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Lung T, Killedar A, Taki S, Wen LM, Dickson M, Howard K, Baur L, Kelly P, Sherriff S, Hayes A. Differences in weight status among Australian children and adolescents from priority populations: a longitudinal study. Int J Obes (Lond) 2024; 48:702-708. [PMID: 38307955 PMCID: PMC11058044 DOI: 10.1038/s41366-024-01471-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND AND SIGNIFICANCE Australia has a high level of cultural and linguistic diversity, including Aboriginal and Torres Strait Islander peoples. Children from specific cultural and ethnic groups may be at greater risk of overweight and obesity and may bear the additional risk of socioeconomic disadvantage. Our aim was to identify differences in body-mass index z-score (zBMI) by: (1) Cultural and ethnic groups and; (2) Socioeconomic position (SEP), during childhood and adolescence. SUBJECTS/METHODS We used data from the Longitudinal Study of Australian children (n = 9417) aged 2-19 years with 50870 longitudinal measurements of zBMI. Children were classified into 9 cultural and ethnic groups, based on parent and child's country of birth and language spoken at home. These were: (1) English-speaking countries; (2) Middle East & North Africa; (3) East & South-East Asia; (4) South & Central Asia; (5) Europe; (6) Sub-Saharan Africa; (7) Americas; (8) Oceania. A further group (9) was defined as Aboriginal and Torres Strait Islander from self-reported demographic information. Longitudinal cohort analyses in which exposures were cultural and ethnic group and family socioeconomic position, and the outcome was zBMI estimated using multilevel mixed linear regression models. We stratified our analyses over three periods of child development: early childhood (2-5 years); middle childhood (6-11 years); and adolescence (12-19 years). RESULTS Across all three periods of child development, children from the Middle East and North Africa, the Americas and Oceania were associated with higher zBMI and children from the two Asian groups were associated with lower zBMI, when compared to the referent group (English). zBMI was socioeconomically patterned, with increasingly higher zBMI associated with more socioeconomic disadvantage. CONCLUSIONS Our findings identified key population groups at higher risk of overweight and obesity in childhood and adolescence. Prevention efforts should prioritize these groups to avoid exacerbating inequalities in healthy weight in childhood.
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Affiliation(s)
- Thomas Lung
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
| | - Anagha Killedar
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Sarah Taki
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), University of Sydney, Sydney, Australia
| | - Li Ming Wen
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), University of Sydney, Sydney, Australia
| | - Michelle Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Louise Baur
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), University of Sydney, Sydney, Australia
- Specialty of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Patrick Kelly
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Simone Sherriff
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Alison Hayes
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Zvonar M, Štefan L, Kasović M, Piler P. Tracking of anthropometric characteristics from childhood to adolescence: an 8-year follow-up findings from the Czech ELSPAC study. BMC Public Health 2022; 22:727. [PMID: 35413828 PMCID: PMC9004100 DOI: 10.1186/s12889-022-13178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although evidence suggests that obesity track well from childhood to adolescence, most of the research has been done in Western and high-income countries. Moreover, most of the studies have tracked body-mass index, as a proxy of nutritional status, while tracking characteristics of circumferences and skinfold thicknesses have been less studies. Therefore, the main purpose of the study was to explore tracking characteristics of complete anthropometric data from childhood to adolescence. METHODS This sub-study was part of the Czech ELSPAC study. In the present 8-year longitudinal study, we collected information from pediatrician's medical records at the ages of 8 y (n = 888), 11 y (n = 1065), 13 y (n = 811) and 15 y (n = 974), including circumferences (head, chest, waist, hips, and arm), indices (body-mass index, waist-to-hip ratio and waist-to-height ratio) and skinfold thicknesses (biceps, triceps, subscapula, suprailiaca, thigh and the sum of 5 skinfolds). Participants were recruited from the two selected regions of the Czech Republic (Brno and Znojmo). Linear generalized estimating equations were conducted to analyze tracking patterns over an 8-year follow-up period for all anthropometric measurements. RESULTS Tracking coefficients were moderate to strong, ranging from 0.40 to 0.62 for circumferences, 0.41 to 0.74 for indices and 0.72 to 0.86 for skinfolds. According to body-mass index and waist circumference standards, overweight/obese children and children with abdominal obesity at the age of 8 y were 11.31 (95% CI = 8.41 to 15.22, p < 0.001) and 10.73 (95% CI = 7.93 to 14.52, p < 0.001) more likely to remain overweight/obese and to have abdominal obesity at the age of 15 y. CONCLUSIONS Findings show moderate to strong tracking of anthropometric characteristics, i.e. circumferences track moderately well, while strong tracking for indices and skinfold thicknesses is observed. Moreover, strong tracking of general overweight/obesity and abdominal obesity between ages 8 y and 15 y indicates that the detection of these risk factors at the beginning of primary school should be advocated.
