Abstract
BackgroundLittle 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.MethodsThis 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.ResultsWhen 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.ConclusionsBoys, 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.
Highlights
Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years
Childhood obesity is related to physical diseases, such as cardiovascular disease [2,3,4], type 2 diabetes [3, 5], some cancers [6], stroke [2], arthritis [6], sleep apnea [7], early adult mortality [8], and poorer mental health [9, 10], e.g. negative self-image [11] and peer perceptions [12]
Participants The original study included 3734 students enrolled in the 2005 kindergarten class from a Southeast Texas Independent School District (ISD), which included 45 elementary schools
Summary
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. The prevalence of childhood obesity may have leveled off among U.S children in recent years [13, 14], it remains high: currently 34 % of schoolaged children 6 to 11 years old were overweight or obese [13]. About body mass index (BMI) developmental trajectories during childhood. A semi-parametric clustering procedure has categorized children using annual BMI into trajectory groups [20, 21]. Among Taiwanese elementary school children, four groups were identified with persistent relative weight status over time. Lin et al [22], we applied this relatively new statistical procedure to semiannual elementary school children data in a community in the southwestern U.S
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