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Background  We have examined the association between adiposity and cardiac structure in adulthood, using a life course approach that takes account of the contribution of adiposity in both childhood and adulthood.    Methods  The Childhood Determinants of Adult Health study (CDAH) is a follow-up study of 8,498 children who participated in the 1985 Australian Schools Health and Fitness Survey (ASHFS). The CDAH follow-up study included 2,410 participants who attended a clinic examination. Of these, 181 underwent cardiac imaging and provided complete data. The measures were taken once when the children were aged 9 to 15 years, and once in adult life, aged 26 to 36 years.    Results  There was a positive association between adult left ventricular mass (LVM) and childhood body mass index (BMI) in males (regression coefficient ( β ) 0.41; 95% confidence interval (CI): 0.14 to 0.67; p = 0.003), and females ( β  = 0.53; 95% CI: 0.34 to 0.72; p < 0.001), and with change in BMI from childhood to adulthood (males:  β  = 0.27; 95% CI: 0.04 to 0.51; p < 0.001, females:  β  = 0.39; 95% CI: 0.20 to 0.58; p < 0.001), after adjustment for confounding factors (age, fitness, triglyceride levels and total cholesterol in adulthood). After further adjustment for known potential mediating factors (systolic BP and fasting plasma glucose in adulthood) the relationship of LVM with childhood BMI (males:  β  = 0.45; 95% CI: 0.19 to 0.71; p = 0.001, females:  β  = 0.49; 95% CI: 0.29 to 0.68; p < 0.001) and change in BMI (males:  β  = 0.26; 95% CI: 0.04 to 0.49; p = 0.02, females:  β  = 0.40; 95% CI: 0.20 to 0.59; p < 0.001) did not change markedly.    Conclusions  Adiposity and increased adiposity from childhood to adulthood appear to have a detrimental effect on cardiac structure.

Impact of adiposity on cardiac structure in adult life: the childhood determinants of adult health (CDAH) study