Obesity status trajectory groups among elementary school children

dc.citation.journalTitleBMC Public Healthen_US
dc.contributor.authorChen, Tzu-Anen_US
dc.contributor.authorBaranowski, Tomen_US
dc.contributor.authorMoreno, Jennette P.en_US
dc.contributor.authorO’Connor, Teresia M.en_US
dc.contributor.authorHughes, Sheryl O.en_US
dc.contributor.authorBaranowski, Janiceen_US
dc.contributor.authorWoehler, Deborahen_US
dc.contributor.authorKimbro, Rachel T.en_US
dc.contributor.authorJohnston, Craig A.en_US
dc.description.abstractBackground: Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years. This study examined whether there were distinct body mass index (BMI) trajectory groups among elementary school children, and predictors of trajectory group membership. Methods: This is a secondary analysis of 1651 elementary school children with complete biannual longitudinal data from kindergarten to the beginning of 5th grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for 11 consecutive assessments. Group-based trajectory clustering and multinomial logit modeling were conducted. Results: When using BMIz score, six trajectory groups were identified revealing substantial consistency in BMIz score across time. When using a categorical variable separating overweight/obese children (BMI ≥ 85%ile) from the rest, five developmental trajectories (persistently non-overweight/obese weight: 51.1 %; early-onset overweight/obese: 9.2 %; late-onset overweight/obese: 9.7 %; becoming healthy weight: 8.2 %; and chronically overweight/obese: 21.8 %) were identified. When using a categorical variable separating obese children (BMI ≥ 95%ile) from the rest, three trajectories (persistently non-obese: 74.1 %, becoming obese: 12.8 %; and chronically obese: 13.2 %) were identified. For both cutoffs (≥ BMI percentile 85 % or 95 %), girls were more likely than boys to be classified in the persistently non-overweight and/or obese group (odds ratios (OR) ranged from 0.53 to 0.67); and Hispanic children and non-Hispanic Black children were more likely to be chronically overweight and/or obese than non-Hispanic White children (OR ranged from 1.57 to 2.44). Hispanic children were also more likely to become obese (OR: 1.84) than non-Hispanic White children when ≥ BMI percentile 95 % was used. Conclusions: Boys, Hispanic and non-Hispanic Black children were at higher risk of being overweight or obese throughout their elementary school years, supporting the need for obesity treatment. Post kindergarten and post second grade summer months were times when some children transitioned into overweight/obesity. It will be important to identify which behavioral factors (e.g., diet, physical activity, sedentary behaviors, and/or sleep) predisposed children to becoming overweight/obese, and whether these factors differ by time (Kindergarten versus second grade). If behavioral predisposing factors could be identified early, targeted obesity prevention should be offered.en_US
dc.identifier.citationChen, Tzu-An, Baranowski, Tom, Moreno, Jennette P., et al.. "Obesity status trajectory groups among elementary school children." <i>BMC Public Health,</i> 16, (2016) BioMed Central: https://doi.org/10.1186/s12889-016-3159-x.
dc.publisherBioMed Central
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stateden_US
dc.titleObesity status trajectory groups among elementary school childrenen_US
dc.typeJournal articleen_US
dc.type.publicationpublisher versionen_US
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