Change in the BMI status from childhood to young adulthood was used to group the participants into the following categories: normal weight to normal weight (NW-NW); normal weight to overweight (NW-OW); overweight to normal weight (OW-NW); and overweight to overweight (OW-OW). From baseline to follow-up, the percentage of participants who were overweight increased from 24.7 to 57.7%. A total of 35.2% of the children shifted from normal weight in childhood to overweight in young adulthood. A total of 61.9% of the participants in the highest BMI quartile in childhood remained in the highest BMI quartile in young adulthood. The percentage tracking (NW-NW and OW-OW) was 72.8% in EA women, 59.6% in AA men, 59.5% in AA women and 48.8% in EA men.

In addition, 62.0% (against 25% expected) of children in the top BMI quartile remained in the top BMI quartile in adulthood, indicating strong BMI tracking, even after an average period of 24.2 years. Of the 46 children, 24 (52.2%) became nonoverweight/obese as adults, 9 (37.5%) of whom were metabolically healthy, and 16 (34.8%) became metabolically abnormal, overweight/obese. Although only 6 (13%) retained MHO status in adulthood, MHO children were 2.7–9.3 times more likely to retain the MHO status as adults compared with children in other categories.

The risk for overweight adolescents to remain overweight as young adults ranged from 52% in black males to 62% in black females. Overweight adolescents were at increased risk of being overweight as adults compared with their normal-weight peers, but a substantial proportion of overweight adolescents were not overweight as young adults.

Twenty-four percent of young adults were overweight and 18% were obese. Eighteen percent of the population was obese and 24% were overweight. A higher percentage of black females was either overweight or obese compared with white females. The prevalence of overweight among the young adults is comparable with the national average.

The prevalence of severe overweight, body mass index ≥31.1 kg/m2 for males and ≥32.3 kg/m2 for females, was much higher for black women (20.1%) than for white women (8.7%), black men (14.0%), or white men (11.7%). The occurrence of morbid levels of cardiovascular disease risk factors varied by race and gender in adults from the Bogalusa Heart Study community.

We used longitudinal data from 11,591 schoolchildren, 3096 of whom were reexamined as adults, to explore the tracking and variability of BMI levels. There was strong tracking of BMI levels. The correlation of adjusted BMI levels was r = 0.88 and 78% of children with severe obesity at one examination had severe obesity at the next examination (mean interval, 2.7 years). Further, an increase in adjusted BMI from +5 kg/m2 (above the median) to +10 increased the risk for adult BMI ≥ 40 by 2.7-fold.

Levels of risk factors and adult BMI (median: 32 kg/m2) among overweight children were midway between those of thinner children and obese children. BMI for age z score, sum of skinfolds, and waist circumference at baseline were associated with adult BMI. Overweight children had higher levels of cardiovascular risk factors and higher adult BMI than thinner children, but lower than obese children.

Adult obesity was defined as a BMI ≥ 30 kg/m2 and adult overfat as a mean subscapular plus triceps skinfold thickness in the upper (gender-specific) quartile. Childhood levels of both BMI and triceps skinfold thickness were associated with adult levels of BMI and adiposity. Mean values of change in BMI were similar in all quintiles of childhood BMI; however, prevalence of adult obesity increased considerably with increasing quintiles. Childhood BMI in the upper quintiles was associated with significantly higher odds of adult obesity.

Levels of risk factors and adult BMI (median: 32 kg/m2) among overweight children were midway between those of thinner children and obese children (BMI for age ≥ 95th percentile). Childhood overweight status was associated with higher adult BMI. Overweight children were more likely than thinner children to become obese adults.

In fact, only ≈3% of the variation in adult CVD risk percentile ranking was explained by childhood CVD risk percentile. This additional loss of 1 ICH sum is clinically meaningful, because it corresponds to an adult going from a BMI of 25 to 30 to >30 kg/m2, or from an SBP in the 120 to 139 range to >140 mm Hg. Childhood cardiovascular risk factors were only weakly associated with adult cardiovascular risk, highlighting the importance of maintaining or adopting healthy behaviors throughout the life course.

Of those with a BMI >99th percentile, 59% had at least two risk factors, 94% had excess adiposity, and 88% had an adult BMI of >35 kg/m2. About 4% of children in the US have a BMI >99th percentile. These severely obese children in the Bogalusa Heart Study cohort were very likely to remain severely obese as adults and to have multiple cardiometabolic risk factors.

The objective of the Bogalusa Heart Study was to examine the natural history of cardiovascular disease and its risk factors among school-age children. The study followed children into adulthood to determine how childhood body mass index (BMI) and other measures of adiposity related to adult cardiovascular risk factor levels and obesity status.

