The effect of childhood body weight status on cardiovascular disease risk in adulthood: A narrative review.

The prevalence of obesity among children and adolescents is rising alarmingly worldwide; however, its long-term effect on adult cardiovascular health is still underestimated. A considerable body of evidence suggests a detrimental effect of childhood obesity on the risk of cardiovascular disease (CVD) in adulthood. This is mostly indicated by an increased prevalence of arterial hypertension and type 2 diabetes mellitus. Longitudinal cohort studies have shown that persistent obesity from childhood to adulthood markedly amplifies these risks, whereas normalization of body mass index (BMI) during puberty can mitigate these adverse outcomes. Childhood obesity is also linked to subclinical atherosclerosis, as indicated by increased carotid intima-media thickness, and to increased left ventricular mass; however, its independent effect on overt CVD - that is, coronary heart disease (CHD), stroke, heart failure - remains less clear and is often confounded by adult BMI. In any case, it is evident that sustained high BMI from childhood to adulthood increases CVD morbidity and mortality. On the other hand, childhood underweight and undernutrition may have the same adverse long-term impact on CVD risk factors in adulthood as seen with childhood obesity. Moreover, early-life undernutrition combined with adult obesity further elevates these risks, especially for CHD. Taken together, these findings highlight the critical role of weight status during early development and necessitate early intervention strategies from childhood in order to reduce long-term CVD risk.