Rate Of Body Mass Index Growth Research Articles

Relationships between Food Insecurity, Self-Efficacy, and Changes in Body Mass Index among the Youth in Taiwan: Analysis from a Longitudinal Cohort Survey.

Food insecurity is a heightened concern among economically disadvantaged youth, and it may contribute to the atypical body mass index (BMI) patterns frequently observed in this group. Self-efficacy seems to intervene in the negative impacts of contextual restraints. This study investigated the relationship between food insecurity, self-efficacy, and BMI trajectory among economically disadvantaged Taiwanese youth. We utilized three-wave longitudinal data from the Taiwan Database of Children and Youth in Poverty. The Food Insecurity Score (FIS) assessed food insecurity with a 4-item scale measuring reduced meal frequency, hunger, skipping meals, and economic constraints. Moreover, the General Self-Efficacy Scale (GSES) assessed self-efficacy, showcasing the ability to handle stress effectively and envision success scenarios, contributing to positive outcomes. By employing latent growth modeling, we were able to delineate the impacts of baseline food insecurity and self-efficacy on initial BMI and its subsequent growth trajectory. Elevated baseline FIS significantly predicted higher initial BMI (coefficient = 0.420, p = 0.042). Baseline GSES was negatively associated with initial BMI (coefficient = -0.093, p < 0.001) but positively predicted the BMI growth rate (coefficient = 0.023, p = 0.011). Enhancing self-efficacy may be an effective multidisciplinary intervention to address psychosocial and socioeconomic factors when tackling weight problems in vulnerable youth groups.

Birth Body Mass Index (Bmi) of Late Preterm and Early-Term Newborns

Introduction: the nutritional status and the growth achieved by the newborn until birth have been used as a marker/indicator of early risks of morbidity and mortality. Even though BMI is a good marker of adiposity and is commonly used in older children and adults, there are still gaps in knowledge and there are few studies on the behavior of BMI according to gestational age.&#x0D; Objective: to analyze the Body Mass Index (BMI) at the birth of late preterm newborns (34th to 36th week of gestational age) and early-term newborns (37th to 38th week of gestational age) and according to gestational age.&#x0D; Methods: this is a descriptive, analytical, and quantitative study with 2,486 newborns, developed from the project’s database “Biometric characteristics at birth, of young adult women’s babies, in a municipality with a high human development index.” After collection, data consistency was verified. The analysis evaluated measures of central tendency and dispersion of values, in addition to correlations and regressions of their evolution according to gestational age.&#x0D; Results: BMI scores Z distribution wasn’t different between male and female late preterm newborns as in early-term newborns. The same was observed concerning gestational ages. In terms of absolute BMI values, it was observed that late preterm newborns had a lower BMI (12.6 kg/m2) than early-term newborns (13.6 kg/m2). However, considering their gestational age, late preterm newborns were proportionally bigger than early-term newborns. A proportionally higher rate of BMI growth was observed in late preterm newborns, with a tendency to slow down in early-term newborns. As for weight gain, from the 37th week of gestational age, it tends to decrease compared to the reference values.&#x0D; Conclusion: Regarding the BMI reference values, early-term and late-preterm newborns are equivalent. Late-preterm newborns have the same BMI Z-scores as reference values as early-term newborns.

Impact of the COVID-19 pandemic lockdown on Body Mass Index: a three-year follow up study in 6,156 Chinese college students.

The novel coronavirus disease 2019 as the most pervasive and consequential pandemic in recent years, has exerted significant impacts on human health, including aspects related to body weight. Objectives: This study aims to assess the influence of the lockdown measures implemented during the COVID-19 pandemic on Chinese college students' Body Mass Index (BMI) through a three-year cohort study. We recruited 6156 college students (n = 4,248, 69% male, and n = 1,908, 31% female, with an average age of 18.68 ± 0.86 yr.) from a University in China to participate in this three-year cohort study. All of the subjects took the same physical fitness tests from 2019 to 2021 (pre-lockdown, during lockdown and post-lockdown). Participants' height and weight data were objectively measured by Tongfang Health Fitness Testing Products 5000 series. A paired t-test was performed in the analysis. During the lockdown, there is 4.2% increase of BMI among the college student (p<0.001). Moreover, males had a greater overall mean BMI rate increase of 4.74% (p<0.001) than females (2.86%, p<0.001). After the lockdown, there is 0.94% increase of BMI among the college student (p<0.001). However, females had a greater overall mean BMI rate increase of 1.49% (p<0.001) than males (0.72%, p<0.001). During this period, the obese and overweight group's growth rate from 2019 to 2020 was smaller than the normal and underweight group, which were 2.94% (p<0.001), 3.90% (p<0.001), 4.44% (p<0.001) and 5.25% (p<0.001), respectively. BMI increased both during and post-lockdown periods among Chinese college students. However, during the lockdown, participants with higher BMI groups appeared to have a diminished BMI growth rate compared to those with lower BMI. After the lockdown, participants with higher BMI levels appeared to have an augmented BMI growth rate. Public policy action is needed to increase the level of physical activity of Chinese college students and take action to improve students' physical fitness performance after the lockdown.

