The association between childhood body size, adulthood lifestyle, and risk of 50 health conditions

Abstract

Background: The long-term health consequences of childhood body size and whether it can be mitigated by a healthy adult lifestyle remains unclear. This study aims to explore the associations between childhood body size and the risk of mortality and major non-communicable diseases (NCDs), and the role of a lifestyle in adulthood in these associations. Methods: This study included 358,990 UK Biobank participants (mean age 56.3 years, 53.2% female). Childhood body size at age 10 was self-reported as thinner, average, or plumper. Adult lifestyle factors included physical activity, diet, sleep duration, smoking, and alcohol consumption. Outcomes included risk of mortality and 47 NCDs. Cox regression models were used to estimate associations between childhood body size and outcomes. Mediation and interaction analyses assessed the role of adult lifestyle in these associations. Results: Here we show that, individuals with plumper body size have a higher risk of mortality and 26 NCDs, compared to those with average childhood body size, where 1.07% to 28.54% of these risks are mediated by adult lifestyle. Thinner body size is associated with increased risk of 24 NCDs, with 2.12% to 32.59% of the risks mediated by adult lifestyle. Significant interactions are observed between plumper childhood body size and adult lifestyle for all-cause mortality and 6 NCDs, including hypertension, alcohol problems, constipation, diverticular disease, chronic obstructive pulmonary disease, and chronic kidney disease. Conclusions: Both plumper and thinner body sizes during childhood are associated with an increased risk of developing NCDs later in life. However, adherence to a healthier lifestyle in adulthood may partially mitigate these long-term health risks, especially for individuals with larger childhood body size.