Childhood Determinants of Adult Health (CDAH) - Phase 3
When researchers went into Australian schools in 1985 and collected data on thousands of children for the Australian Schools Health and Fitness Survey, the intention was to catch a snapshot of the health and fitness of school-age Australians at that time.
Now, almost 30 years on, this data is helping to inform researchers at the Menzies Research Institute Tasmania about the origins of heart disease, diabetes and mental health.
The data collected in 1985 is the basis of the Childhood Determinants of Adult Health study (CDAH), which enters an important new phase this year with the 30-year follow-up of participants who were aged between 7 and 15 in 1985.
The leader of the project, Professor Alison Venn, says the data still has much to tell us. "It was intended to show the state of Australian children's health and fitness at that time," Professor Venn said. However, the study had greater potential because, unusually, it included measures of blood cholesterol and blood pressure (from the children aged 9, 12 and 15) as well as measures of fitness, height and weight and information about health-related behaviour.
"The classic cardiovascular risk factors are high cholesterol, high blood pressure, overweight and obesity, smoking, poor diet and physical inactivity. If you are really interested in when the risk of cardiovascular disease kicks in, and whether or not it really matters that you've got these risk factors already in childhood, you have to have studies with thousands of children with those measures. Hardly any studies around the world do."
As part of the international i3C Consortium, CDAH data is pooled with similar studies from Finland and the USA, which means around 10,000 participants can be compared.
In 2004-6 the CDAH team set up clinics around Australia to repeat some of the measures done 20 years earlier and bring in some new tests. They followed up again with questionnaires five years after that, and are now preparing to set up clinics in Tasmania and Victoria to carry out the 30-year follow-up, known as CDAH3. At this stage funding has been secured for a CDAH3 pilot. A full roll-out of the third phase around the rest of Australia will depend on fundraising.
A recently published finding from the first follow-up of the cohort in 2004-6 was the association of childhood exposure to passive (parental) smoking and poorer blood vessel health in adulthood. The research has established other associations of childhood obesity, fitness and physical activity with adult heart disease and diabetes risk, bone mass and depression.
This study has helped us to answer important questions about the long term effects of childhood obesity. We’ve found that most children that are overweight or obese will remain that way into adulthood (MJA, Venn et al. https://www.ncbi.nlm.nih.gov/pubmed/17484707). We’ve shown that childhood obesity does have a negative impact on the heart health of adults including in the structure of the heart (Tapp, BMC Cardiovascular Disorders https://www.ncbi.nlm.nih.gov/pubmed/24980215 ) and arteries (NEJM, Juonala et al. https://www.ncbi.nlm.nih.gov/pubmed/22087679 ).
It’s not all bad news though. The negative effects of childhood obesity can be overcome through improving cardiorespiratory fitness (Int J Obesity, Schmidt et al. https://www.ncbi.nlm.nih.gov/pubmed/27102049 and Obesity, Sun et al. https://www.ncbi.nlm.nih.gov/pubmed/25297830 ) and if children that were overweight or obese lose weight by the time they are adults, their heart health looks similar to people that were never overweight or obese as children https://www.ncbi.nlm.nih.gov/pubmed/22087679).
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Funding and Sponsors
The CDAH Study would like to acknowledge our funding partners:
National Health & Medical Research Council
National Heart Foundation
Tasmanian Community Fund
Veolia Environmental Services
And also the generous sponsorship of:
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