Socioeconomic disparities and infancy growth trajectory: a population-based and longitudinal study

BackgroundThe association of low socioeconomic status (SES) with childhood and adolescent obesity has been reported. It is unknown whether low SES affects body mass index (BMI) growth trajectory in the first 12 mo of life. Moreover, accelerated growth as a compensatory mechanism for low birth weight (LBW) during infancy, is an important predictor of later obesity. The aim of the present study was to examine the association of low SES with infancy BMI growth rate and trajectory for LBW and normal birth weight (NBW) infants.MethodsFrom September 2012 to October 2014, a total of 387 infants in this longitudinal study was subjected to repeated measures of weight and length from birth to 12 mo in Hefei. Generalized growth mixture modeling was used to classify the infancy BMI growth trajectories. Differences in infancy BMI z score (zBMI) and BMI growth rate between low SES and high SES were estimated based on linear regression after adjusting for several confounders including maternal age, pregnancy BMI, physical activity during pregnancy, paternal BMI as well as alcohol use, paternal smoking status, breastfeeding duration and delivery mode.ResultsInfancy BMI trajectories in this study were classified into three categories: rapid growth (class 1), normal growth (class 2) and slow growth (class 3). Low SES infants had the higher zBMI than high SES infants for LBW group at age 6 mo [zBMI difference with 95% CI at 6 mo: 0.28(0.03, 0.53); at 12 mo: 0.21(0.01, 0.43)]. Low SES infants had more rapid zBMI growth rate than those with high SES for low birth weight between 0 and 6 months. Controlling for the confounders, these associations remained robust. We found the lower SES in the rapid growth group.ConclusionsThese findings highlighted the impact of low SES on increasing BMI and accelerated growth during early infancy. Health care and relatively optimal family environment in the first 12 mo of life, especially for LBW infants, are benefit to shape the better infancy growth trajectory.

Joint effects of ambient air pollution and maternal smoking on neonatal adiposity and childhood BMI trajectories in the Healthy Start study.

Participants were 526 mother-child pairs, born ≥37 weeks. Cotinine was measured at ~27 weeks gestation. Whole pregnancy and trimester-specific O3 and PM2.5 were estimated via. inverse-distance weighted interpolation from stationary monitors. Neonatal adiposity (fat mass percentage) was measured via. air displacement plethysmography. Child weight and length/height were abstracted from medical records. Interaction was assessed by introducing cotinine (<31.5 vs. ≥31.5 ng/mL [indicating active smoking]), O3/PM2.5 (low [tertiles 1-2] vs. high [tertile 3]), and their product term in linear regression models for birth weight and neonatal adiposity and mixed-effects models for BMI trajectories. The rate of BMI growth among offspring jointly exposed to maternal smoking and high PM2.5 (between 8.1 and 12.7 μg/m3) in the third trimester was more rapid than would be expected due to the individual exposures alone (0.8 kg/m2 per square root year; 95% CI = 0.1, 1.5; P for interaction = 0.03). We did not detect interactions between maternal smoking and O3 or PM2.5 at any other time on birth weight, neonatal adiposity, or BMI trajectories. Although PM2.5 was generally below the EPA annual air quality standards of 12.0 μg/m3, exposure during the third trimester may influence BMI trajectories when combined with maternal smoking.

Grandparents' wealth and the body mass index trajectories of grandchildren.

