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 > or = 30) and overweight (BMI > or = 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.