Body-mass index trajectories from childhood to mid-adulthood and their sociodemographic predictors: Evidence from the International Childhood Cardiovascular Cohort (i3C) Consortium

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

Research output: Contribution to journalArticlepeer-review

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).

Original languageEnglish (US)
Article number101440
JournalEClinicalMedicine
Volume48
DOIs
StatePublished - Jun 2022

Bibliographical note

Funding Information:
The CDAH study was supported by the Commonwealth Department of Sport, Recreation and Tourism, the Commonwealth Department of Health, the Commonwealth Schools Commission, the National Heart Foundation, the National Health and Medical Research Council (grant numbers 211316, 544923, 1128373), the Tasmanian Community Fund, Veolia Environmental Services, and the Mostyn Family Foundation. The Bogalusa Heart Study has been financially supported by National Heart, Lung and Blood Institute and National Institute on aging (grant numbers R01 AG016592, R03 AG060619). The Muscatine Study has been financially supported by SCOR-Lipids, Atherosclerosis and Thrombosis HL14230, and R01s HL20124, HL48050, HL54730, HL61857. The Young Finns Study has been financially supported by The Academy of Finland, University Hospital grants (government funding to University Hospitals), and several Finnish Foundations. VC is supported by a National Heart Foundation of Australia Future Leader Fellowship (ID 100444). JT is supported by a National Heart Foundation of Australia Postdoctoral Fellowship (ID 102614). CGM was supported by a National Heart Foundation of Australia Future Leader Fellowship (100849) and is currently supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (APP1176494). The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of the NHMRC. We thank the teams that collected data at all measurement time points across all study centers; the persons who participated as both children and adults in these longitudinal studies; and biostatisticians Professor Leigh Blizzard and Mr. Petr Otahal for statistical advice.

Funding Information:
This study was supported by funding from the National Institutes of Health, National Heart, Lung and Blood Institute (grant number R01 HL121230).

Publisher Copyright:
© 2022 The Author(s)

Keywords

  • Adulthood
  • Body mass index
  • Childhood
  • Cohort study
  • Predictor
  • Trajectory

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