The aims of this study are to (i) examine associations between grandparents' wealth and grandchild's initial body mass index (BMI) in early childhood and its subsequent growth patterns, and to (ii) assess whether the associations are similar for white and black children. Data are from the U.S. Panel Study of Income Dynamics (PSID) and its supplemental studies of Child Development Supplement (CDS) and Transition to Adulthood (TA) (N = 2,128). Three-level growth curve models are used to analyze the association between exposure to grandparental wealth in early childhood and grandchildren's BMI growth trajectories, accounting for parental sociodemographic characteristics and maternal BMI levels. Children with less grandparental wealth in early childhood have higher initial BMI than children with more grandparental wealth. Further, increases in grandparental wealth in childhood are associated with a slower BMI growth rate. The wealth-body mass index associations are more evident among white children than black children. The study reveals a multigenerational social gradient to body mass index. Elevating the wealth levels of the grandparent generation could potentially reduce their grandchildren's obesity risk. The protective role of grandparental wealth seems to be more evident among white families than black families.

A three-year multifaceted intervention to prevent obesity in children of Mexican-heritage

BackgroundObesity and overweight have increased dramatically in the United States over the last decades. The complexity of interrelated causal factors that result in obesity needs to be addressed within the cultural dynamic of sub-populations. In this study, we sought to estimate the effects of a multifaceted, community-based intervention on body mass index (BMI) among Mexican-heritage children.MethodsNiños Sanos, Familia Sana (Healthy Children, Healthy Family) was a quasi-experimental intervention study designed to reduce the rate of BMI growth among Mexican-heritage children in California’s Central Valley. Two rural communities were matched based on demographic and environmental characteristics and were assigned as the intervention or comparison community. The three-year intervention included parent workshops on nutrition and physical activity; school-based nutrition lessons and enhanced physical education program for children; and a monthly voucher for fruits and vegetables. Eligible children were between 3 and 8 years old at baseline. Intent-to-treat analyses were estimated using linear mixed-effect models with random intercepts. We ran a series of models for each gender where predictors were fixed except interactions between age groups and obesity status at baseline with intervention to determine the magnitude of impact on BMI.ResultsAt baseline, mean (SD) BMI z-score (zBMI) was 0.97 (0.98) in the intervention group (n = 387) and 0.98 (1.02) in the comparison group (n = 313) (NS). The intervention was significantly associated with log-transformed BMI (β = 0.04 (0.02), P = 0.03) and zBMI (β = 0.25 (0.12), P = 0.04) among boys and log-transformed BMI among obese girls (β = − 0.04 (0.02), P = 0.04). The intervention was significantly and inversely associated with BMI in obese boys and girls across all age groups and normal weight boys in the oldest group (over 6 years) relative to their counterparts in the comparison community.ConclusionsA community-based, multifaceted intervention was effective at slowing the rate of BMI growth among Mexican-heritage children. Our findings suggest that practitioners should consider strategies that address gender disparities and work with a variety of stakeholders to target childhood obesity.Trial registrationclinicaltrials.gov Identifier: NCT01900613. Registered 16th July 2013.

Rate of change in body mass index at different ages during childhood and adult obesity risk.

Childhood body mass index (BMI) predicts adult obesity. How growth trajectories during childhood relate to adult obesity risk is not well defined. We aimed to characterize BMI growth trajectories from childhood to midlife and to examine the associations between BMI growth rates at childhood age points and adult obesity risk. The longitudinal study included 2732 participants with repeated BMI measurements from childhood (4-19y) to adulthood (20-51y). A random-effects model was used to construct BMI growth curves by race and sex. Model-estimated levels and linear growth rates of BMI were linked to adult obesity in separate multivariable logistic regression models at individual childhood age points. BMI followed cubic growth curves. Childhood BMI linear slope estimates were higher in adults with obesity than in adults without obesity (P<0.001). The association between childhood BMI growth rate and adult obesity was significantly higher in puberty and postpuberty (12-19y) than in early childhood (4-11y) with a peak at age 14 (odds ratio=3.1 and 95% confidence interval, 2.7-3.5). Rates of change in BMI at different childhood ages are differentially associated with adult obesity. Puberty and postpuberty are crucial periods for the development of obesity in later life.

Fetal exposure to maternal active and secondhand smoking with offspring early-life growth in the Healthy Start study.

