The research, led by Claes Ohlsson and colleagues from the Sahlgrenska Academy at the University of Gothenburg, examined data from more than 103,000 Swedish men and women to understand how changes in weight status from childhood to young adulthood impact long-term cardiovascular outcomes.
Childhood overweight has long been recognized as a predictor of adult cardiovascular disease. However, whether this risk can be mitigated if excess weight normalizes before adulthood has remained unclear. The present analysis, part of the BMI Epidemiology Study (BEST), provides important insight into this question.
The cohort included individuals born between 1945 and 1968 in Gothenburg. Childhood body measurements were recorded in school health records at ages 7 for girls and 8 for boys. Young adult weight and height were captured at ages 18 and 20, respectively. These data were linked with national health registers to track CHD events—both fatal and nonfatal—later in adult life. Analyses were performed between 2024 and 2025.
The study led to the following notable findings:
- Both childhood overweight and overweight during young adulthood were linked to an increased risk of developing coronary heart disease later in life.
- The pattern of risk was similar for both men and women, with no notable sex-based differences.
- Individuals who were overweight in childhood but reached a normal weight by young adulthood had CHD risk levels similar to those who maintained a normal weight throughout, with an HR of 0.98.
- These findings suggest that reversing childhood overweight before adulthood may eliminate the elevated cardiometabolic risk associated with early excess weight.
- Those who became overweight during puberty—after having a normal weight in childhood—had the highest risk of CHD, with an HR of 1.83.
- Participants who remained overweight from childhood through young adulthood also faced an increased CHD risk, with an HR of 1.53.
- Pubertal-onset overweight was associated with significantly greater CHD risk than persistent overweight, with an HR of 1.23.
These findings highlight the critical importance of monitoring weight trajectories during childhood and adolescence. The authors note that although early-life overweight poses cardiovascular risk, achieving a healthy weight by adulthood may neutralize that risk entirely.
The study’s limitations include the inability to adjust for lifestyle factors such as smoking and restricted generalizability due to the predominantly White population. Severe obesity was rare in the cohort, limiting conclusions for that group.
"Despite these constraints, the results reinforce a powerful message: preventing and treating overweight early in life—especially before or during puberty—could play a major role in reducing adult coronary heart disease burden," the authors concluded.
Reference:
Ohlsson C, Bramsved R, Bygdell M, Martikainen J, Rosengren A, Kindblom JM. Change in Weight Status From Childhood to Young Adulthood and Risk of Adult Coronary Heart Disease. JAMA Pediatr. Published online December 01, 2025. doi:10.1001/jamapediatrics.2025.4950
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