Men and women who had been overweight in adolescence are more likely to die from coronary heart disease and other serious health problems even if they become leaner as adults, according to a report in the Nov. 5 issue of the New England Journal of Medicine.
In what is thought to be the longest longitudinal study of its kind, researchers at Tufts University’s Human Nutrition Research Center on Aging tracked overweight and lean adults over a 70-year period in western Massachusetts and southern New Hampshire.
They selected 508 subjects who had participated in the Harvard Growth Study of 1925 to 1933, which assessed the mental and physical development of Boston-area schoolchildren, and compared the health of those who had been overweight and those who had been lean as adolescents.
The overweight group was defined as those with a body mass greater than that of 75 percent of the students of the same age and grade level, or about 15 to 20 pounds heavier than the average.
Researchers have found that obesity increases the long-term risk of developing heart disease, hypertension, gout, arthritis, and certain cancers.
But the new study suggests that adolescent weight problems can have an even greater effect on an individual’s health because of the physiological changes associated with adolescence that may create a predisposition for health problems in the future.
“When boys deposit fat in their gut, it elevates the risk of heart disease,’' said Aviva Must, a nutritional epidemiologist at Tufts University and the study’s primary author.
Ninety-six of the 256 men in the study had died by 1988. Boys who were overweight between the ages of 13 and 18 years were 80 percent more likely to die earlier from heart disease than their average-weight counterparts.
The men who had been overweight teenagers had a nearly three times greater chance of developing coronary heart disease and had a six times greater chance of contracting cancer of the colon or rectum.
Though 68 of the 252 women in the Harvard study had died by 1988, the formerly overweight teenagers, unlike the men, showed no greater risk of dying earlier than their leaner counterparts.
However, the formerly overweight women did have an increased likelihood of developing heart problems and arthritis.
Women who were overweight during their teens also were eight times more likely to report difficulty with daily living and performing such routine acts as climbing stairs, lifting objects, and walking, according to the report.
What Is ‘Fat’?
Some observers voiced concern that the study might encourage greater numbers of teenagers to be categorized as fat even if they do not meet current medical standards for being overweight. In addition, some said that if the study’s authors had used stricter criteria for defining overweight teenagers, they might have found effects among women as well.
The study used the top 25 percent of the weight group, not 15 percent, which is the traditional measurement for determining who is overweight.
“Though the study demonstrates that adolescent overweight has some adverse affects later in life, one must be careful in making public-health recommendations to adolescents on the basis of their weight,’' warned Dr. George A. Bray of the Pennington Biomedical Research Center in Baton Rouge, La.,in an editorial published in the same issue of the journal.
Ms. Must acknowledged that the “criteria are somewhat arbitrary, but the idea is to get as close to one’s ideal body weight as you can.’' Some moderately overweight people may be at risk for becoming obese, she added.
Some observers have expressed concern that the study might precipitate a diet frenzy. A “yo-yo’’ pattern of weight gain and loss is unhealthy, the study’s authors warn. Rather, a person should develop a consistent exercise regimen to achieve and maintain an ideal weight.
“The emphasis is on making changes that can be permanent, and efforts at prevention are the best alternative,’' Ms. Must said.
