Long-term burden of body mass index since childhood and impaired physical performance in midlife.

Abstract

Background: The impact of long-term burden of body mass index (BMI) since childhood on physical performance in midlife remains unclear. We aimed to investigate the association between cumulative exposure to BMI since childhood and midlife physical performance by using data from the Bogalusa Heart Study (BHS).

Methods: This longitudinal study consisted of 749 participants (aged 37.6 to 56.7 years at follow-up) who had been examined at least four times during childhood, with 39.3 years of follow-up.

Results: BMI in childhood, adulthood, as a cumulative burden of BMI in childhood, or as a cumulative burden from childhood to adulthood were inversely associated with midlife Short Physical Performance Battery (SPPB) scores, 4-m gait speed, and 6-min walking distance. Individuals with higher BMI as adults but not as children did not have lower SPPB scores (OR,1.67; 95% CI, 0.85-3.27), while individuals with consistently high BMI from childhood to adulthood (2.13 1.18-3.82) and individuals with high childhood BMI (2.12 [1.10-4.10]) but low adult BMI had significantly increased risk compared with individuals with low child and low adult BMI.

Conclusion: Cumulative burden of BMI from childhood to midlife associated with worse midlife physical performance. Maintaining a healthy body weight throughout life may play a role in preventing or delaying the onset of functional decline.

Impact: We examined the impact of long-term burden of body mass index (BMI) since childhood on subsequent physical performance in midlife. We found that ①BMI in childhood and cumulative burden of BMI since childhood were associated with poor physical function in midlife; ② Individuals with high childhood BMI but low adult BMI have poor midlife physical performance; ③ Subjects with both high childhood and adulthood BMI have worse midlife physical performance. Our findings have important implications for active monitoring BMI from childhood and turning the focus of functional decline prevention to primary and primordial prevention.