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.