TOPLINE:

Individuals who had overweight during childhood had an increased risk for coronary heart disease (CHD) during adulthood, but early weight normalisation before young adulthood could reverse this risk. Those who developed overweight during puberty carried an even higher long-term risk for CHD during adulthood than those who had persistent overweight from childhood.

METHODOLOGY:

• Researchers conducted a population-based cohort study in Gothenburg, Sweden, to assess whether the remission of childhood overweight before young adulthood reduces the risk for CHD during adulthood.
• They included 103,232 individuals (mean childhood BMI, 15.6; 44.5% women) born between 1945 and 1968 and followed them from the age of 22 years for a mean follow-up duration of 37.8 years until December 2021.
• Childhood overweight and obesity were assessed using cutoffs defined by the International Obesity Task Force; however, in young adulthood, overweight was defined as BMI of 25 or greater to less than 30, and obesity was defined as BMI of 30 or greater.
• The primary outcome was the first CHD event (both fatal and non-fatal).

TAKEAWAY:

• Both childhood overweight (hazard ratio [HR], 1.15; 95% CI, 1.02-1.28) and young adult overweight (HR, 1.71; 95% CI, 1.56-1.86) were associated with an increased risk for CHD during adulthood, with young adult overweight conferring a substantially higher risk than childhood overweight.
• Individuals who normalised their weight before young adulthood had a similar risk for CHD during adulthood as those who maintained a normal weight (HR, 0.98; 95% CI, 0.84-1.14).
• Individuals who had pubertal onset overweight and persistent overweight had 83% and 53% higher risks for CHD during adulthood, respectively, than those who maintained a normal weight.
• Moreover, individuals with pubertal onset overweight had a 23% higher risk for CHD during adulthood than those with persistent overweight (P = .03).

IN PRACTICE:

"Public health efforts aiming to prevent CHD in adults should include preventive measures in early life, as well as early treatment of childhood and pubertal overweight," the authors wrote.

SOURCE:

This study was led by Claes Ohlsson, PhD, Centre for Bone and Arthritis Research, University of Gothenburg, Gothenburg, Sweden. It was published online on December 01, 2025, in JAMA Pediatrics.

LIMITATIONS:

The cohort was predominantly White, potentially limiting generalisability. Adjustments for confounding factors were eliminated. Severe obesity was rare in this cohort; hence, the ability to estimate risks for this group was limited.

DISCLOSURES:

This study was supported by grants from the Swedish Research Council, the Heart-Lung Foundation, the Swedish state under the ALF-agreement, and others. Two authors reported receiving grants from the Swedish Research Council and other sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.