Factors affecting the stability of blood lipid and lipoprotein levels from youth to adulthood : evidence from the Childhood Determinants of Adult Health Study

Objective: To examine the effect of lifestyle changes on the stability of blood lipid and lipoprotein levels from youth to adulthood. Design: Prospective cohort study. Setting: Australia. Participants: Five hundred thirty-nine young adults who underwent measurement at baseline in 1985 when aged 9, 12, or 15 years and again at follow-up between 2004 and 2006. Main Exposures: Changes in adiposity, cardiorespiratory fitness, saturated fat intake, smoking, and socioeconomic position. Main OutcomeMeasures: Child and adult blood lipid levels. Results: Using established cut points, we found that substantial proportions of individuals with high-risk blood lipid and lipoprotein levels at baseline no longer had highrisk levels at follow-up. Of the participants who had highrisk levels in youth, those with greater increases in adiposity or who commenced or continued smoking were more likely to maintain high-risk blood lipid and lipoprotein levels (P<.05). Participants who became high risk at follow-up had greater increases in adiposity, were less likely to improve their socioeconomic position, and tended to become less fit between surveys compared with those who maintained normal-risk levels (P≤.05). These effects tended to remain (P≤.10) after adjustment for all predictive lifestyle variables. Conclusions: Unhealthy lifestyle changes that occur between youth and adulthood affect whether an individual maintains, loses, or develops high-risk blood lipid and lipoprotein levels in adulthood. Interventions that promote weight control in the first instance, but also physical activity, not smoking, and improved socioeconomic position in the transition from youth to adulthood, are likely to be of benefit in preventing adult dyslipidemia.