, health promotion, and adolescent health management.