Previous studies have modeled the association between fetal exposure to tobacco smoke and body mass index (BMI) growth trajectories, but not the timing of catch-up growth. Research on fetal exposure to maternal secondhand smoking is limited. To explore the associations between fetal exposure to maternal active and secondhand smoking with body composition at birth and BMI growth trajectories through age 3 years. We followed 630 mother-child pairs enrolled in the Healthy Start cohort through age 3 years. Maternal urinary cotinine was measured at ~ 27 weeks gestation. Neonatal body composition was measured using air displacement plethysmography. Child weight and length/height were abstracted from medical records. Linear regression models examined the association between cotinine categories (no exposure, secondhand smoke, active smoking) with weight, fat mass, fat-free mass, and percent fat mass at birth. A mixed-effects regression model estimated the association between cotinine categories and BMI. Compared to unexposed offspring, birth weight was significantly lower among offspring born to active smokers (-343-g; 95% CI: -473, -213), but not among offspring of women exposed to secondhand smoke (-47-g; 95% CI: -130, 36). There was no significant difference in the rate of BMI growth over time between offspring of active and secondhand smokers (p = 0.58). Therefore, our final model included a single growth rate parameter for the combined exposure groups of active and secondhand smokers. The rate of BMI growth for the combined exposed group was significantly more rapid (0.27 kg/m2 per year; 95% CI: 0.05, 0.69; p < 0.01) than the unexposed. Offspring prenatally exposed to maternal active or secondhand smoking experience rapid and similar BMI growth in the first three years of life. Given the long-term consequences of rapid weight gain in early childhood, it is important to encourage pregnant women to quit smoking and limit their exposure to secondhand smoke.

Longitudinal state-level effects on change in body mass index among middle-aged and older adults in the USA

Objective: The purpose of this longitudinal study was to examine the effects of state-level socioeconomic status (SES), the density of fast food restaurants and walking to work on body mass index (BMI) among US adults aged 50 years and older. The study sought further to account for the interaction effects of three different hierarchical levels of variables, including time-varying variables and time-invariant variables such as individual and state-level variables. Confounding related to environmental/neighbourhood effects was controlled for through sample selection. Methods: Data were drawn from the 2000–2010 Health and Retirement Study (HRS) and the 2010 US Census. HRS survey participants aged 50 years and older in 2000, residing in the same census tract during 2000–2010 ( N = 6,156) comprised the study sample. A three-level growth model was fitted to BMI trajectories. Results: BMI significantly increased over time showing both a linear and quadratic decelerating trajectory ( p &lt; .001) where BMI grew faster among sampled adults in their early 50s. Women living in the US states with a lower state-level SES had higher BMIs, while men with higher state-level SES had a higher BMI ( b = −.242, p = .013). In states with a higher proportion of people who walked to work, Hispanics had higher BMIs at baseline and a lower BMI growth rate, compared with non-Hispanic whites ( b = −.033, p &lt; .001). Conclusions: Obesity interventions specific to adults aged 50 years and older require greater emphasis. Potential health inequalities regarding weight gain can be ameliorated through tailoring interventions based on sex, environmental and state-level SES influences.

Social disparities in body mass index (BMI) trajectories among Chinese adults in 1991\u20132011

BackgroundObesity is a serious public health problem in China. The relationship between obesity and socio-economic status (SES) is changing and affected by uncertainty, particularly, in developing countries. The sex-related differences in body mass index (BMI) trajectories are controversial and require substantial empirical data for updating and enriching.MethodsThis study examined the relationship between SES and BMI in Chinese adults from a dynamic perspective using longitudinal data (1991–2011) from the China Health and Nutrition Survey (CHNS). Then, sex-related differences were determined. A hierarchical linear model was used.ResultsSES positively affected the male BMI changes, with faster BMI growth rates in the high-SES males over the past 20 years. By contrast, female BMI was only affected by BMI baseline and residential area. Specifically, greater BMI baseline led to greater BMI growth rate and earlier BMI decline. In the past 20 years, the BMI growth rate has been greater in the urban females than in the rural females.ConclusionsThe relationship between SES and obesity is complex in China, and a substantial sex-related difference exists. We argue that this large sex-related difference is due to the rapid economic and social changes that have affected national health and increased the gender inequality and social role restrictions in females. We provide insights for further research and policy recommendations.

