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Cohort study
Body mass index in adolescence may influence the risk of cardiovascular disease later in life
  1. Gerben Hulsegge1,2
  1. 1Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands,
  2. 2Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  1. Correspondence to : Dr Gerben Hulsegge, Department of Public and Occupational Health, VU University Medical Center, P.O. Box 7047, 1007 MB Amsterdam, The Netherlands; g.hulsegge{at}

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Commentary on: Twig G, Yaniv G, Levine H, et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med 2016;374:2430–40.

Implications for practice and research

  • Adolescents who are considered to be in the normal body mass index (BMI) range had an increased risk of cardiovascular disease and all-cause mortality at 10–40 years follow-up, which continuously increased with a higher BMI.

  • Future research is needed to establish the optimal threshold for a healthy BMI during adolescence.


The prevention and treatment of cardiovascular disease (CVD) has improved over recent decades. As a consequence, age-standardised mortality rates of CVD in high-income countries have steadily been decreasing since the 1970s.1 At the same time, however, prevalence of obesity has reached epidemic proportions and seems to be one of the main public health threats the younger generations face today.2 Insight into adverse effects of obesity among …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.