Childhood Body Size May Affect Cardiovascular Disease Outcomes in Adulthood

An overweight young man.
Large boy with overweight checking out his weight isolated on white background
Larger body size during childhood was found to have direct causal effect on CVD outcomes in adulthood.

Larger body size during childhood was found, in a mendelian randomization analysis, to have direct causal effect on cardiovascular disease (CVD) outcomes during adulthood. These findings were published in the Journal of the American Heart Association.

Data for this study were sourced from the UKBiobank (n=453,169), CARDIOGRAMplusC4D (n=185,000), MEGASTROKE (n=521,612), and FinnGen (n=521,612) projects. Genetic predictions of childhood body size, childhood weight, adult BMI, and CVD outcomes were related using a 2-sample Mendelian randomization analysis to assess the effect of childhood and adult body sizes on 12 CVD outcomes.

Most of the CVD outcomes (n=8) were significantly related with genetically predicted childhood body size. Higher childhood body size specifically increased risk for hypertension (odds ratio [OR], 1.77; P =6.30´10-15), coronary artery disease (OR, 1.53; P =1.61´10-12), myocardial infarction (OR, 1.51; P =8.85´10-11), heart failure (OR, 1.72; P =5.5´10-10), peripheral artery disease (OR, 1.89; P =4.69´10-7), atrial fibrillation and flutter (OR, 1.69; P =2.00´10-7), varicose veins (OR, 1.57; P=6.7´10-6), and atherosclerosis (OR, 1.76; P =1.25´10-5).

After accounting for adult body size, estimates for all 8 associated CVD outcomes were no longer significant. However, adult body size substantially and directly increased risk for all 8 CVD outcomes.

In addition, the 4 CVD outcomes which did not reach significance in the genetically predicted childhood body size analysis, the analysis of adult body size were significantly affected; these specific events included stroke (OR, 1.56; P =1.36´1010), angina pectoris (OR, 1.67; P =1.28´106), pulmonary heart disease (OR, 1.77; P =2.96´104), and pulmonary embolism (OR, 1.61; P =.005).

This study may have included some recall bias as participants self-reported whether they were thinner, average, or larger than their counterparts at the age of 10 years.

“The effect of genetically predicted childhood body size on the cardiovascular disease outcomes analyzed in this study are a result of larger body size persisting into adulthood,” the study authors concluded.  Additional study is needed to assess the optimum intervention point such that the effect of childhood obesity on CVD may be mitigated.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Power GM, Tyrrell J, Frayling TM, Smith GD, Richardson TG. Mendelian Randomization Analyses Suggest Childhood Body Size Indirectly Influences End Points From Across the Cardiovascular Disease Spectrum Through Adult Body Size. J Am Heart Assoc. 2021;10(17):e021503. doi:10.1161/JAHA.121.021503