Prospective investigation of long-term associations between childhood overweight, health-related determinants and health in young adults

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Overweight can occur at all stages of life or remain permanently. The time of incidence of overweight and nutrition-related diseases differs between subjects. However, the importance of early versus late manifestation of overweight is unclear. Until now, the long-term effect of childhood overweight on health of young adults has not been systematically analyzed. In addition, the associations between determinants of childhood overweight and disease risks in adulthood have not been investigated. To address these questions a life course approach is required. The aim of this application is to investigate the impact of childhood overweight and its determinants on the manifestation of health-related risks in young adults. A cohort of 1332 young adults aged between 20 and 25 years who were participants of the Kiel Obesity Prevention Study (KOPS) will be re-investigated. Within KOPS the subjects were already measured at 5 or 6 time points (at birth, at ages 1, 2, 6, 10, and 14 years) regarding body composition (height, weight, fat mass, waist circumference) and familiar, social, pre- and postnatal determinants as well as lifestyle factors. Outcome parameters of the proposed re-investigation include overweight (prevalence, incidence and persistence), BMI, fat mass, metabolic disorders, inflammation, and nutrition-related diseases. Disease risks cover (i) functional disorders like elevated level of triglycerides and insulin as well as HOMA index, (ii) established diseases like hypertension and elevated levels of CRP and (ii) structural disorders like liver fat. Within a nested case-control study liver fat will be analyzed in 200 overweight subjects with magnetic resonance imaging (MRI). Subjects will be stratified by persistent (e.g. since childhood) and incident (e.g. normal weight during childhood and overweight as adults) overweight. Persistent normal weight subjects will serve as controls expecting no metabolic disorders. All 1332 participants will fill out a questionnaire to lifestyle (nutrition, physical activity, media consumption), environmental, social and familiar variables. The determinants (previously collected within KOPS as well as new collected) will be stratified by so called critical time periods. The critical time periods include (i) the first two years of life, (ii) age 5 to 8 years, (iii) puberty (e.g. age 13 to 16 years) and (iv) age 18 to 22 years. The impact of different determinants and their interactions from birth until age 25 years will be estimated using latent class growth models as well as additive quantile mixed models with boosting algorithm.