LAUSR

The worldwide prevalence and severity of childhood obesity has steadily risen over the last 50 years.1 Although there have been some indicators of recent stabilization,2 it has been suggested that we have simply reached our upper genetic limit.3 Whether this is true, the current prevalence is shockingly high; one-third of children aged 2 to 19 have a BMI >85th percentile, and 18.5% have a BMI >95th percentile,4 consequently affecting 13.7 million children in the United States and 340 million children worldwide. It makes intuitive sense that childhood obesity is a serious health problem. However, at exactly what age obesity begins to predict future disease has proven an elusive question. The evidence is clear that (1) child obesity predicts adult obesity,5 (2) adult obesity predicts cardiometabolic disease and early mortality,6 and (3) obesity in late adolescence predicts early mortality, the majority of which is related to cardiovascular disease.7 But is obesity something to be concerned about in a 3-year-old? Researchers in previous studies have demonstrated that single time-point measures … Address correspondence to Sarah Armstrong, MD, Duke Clinical Research Institute, 200 Morris St, Durham, NC 27701. E-mail: sarah.c.armstrong{at}duke.edu