Evaluating the best way of assessing adolescents' obesity as predictor of cardiovascular risk in adulthood

Elisabete Ramos

Principal Investigator

Integrated Member (PhD)



Participating institutions:

Faculdade de Medicina da Universidade do Porto, Unidade de Investigação e Desenvolvimento Cardiovascular

Start date:


(Predicted) End date:


Total budget:



The increasing prevalence of overweight and obesity is considered a major public health issue with serious health, social and economic repercussions.
Despite this recognition and the acceptance of body mass index (BMI) as a useful measure of overweight and obesity; widely accepted diagnostic definitions are not available for children and adolescents.
The absence of a broadly accepted definition is mainly due to the lack of information that could support the identification of which exposures are related with the development of long-term health risk conditions, namely cardiovascular and metabolic risk factors.
The project will be developed as part of the EPITeen (Epidemiological Investigation of Teenagers Health in Porto), a cohort of urban adolescents born in 1990 and enrolled at Porto private and public schools.

The assembling was performed in 2003, when the participants had 13-yeard-old, and they were re-evaluated the first time at 17-yeard-old. At baseline the overall proportion of participation was 77.5% corresponding to a sample of 2160 adolescents. During 2007, the first follow-up was performed and 1716 (79.4%) of the participants were re-evaluated. Additionally, 783 adolescents that were born in 1990 but did not attend school in the Porto area at the baseline assembling were evaluated for the first time. Thus, our target for the evaluation at 21-year-old comprises a total of 2943 participants.

Each evaluation, baseline (at 13-year-old), first follow-up (at 17-year-old) and the future follow-up (at 21-year-old), comprised self-administered questionnaires and a physical examination, between 8 and 10 a.m. The physical examination comprise weight (measured using a digital scale Tanita®), height, waist and hip circumferences, skinfolds thicknesses, blood pressure and a 12-hour overnight intravenous blood sample taken from an antecubital vein.

This project aims to understand the tracking of weight status from 13 to 21-year-old and to examine the ability of different body fat assessments in the prediction of metabolic and cardiovascular risk factors in young adults.

We expect to accomplish the following specific objectives:

1. To assess the tracking of weight status from 13 to 21 years;
2. To assess the role of social, demographic and behavioural exposures in the magnitude of weight status changes;
3. To examine the ability of the most widely used categories of body mass index (BMI) in adolescence to predict obesity and overweight in the adulthood;
4. To examine the ability of different body fat assessments (BMI, waist circumference, skinfold thickness and total fat estimate by bioelectrical impedance analysis) in the prediction of high levels of blood pressure, serum lipids, C-reactive protein, insulin resistance and metabolic syndrome in young adults.

Our longitudinal and population based approach will allow us to add better understanding of the onset and progression of obesity and metabolic diseases in young adults, even between those who have not yet developed enough characteristics to a clinical diagnosis of cardiovascular disease.