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Affiliation(s)
- Martin Zvonar
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 611 37, Brno, Czech Republic
| | - Lovro Štefan
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 611 37, Brno, Czech Republic. .,Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10 000, Zagreb, Croatia. .,Department of Sport Motorics and Methodology in Kinanthropology, Faculty of Sports Studies, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
| | - Mario Kasović
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 611 37, Brno, Czech Republic.,Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10 000, Zagreb, Croatia
| | - Pavel Piler
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 611 37, Brno, Czech Republic
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Killedar A, Lung T, Hayes A. Investigating socioeconomic inequalities in BMI growth rates during childhood and adolescence. Obes Sci Pract 2022; 8:101-111. [PMID: 35127126 PMCID: PMC8804938 DOI: 10.1002/osp4.549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/08/2021] [Accepted: 07/26/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Many countries report socioeconomic inequalities in childhood obesity, but when they develop is not well-characterised. Studies rarely isolate BMI growth rates from overall BMI, perhaps overlooking an important precursor to the observed inequalities in obesity. The objective of this study was to determine the age at which inequalities in BMI growth rates develop in children and whether they are similar across the BMI spectrum. METHODS Using the Longitudinal Study of Australian Children (n = 9024), a cohort study, we measured socioeconomic inequalities in annual BMI growth from age 2 to 17 years by age, sex and weight status. We fit a linear model using generalised estimating equations (GEE) to estimate simultaneously the effects of age and weight status on inequalities in BMI growth rate. RESULTS The slope (SII) and relative (RII) indexes of inequality for annual BMI growth were greatest in middle childhood (age 4-11 years) (SII 0.25, RII 1.83 (boys) 1.78 (girls)) and were moderate during adolescence (age 10-17 years) (SII 0.11, RII 1.16 [boys] 1.15 [girls]). In early childhood, there was little evidence of inequality in annual BMI growth except in children with obesity. In middle childhood and adolescence, inequalities were greater at higher weight status. The GEE indicated that both weight status (P < 0.001) and age period (P < 0.001) affected inequalities in BMI growth rates. CONCLUSIONS Inequalities in annual BMI growth were strongest in middle childhood, and widest in children at the upper end of the BMI spectrum. This could signify a key age bracket to intervene clinically and at a public health level and improve inequalities in childhood obesity.
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Affiliation(s)
- Anagha Killedar
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Thomas Lung
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Alison Hayes
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
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Pehkonen J, Viinikainen J, Kari JT, Böckerman P, Lehtimäki T, Viikari J, Raitakari O. Birth weight, adult weight, and cardiovascular biomarkers: Evidence from the Cardiovascular Young Finns Study. Prev Med 2022; 154:106894. [PMID: 34801564 DOI: 10.1016/j.ypmed.2021.106894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/12/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
This study quantifies the causal effect of birth weight on cardiovascular biomarkers in adulthood using the Cardiovascular Risk in Young Finns Study (YFS). We apply a multivariable Mendelian randomization (MVMR) method that provides a novel approach to improve inference in causal analysis based on a mediation framework. The results show that birth weight is linked to triglyceride levels (β = -0.294; 95% CI [-0.591, 0.003]) but not to low-density lipoprotein (LDL) cholesterol levels (β = 0.007; 95% CI [-0.168, 0.183]). The total effect of birth weight on triglyceride levels is partly offset by a mediation pathway linking birth weight to adult BMI (β = 0.111; 95% CI [-0.013, 0.234]). The negative total effect is consistent with the fetal programming hypothesis. The positive indirect effect via adult BMI highlights the persistence of body weight throughout a person's life and the adverse effects of high BMI on health. The results are consistent with previous findings that both low birth weight and weight gain increase health risks in adulthood.
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Affiliation(s)
- Jaakko Pehkonen
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland.
| | - Jutta Viinikainen
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Jaana T Kari
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Petri Böckerman
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland; Labour Institute for Economic Research, Helsinki, Finland; IZA, Bonn, Germany
| | - Terho Lehtimäki
- Department of Clinincal Chemistry, Tampere University, Finland; Fimlab Laboratoriot Oy Ltd, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Cardiovascular Research Center Tampere, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland, Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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