Body Mass Index Trajectories From Childhood to Mid-Adulthood and Their Sociodemographic Predictors: Evidence From the International Childhood Cardiovascular Cohort (i3C) Consortium
Year: 2021
Type: article
Study design: Observational Study
Abstract: Background Understanding lifecourse trajectories of body-mass index (BMI) is important for identifying groups at high risk of poor health and potential target points for intervention. This study aimed to describe BMI trajectories from childhood to mid-adulthood in four population-based cohorts established in the 1970s and 1980s and to identify childhood sociodemographic factors related to trajectory membership. Methods Between Dec 17, 1970 and Dec 15, 1994, data were collected at the first visit from 9830 participants from the International Childhood Cardiovascular Cohort (i3C) Consortium, which includes participants from Australia (1985), Finland (1980) and the USA (1970–1994). Participants had at least three measures of height and weight, including one in childhood (6–18 years) and one in adulthood (>18 years), and were aged 30–49 years at last measurement. Latent Class Growth Mixture Modelling was used to identify lifecourse BMI trajectory groups and log multinomial regression models were fit to identify their childhood sociodemographic predictors. Findings Five consistent BMI trajectory groups were identified amongst the four cohorts: persistently low (35.9–58.6%), improving from high (0.7–4.8%), progressing to moderate (9.3–43.7%), progressing to high (1.1–6.0%), and progressing to very high (0.7–1.3%). An additional three BMI trajectory groups were identified in some, but not all, cohorts: adult onset high (three cohorts; 1.8–20.7%), progressing to moderate-high (two cohorts; 5.2–13.8%), and relapsing yo-yoers (alternating upward and downward; one cohort; 1.3%). In pooled analyses, each predictor variable in childhood, including age, gender, parental education and race, was associated with increased likelihood of belonging to the most (e.g., improving from high) and least (e.g., progressing to very high) favourable BMI trajectory groups, suggesting a U-shaped (or inverse U-shaped) pattern of association. Interpretation Five consistent BMI trajectory groups were identified across four cohorts from Australia, Finland, and the USA, mainly across two eras of birth. While most participants remained on a persistently low trajectory (50%), many demonstrated worsening BMI trajectories (47%), with only few demonstrating improving trajectories (<5%). Age, gender, parental education, and race appear to be important predictors of BMI trajectory group membership and need consideration in preventive and management strategies. Funding This study was supported by funding from the National Institutes of Health, National Heart, Lung and Blood Institute (grant number R01 HL121230).
Source: EClinicalMedicine
Authors: Verity Cleland, Jing Tian, Marie-Jeanne Buscot, Costan G. Magnussen, Lydia Bazzano, Trudy L. Burns, Stephen Daniels, Terence Dwyer, Nina Hutri-Kahonen, Johanna Ikonen, David Jacobs, Markus Juonala, Ronald Prineas, Olli Raitakari, Alan Sinaiko, Julia Steinberger, Elaine M. Urbina, Jessica G. Woo, Alison Venn
Institutions: University of Tasmania, Menzies Institute for Medical Research, University of Turku, Turku University Hospital, Tulane University, University of Iowa, University of Colorado Anschutz, University of Oxford, Murdoch Children's Research Institute, Tampere University, University of Tampere, University of Minnesota, Wake Forest University Health Sciences, Wake Forest University, Cincinnati Children's Hospital Medical Center, University of Cincinnati
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,500
Funders: University Hospitals, Commonwealth Scholarship Commission, National Heart Foundation of Australia, Academy of Finland, Tasmanian Community Fund, National Institutes of Health, Medical Research Council, National Health and Medical Research Council, National Institute on Aging, National Heart, Lung, and Blood Institute
Awards: Childhood CV Risk and Adult CVD Outcomes: an International Long-term Follow-up, G1430279468, G1610810711, Childhood Growth, Biological Aging and Midlife Cardio-Metabolic Outcomes, How do life-stage transitions and depression affect the risk of heart disease and diabetes in young adults?, CT VASCULAR CALCIUM-AN EPIDEMIOLOGIC STUDY IN THE YOUNG, The long-term effects of child, adolescent, and young adult cholesterol levels on future cardiovascular disease., G4001071766, G4400456065, ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY, ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY, G6894421026, G6968042294, Follow up of the 1985 Australian Schools Health and Fitness Survey Cohort, Cardiometabolic risk trajectories from childhood to midlife: finding pathways to better health, Epidemiology of Carotid Artery Atherosclerosis in Youth, Evolution of Cardiovascular Risk with Normal Aging
OpenAlex ID: W4280647562