The study found that teenagers at the upper end of the "normal" BMI range later experienced higher death rates from lesser-known cardiovascular diseases.
Being obese as a teenager has long been associated with coronary heart disease (CHD) and stroke in later years. But a 45-year study from Israel published by the Endocrine Society finds that even teenagers with a body mass index (BMI) in the normal range in late adolescence may be related to a higher risk of death in middle adulthood from lesser known cardiovascular ailments.
These include fatal arrhythmia, hypertensive heart disease, cardiomyopathy, arterial disease, heart failure, and pulmonary embolism.
The study specifically examined the relationship between BMI in adolescence at cardiovascular diseases other than coronary heart disease or stroke, which are frequently studied. While cardiovascular disease remains the leading cause of death in the United States, an avalanche of medications have been developed to treat high blood pressure and cholesterol, so death rates from heart disease and stroke are falling.
Israeli researchers studied health records from 2.3 million Israelis who were 16-19 in 1967, and followed them until 2011. Between 1981 and 2011, 32,137 were recorded, of which 800 were found to be non-coronary, non-stroke cardiovascular deaths, while 3178 deaths overall were attributed to cardiovascular mortality.
Being overweight or obese in adolescence was closely associated with increases risk for all study outcomes, the researchers found. But the study also showed that the “normal” range of the BMI is quite broad, and those at the upper end of this range in their teen years had increased risk compared with teens at the lower end. This means that an optimal BMI for a 17-year-old is lower than that for an older adult, according to Gilad Twig, MD, PhD, of the Medical Corps of the Israeli Defense Forces, one of the groups that took part in the study.
“Our findings show that adolescents with BMI values well within the currently accepted normal range may still be at future risk of cardiovascular diseases,” Twig said in a statement. “This is important, because while CHD and stroke mortality of adults younger than 50 have declined in most western countries in the last 2 decades, non-CHD and non-stroke mortality has increased.”
Other groups taking part in the study included Sheba Medical Center, Tel Aviv Medical Center, and Hebrew University-Hadassah School of Public Health.
Twig G, Shor DB, Furer A, et al. Adolescent body mass index and cardiovascular disease-specific mortality by midlife [published online June 9, 2017]. J Clin Endocrinol Metab DOI: https://doi.org/10.1210/jc.2017-00329