Barbara A. Lararia

Objective This study examined the association of adolescent BMI trajectory with adult metabolic syndrome (MetSyn) and with intergenerational obesity. Methods This study used data from the National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (1987–1997). Data from the 20‐year follow‐up (2016–2019) study were included from the original participants ( N = 624) and their children ( N = 645). Adolescent BMI trajectories were identified using latent trajectory modeling. Mediation analysis using logistic regression models was performed to estimate confounder‐adjusted odds ratios (OR) and 95% CI between adolescent BMI trajectory and adult MetSyn. Using similar methods, the association between BMI trajectory and offspring obesity was examined. Results Latent trajectory modeling identified four patterns: “weight loss then gain” ( N = 62); “persistently normal” ( N = 374); “persistently high BMI” ( N = 127); and “weight gain then loss” ( N = 61). Women who had a persistently high BMI trajectory had twice the odds of having children who met the definition for obesity compared with the persistently normal group, adjusting for adult BMI (OR: 2.76; 95% CI: 1.39–5.46). None of the trajectory groups was associated with adult MetSyn compared with the persistently normal group. Conclusions Intermittent adolescent obesity may not confer MetSyn risk during adulthood. However, maternal adolescent BMI trajectories that are persistently high may increase the odds of intergenerational obesity among offspring.