At what age do normal weight Canadian children become overweight adults? Differences according to sex and metric

Background: The prevalence of overweight and obesity doubles between adolescence and young adulthood. However, the exact age, and appropriate metric to use, to identify when overweight develops is still debated. Aim: To examine the age of onset of overweight by sex and four metrics: body mass index (BMI), fat mass (%FM), waist circumference (WC) and waist-to-height ratio (WHtR). Methods: Between 1991 and 2017, serial measures of body composition, were taken on 237 (108 males) individuals (aged 8 to 40 years of age). Hierarchical random effects models were used to develop growth curves. Curves were compared to BMI, %FM and WC overweight age and sex-specific cut-points. Results: In males the BMI growth curve crossed the cut-point at 22.0 years compared to 23.5 and 26.5 years for WHtR and %FM respectively; WC cut-off were not reached until 36 years. In females the BMI growth curve, crossed the overweight cut-point at 21.5 years compared to 14.2 years for %FM and at 21.9 and 27.5 years for WC and WHtR respectively. Conclusions: Overweight onset occurs during young adulthood with the exception of WC in males. BMI in males and %FM in females were the metric identifying overweight the earliest.