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Stability of body mass index in Australian children: a prospective cohort study across the middle childhood years

Published online by Cambridge University Press:  02 January 2007

Kylie Hesketh*
Affiliation:
Centre for Community Child Health, Murdoch Childrens Research Institute & University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
Melissa Wake
Affiliation:
Centre for Community Child Health, Murdoch Childrens Research Institute & University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
Elizabeth Waters
Affiliation:
Centre for Community Child Health, Murdoch Childrens Research Institute & University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
John Carlin
Affiliation:
Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute & University of Melbourne, Royal Children's Hospital, Melbourne, Australia
David Crawford
Affiliation:
Centre for Physical Activity and Nutrition Research, School of Health Sciences, Deakin University, Melbourne, Australia
*
*Corresponding author: Email kylie.hesketh@mcri.edu.au
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Abstract

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Objective:

To investigate the prevalence and incidence of overweight and obesity, the frequency of overweight resolution and the influence of parental adiposity during middle childhood.

Design:

As part of a prospective cohort study, height and weight were measured in 1997 and 2000/2001. Children were classified as non-overweight, overweight or obese based on standard international definitions. Body mass index (BMI) was transformed into age- and gender-specific Z-scores employing the LMS method and 2000 growth chart data of the Centers for Disease Control and Prevention. Parents self-reported height and weight, and were classified as underweight, healthy weight, overweight or obese based on World Health Organization definitions.

Setting:

Primary schools in Victoria, Australia.

Subjects:

In total, 1438 children aged 5–10 years at baseline.

Results:

The prevalence of overweight and obesity increased between baseline (15.0 and 4.3%, respectively) and follow-up (19.7 and 4.8%, respectively; P < 0.001 for increase in overweight and obesity combined). There were 140 incident cases of overweight (9.7% of the cohort) and 24 of obesity (1.7% of the cohort); only 3.8% of the cohort (19.8% of overweight/obese children) resolved to a healthy weight. The stability of child adiposity as measured by BMI category (84.8% remained in the same category) and BMI Z-score (r = 0.84; mean change = −0.05) was extremely high. Mean change in BMI Z-score decreased with age (linear trend β = 0.03, 95% confidence interval 0.01–0.05). The influence of parental adiposity largely disappeared when children's baseline BMI was adjusted for.

Conclusions:

During middle childhood, the incidence of overweight/obesity exceeds the proportion of children resolving to non-overweight. However, for most children adiposity remains stable, and stability appears to increase with age. Prevention strategies targeting children in early childhood are required.

Type
Research Article
Copyright
Copyright © CAB International 2004

References

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