Adolescent obesity and risk of serious chronic morbidity and mortality in young adulthood: a systematic review of cohorts from national registries.
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BACKGROUND: The rising prevalence of adolescent obesity necessitates a precise understanding of its corresponding risks for severe chronic morbidity and premature mortality during young adulthood and midlife. METHODS: We conducted a systematic review of nationwide longitudinal cohort studies, using validated national registries, aimed at assessing the short- and long-term risk of morbidity and mortality associated with adolescent overweight and obesity. RESULTS: We included 38 studies in this systematic review. Adolescent overweight and obesity were associated with severe morbidity and disease related mortality, from young adulthood. Within < 4 years of follow-up and before the age of 25 years, severe adolescent obesity was associated with increased risk of serious morbidity (hazard ratio (HR) = 5.1 among men and HR = 7.3 among women), type 2 diabetes (HR = 27.0 among men, and HR = 45.3 among women), and obesity was associated with type 1 diabetes (HR = 2.0). Before the age of 30 years, adolescent severe obesity was associated with chronic kidney disease (CKD), obesity was associated with colorectal cancer (CRC) and with cardiovascular disease (CVD) mortality. Before the age of 40 years adolescent overweight and obesity were associated with ischemic stroke. Last, before the age of 50 years, adolescent severe obesity was associated with all-cause mortality, obesity was associated with diabetes mortality, and cancer. CONCLUSIONS: Adolescent obesity is strongly associated with an elevated hazard for severe disease morbidity and mortality beginning in young adulthood, with associations progressing with obesity severity and time. The findings of this study demonstrate the need for public health mitigation and preventive strategies, which may yield substantial short, and long-term health benefits in this population.