Bayesian hierarchical piecewise regression models: a tool to detect trajectory divergence between groups in long-term observational studies

BackgroundBayesian hierarchical piecewise regression (BHPR) modeling has not been previously formulated to detect and characterise the mechanism of trajectory divergence between groups of participants that have longitudinal responses with distinct developmental phases. These models are useful when participants in a prospective cohort study are grouped according to a distal dichotomous health outcome. Indeed, a refined understanding of how deleterious risk factor profiles develop across the life-course may help inform early-life interventions. Previous techniques to determine between-group differences in risk factors at each age may result in biased estimate of the age at divergence.MethodsWe demonstrate the use of Bayesian hierarchical piecewise regression (BHPR) to generate a point estimate and credible interval for the age at which trajectories diverge between groups for continuous outcome measures that exhibit non-linear within-person response profiles over time. We illustrate our approach by modeling the divergence in childhood-to-adulthood body mass index (BMI) trajectories between two groups of adults with/without type 2 diabetes mellitus (T2DM) in the Cardiovascular Risk in Young Finns Study (YFS).ResultsUsing the proposed BHPR approach, we estimated the BMI profiles of participants with T2DM diverged from healthy participants at age 16 years for males (95% credible interval (CI):13.5–18 years) and 21 years for females (95% CI: 19.5–23 years). These data suggest that a critical window for weight management intervention in preventing T2DM might exist before the age when BMI growth rate is naturally expected to decrease. Simulation showed that when using pairwise comparison of least-square means from categorical mixed models, smaller sample sizes tended to conclude a later age of divergence. In contrast, the point estimate of the divergence time is not biased by sample size when using the proposed BHPR method.ConclusionsBHPR is a powerful analytic tool to model long-term non-linear longitudinal outcomes, enabling the identification of the age at which risk factor trajectories diverge between groups of participants. The method is suitable for the analysis of unbalanced longitudinal data, with only a limited number of repeated measures per participants and where the time-related outcome is typically marked by transitional changes or by distinct phases of change over time.

Genetic polymorphisms in genes related to risk-taking behaviours predicting body mass index trajectory among Mexican American adolescents.

Obesity is associated with multiple health problems and often originates in childhood. The purpose is to investigate the associations of genetic polymorphisms in genes related to risk-taking behaviours with body mass index (BMI) trajectory over adolescence among Mexican Americans. This study included 1229 Mexican American adolescents who participated in a large population-based cohort study in Houston, Texas. BMI data were obtained at baseline and two follow-ups. The median follow-up time was 59 months. Participants were genotyped for 672 functional and tagging variants in genes involved in the dopamine, serotonin and cannabinoid pathways. After adjusting for multiple comparisons, three genetic variants, namely, rs933271 and rs4646310 in COMT gene, and rs9567733 in HTR2A gene were significantly associated with BMI growth over adolescence. Using those three variants, we created an allelic score, and the allelic score was associated with BMI growth over adolescence (P < 0.001). With the increase number of variant allele, the rate of BMI growth over adolescence was slower. Finally, we identified another two genetic variants, namely, rs17069005 in HTR2A gene and rs3776511 in SLC6A3A gene were associated with obesity at last follow-up. The results suggest that genetic variants in selected genes involved in dopamine and serotonin pathways have noticeable effects on BMI over adolescence.

Multifaceted community-based intervention reduces rate of BMI growth in obese Mexican-origin boys.

Latino children and youth have some of the highest rates of overweight and obesity. Early intervention is important to prevent future obesity and illness in this population. A 3-year, multifaceted intervention was designed to reduce the rate of growth of body mass index (BMI) among Mexican-origin children. Two communities in California's agricultural Central Valley were targeted for intervention and comparison. To assess impact, anthropometric measures of participating children (N = 422) were collected and analysed at baseline and after 1 year of intervention. After 1 year of intervention, triceps skin-fold thickness in girls showed a significant decrease in unadjusted analysis between children in the two communities. In multivariate analysis, a reduction in BMI growth was seen among obese boys in the intervention community (ß-coefficient = -1.94, P = 0.05). Obese boys in the intervention community also had a smaller increase in waist circumference (ß-coefficient = -5.2, P = 0.04) than the comparison community. These early findings indicate the intervention's effectiveness for preventing BMI growth among obese boys. Longitudinal follow-up is needed to determine the sustainability of results and whether similar results extend to obese girls and overweight boys or girls.