Children in the upper percentiles for specific risk factors, such as blood pressure and body mass index, were more likely to have abnormal levels of these risk factors as adults; risk factors for CVD tended to cluster.[1] Central obesity was associated with abnormal glucose metabolism, an adverse serum lipid profile, and elevations in blood pressure, most pronounced after puberty and into early adulthood.[1] This synopsis of the Bogalusa Heart Study underscores tracking of obesity and cardiometabolic risk from childhood to adulthood but does not provide an overall statistic that 25% of participants reached a healthy weight while 75% remained overweight or obese.[1]

Previously in the Bogalusa Heart Study, subjects were shown that a high waist/height ratio is associated with adverse cardiometabolic risk among normal weight and overweight children. On multivariate analysis the normal weight centrally obese children were 1.66, 2.01, 1.47 and 2.05 times more likely to have significant adverse cardiometabolic risk factors than normal weight non–centrally obese children in European American boys, European American girls, African American boys and African American girls, respectively.

The Bogalusa Heart Study is a long-term epidemiologic study of cardiovascular risk factors from birth through the age of 38 years in a biracial (black/white) community in Bogalusa, Louisiana. These studies have established that the major adult cardiovascular diseases begin in childhood. Autopsy studies show coronary atherosclerotic lesions occur in early life and are strongly associated with obesity and have an inverse relationship with high-density lipoprotein cholesterol.

The Bogalusa Heart Study, which tracked the health of the town's children into adulthood, found for the first time that heart disease begins in childhood. Over 50 years, the study has shown that childhood factors like obesity, diet, and physical activity impact heart disease risk later in life, emphasizing that excess weight in youth often carries forward into adult cardiovascular risk.

In 1997, the study was renewed and extended through 2002, and from 2002-2010, and again in 2012 in order to study the impact of genetic factors on the evolution from childhood cardiovascular risk factors to subclinical and clinical morbidity in an adult population, ages 20 to 43, who had been followed over a long period of time. The Bogalusa Heart Study is a long-term epidemiologic study of cardiovascular disease risk factors in children and young adults.

The Bogalusa Heart Study has followed participants from childhood to adulthood since 1973. Adiposity was measured via body mass index (BMI) at multiple time points across the lifespan. The mean BMI percentile for childhood/adolescence was within the healthy weight range, whereas average BMI in young adulthood and midlife were in the overweight and class 1 obesity ranges. In this community-based cohort, greater adiposity during early adulthood and middle age was associated with better cognition in midlife in certain subgroups.

The Bogalusa Heart Study, which meticulously followed the health of local children into their adult years, was the first to reveal that heart disease can start in childhood.[7] The Bogalusa Heart Study has shown that childhood factors like obesity, diet, and physical activity impact heart disease risk later in life.[7] The public-facing "Impact" page emphasizes that childhood obesity affects adult cardiovascular risk but does not quantify adult weight outcomes with percentages such as 25% healthy weight vs 75% overweight/obese.[7]

A BMI between 18.5 and 25 kg/m² indicates a normal weight. A BMI of less than 18.5 kg/m² is considered underweight. A BMI between 25 kg/m² and 29.9 kg/m² is considered overweight. A BMI of 30 kg/m² or higher is considered obese. These cut points are commonly used in adult studies of body mass index, including longitudinal studies such as the Bogalusa Heart Study, to define normal weight versus overweight or obese status.

The Bogalusa Heart Study, a long-term population study with a continued relationship with a community, addresses the problem of capacity building in minority communities while generating extensive data on cardiovascular risk factors.[9] The article notes secular trends of increasing adiposity and tracking of obesity from childhood to adulthood but does not present an aggregate statistic stating that a fixed proportion such as 75% of participants remained overweight or obese as adults.[9] Discussion focuses on community-based longitudinal design and general patterns of obesity rather than a specific 25%/75% split.[9]

Being overweight was considered an effective screening tool for cardiovascular risk with over 50% of overweight participants having at least 1 risk factor.[3] Eleven percent of the 9167 children included in the study were overweight.[3] This 2 Minute Medicine summary of a classic Bogalusa Heart Study paper describes childhood overweight and its associated cardiovascular risk factors but does not report adult weight outcomes or any figure like "75% remained overweight or obese" among all participants.[3]

Across multiple analyses from the Bogalusa Heart Study, childhood BMI shows strong tracking into adulthood. For example, roughly 60–62% of children in the highest BMI quartile remain in the highest quartile as adults, and a majority of children with severe obesity retain severe obesity. While some overweight or obese children return to a nonoverweight adult BMI, the proportion is well below 50%; in specific phenotypic subgroups, about half became nonoverweight adults.

The Bogalusa Heart Study taught us, if your childhood weight was high, if you did not exercise and eat fruits and vegetables, and if your parents smoked, you were at risk for heart disease as an adult.[8] With more than 1,000 published scientific studies, the study showed doctors worldwide that lifestyle from the time you are in the womb, and as a child, contributes to the heart disease as an adult.[8] This local news piece highlights the importance of childhood weight in predicting adult health, but it does not provide numeric estimates of what proportion of Bogalusa participants reach a healthy weight or remain overweight/obese in adulthood.[8]