A longitudinal examination of childhood maltreatment and adolescent obesity: Results from the National Longitudinal Study of Adolescent Health (AddHealth) Study

ObjectivesWe sought to explore the association between childhood maltreatment (e.g., neglect, physical and sexual abuse) and longitudinal growth trajectories of body mass index (BMI) from adolescence to young adulthood. MethodsWe used latent curve modeling to examine data from the National Longitudinal Study of Adolescent Health (N=8,471), pooling years 1995–2008. Relative weight was indicated by BMI. ResultsChildren who experienced neglect had a faster average rate of BMI growth over time compared to children who experienced no childhood maltreatment. In addition, the co-occurrence of childhood neglect and physical abuse was related to increased levels of BMI at baseline, even after adjustment for 14 separate child and parental demographic and psychosocial characteristics. Parental obesity and education, child birth place, and family income were also associated with both baseline BMI and the rate of change in BMI over time. ConclusionChildhood neglect plays a role in the development of adolescent obesity. Future research should examine potential mediators or moderators of the longitudinal relation between childhood neglect and adolescent and young adult obesity including impulsivity, depression, and compulsive eating behavior.

Associations between the home and school environments and child body mass index

This paper examined associations between various aspects of home and school environments and child body mass index (BMI) in the Early Childhood Longitudinal Study - Kindergarten cohort, a panel dataset of US children collected from 1998 to 2004. Using three-level growth curve modeling with a sample of approximately 11,400 children, it assessed whether these aspects were related to initial BMI and to the rate of growth of BMI over the period from kindergarten to fifth grade, independent of a large number of controls. A number of home and school factors were associated with initial BMI and the growth of BMI. Greater hours of sleep by children, more lunches eaten at school, and the adequacy of their school cafeterias and the adequacy of their school gymnasiums were all significantly associated with lower initial levels of BMI. More breakfasts typically eaten per week with their families and greater minutes of recess (free time for activity at school) were each associated with decreases in the rate of BMI growth over time, while more television watched, greater average hours of weekly maternal employment, more school lunches and school breakfasts eaten, and the adequacy of children's gymnasiums were associated with faster rates of BMI growth over the study period. The study adds to the existing literature on environmental influences on child BMI by illustrating the utility and necessity of examining multiple influences within a single analytic framework. Further research and policy efforts should continue to acknowledge the multi-etiological manner by which the environment can affect rates of child obesity.

Reference values for change in body mass index from birth to 18 years of age

Body mass index (BMI) has become the measure of choice for determination of nutritional status during the paediatric years, as in adults. Recently, several cross-sectional BMI childhood reference values standards have been published. In order precisely to evaluate childhood nutritional interventions, reference values allowing for the evaluation of changes in BMI values are also needed. For the first time, such reference values can be presented based on 3650 longitudinally followed healthy Swedish children born full term. The reference values for the change in BMI are given as the change in BMI standard deviation scores. The reference values are given as means of mathematical functions adjusting for gender, age of the child and the length of the interval between two measurements for interval lengths of 0.25 to 1.0 y before 2 y of age and of 1 to 5 y between birth and 18 y. The usefulness of the reference values is proved by a graph that forms a part of a clinical computer program; the -2 to +2 standard deviation range of the predicted change in BMI can be computed for an individual child and drawn in the graph as an extended support for clinical decision-making. For the first time this communication gives access to BMI growth rate values that can be used both in research and in the clinic to evaluate various interventions, be they nutritional, surgical or therapeutic.

Reference values for change in body mass index from birth to 18 years of age

Body mass index (BMI) has become the measure of choice for determination of nutritional status during the paediatric years, as in adults. Recently, several cross-sectional BMI childhood reference values standards have been published. In order precisely to evaluate childhood nutritional interventions, reference values allowing for the evaluation of changes in BMI values are also needed. For the first time, such reference values can be presented based on 3650 longitudinally followed healthy Swedish children born full term. The reference values for the change in BMI are given as the change in BMI standard deviation scores. The reference values are given as means of mathematical functions adjusting for gender, age of the child and the length of the interval between two measurements for interval lengths of 0.25 to 1.0 y before 2y of age and of 1 to 5 y between birth and 18 y. The usefulness of the reference values is proved by a graph that forms a part of a clinical computer program; the -2 to +2 standard deviation range of the predicted change in BMI can be computed for an individual child and drawn in the graph as an extended support for clinical decision-making. Conclusion: For the first time this communication gives access to BMI growth rate values that can be used both in research and in the clinic to evaluate various interventions, be they nutritional, surgical or therapeutic.