BMI Growth Research Articles

PFAS exposures and child growth: a longitudinal study from fetal life to early childhood.

PFAS exposures and child growth: a longitudinal study from fetal life to early childhood.

Long-term outcomes of untreated micropenis: growth patterns and predictive factors

BackgroundMicropenis, defined as a penile length more than 2.5 standard deviations below the mean for age and population, presents significant concerns for patients and parents. Despite current guidelines recommending multidisciplinary management, there is limited evidence on long-term outcomes, particularly in untreated patients.MethodsThis prospective cohort study involved 46 male children aged 7–9 years presenting with micropenis at the Ali Asghar Endocrine Clinic from 2015 to 2023. Initial penile size, BMI, and other growth parameters were measured, with biannual follow-ups extending 3 years post-bone fusion to evaluate growth rates and influential factors.ResultsInitial mean stretched penile length (SPL) was 3.22 ± 0.21 cm. Significant increases in penile size were observed across all intervals, with the highest growth rates occurring between the first- and second-years post-fusion. BMI emerged as the most significant predictor of penile growth, while initial SPL was the least influential factor. By the third-year post-fusion, the vast majority of subjects (44) achieved penile lengths within the normal range. Two patients, while showing penile growth over time, remained below the cutoff value defined by reference standards.ConclusionOur findings indicate that most untreated micropenis patients reach normal penile size by adulthood, highlighting the importance of monitoring growth rates rather than focusing only on initial penile size. This study provides critical insights for developing guidelines and management strategies for micropenis, emphasizing the necessity of continued follow-up to ensure optimal outcomes.

Childhood Exposure to Air Pollution, Body Mass Index Trajectories, and Insulin Resistance Among Young Adults

Emerging evidence suggests that exposure to air pollution affects children's glucose metabolism. However, the underlying mechanisms are not fully understood. To investigate whether body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) growth trajectories mediate the association between traffic-related air pollution (TRAP) and insulin resistance. As part of the Southern California Children's Health Study, the ongoing Meta-Air2 cohort substudy followed up participants from pregnancy to 24 years of age and examined the mediation role of BMI. Cardiometabolic follow-up was initiated as participants transitioned into adulthood. Data from the Meta-Air2 substudy were collected from November 27, 2018, to May 31, 2023. The California Line Source Dispersion Model was used to calculate mean childhood exposure to traffic-related total nitrogen oxides (NOx) from pregnancy to 13 years of age by calculating mean monthly estimates. Traffic density within a 300-m buffer around participants' residence was calculated as a secondary outcome. Insulin resistance markers were assessed during the recent visit in young adulthood, including the homeostatic model assessment of insulin resistance (HOMA-IR; calculated from fasting glucose and insulin levels) and glycated hemoglobin (HbA1c) level. Participants' BMI growth trajectories, including BMI at 13 years of age and accelerated BMI growth, were analyzed as potential mediators. Using fully adjusted PROCESS macro mediation models, their role in mediating the association between traffic-related total NOx exposure and insulin resistance was examined with adjustment for demographic characteristics, smoking status, and parental history of diabetes. Among the 282 participants (mean [SD] age, 24.0 [1.7] years), each 1-SD increase in childhood exposure to traffic-related total NOx was associated with a BMI increase of 0.71 (95% CI, 0.29-1.13) at 13 years of age and adult HOMA-IR increase of 0.55 (95% CI, 0.23-0.87). An estimated mediation effect identified BMI at 13 years of age combined with accelerated BMI growth as accounting for 41.8% of the estimated total effect (β, 0.23; 95% bootstrap CI, 0.01-0.52) between total NOx and HOMA-IR. Similar patterns were observed when exploring traffic density as an exposure or HbA1c level as an outcome. In this cohort study of young adults, the long-term association between TRAP and insulin resistance may be partially explained by higher BMI and accelerated BMI growth from early adolescence into young adulthood. These findings highlight the importance of weight management in children, particularly those residing in highly polluted areas.

Exploring the bidirectional associations of ADHD symptomatology, nutritional status, and body composition in childhood: evidence from a Brazilian Birth Cohort Study.

Attention deficit hyperactivity disorder (ADHD) has been linked to excessive weight; however, the underlying mechanisms of this association are not well understood. To date, the bidirectional associations between ADHD and nutritional status in childhood have been explored in a limited number of studies, with particularly few of those incorporating body composition data. This study aims to evaluate the associations of ADHD symptoms, nutritional status, and body composition in childhood. We analyzed data from 3940 children from the 2015 Pelotas (Brazil) Birth Cohort at 4 and 6-7 years of age. Linear regression was performed to evaluate the association between ADHD symptoms and nutritional status (weight, height, and body mass index [BMI]) at ages 4 and 6-7, as well as body composition, specifically fat mass (FF) and fat-free mass (FFM) at ages 6-7. Moreover, a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI was performed to explore the bidirectional associations. ADHD symptoms were associated with increased height (β 0.01, 95%CI 0.001, 0.026) and FFM (β 0.02, 95%CI 0.008-0.035) at age 4, and increased BMI (β0.02, 95%IC 0.002, 0.038), weight (β 0. 02, 95%CI 0.005, 0.039), height (β 0.01, 95%CI 0.000, 0.024), and FFM (β 0.02, 95%CI 0.012, 0.040) at ages 6-7. Although the CLPM indicated a small effect suggesting a bidirectional relationship between ADHD symptoms and BMI, the observed associations were not statistically significant: ADHD scores at age 4 predicting BMI z-scores at ages 6-7 (β 0.003; 95% CI: -0.026, 0.020), and BMI z-scores at age 4 predicting ADHD scores at ages 6-7 (β 0.013; 95% CI: -0.018, 0.044). Children with higher ADHD symptoms showed increased growth in weight, height, and BMI. The observed increase in weight and BMI was attributed to greater FFM in these children.

일제강점기 조선과 현대 한국 남학생의 성장 비교

This study analyzed changes in physical development by comparing the growth patterns of Korean male students during the Japanese colonial period and modern Korea. Using the ‘Physical Examination Results of Korean School Students’ of the Government-General of Korea in 1916 and the 2017 Child and Adolescent Growth Chart, we compared age-related changes in height, weight, and BMI and growth rates. Modern male students were taller and heavier than Joseon male students, and their height and weight growth rates and BMI growth rates were also faster. Most of the BMIs of Joseon male students were underweight by modern standards. This study confirmed the impact of changes in the times on physical development through a comparison of growth patterns and derived modern implications.

Body mass index and head circumference growth charts for the United Arab Emirates-the UAEMCGS 2 study

This study was undertaken to establish the UAE population’s normal BMI and HC growth charts. BMI growth charts represent BMI values at each age and gender-specific percentiles. The UAE’s development is unique in its cultural practices and genetic makeup; therefore, extrapolating health determinants from other nations to the UAE is unwise. It is, therefore, essential to have reference growth parameters for the UAE population. In this cross-sectional study, we measured BMI and Head Circumference in 20,998 infants and children, of both sexes, 0–18 years of age from all seven states that make up the United Arab Emirates (UAE), enabling us to construct the BMI and HC charts for the UAE. Using the LMS system BMI and HC charts were created. The prevalence of obesity ranged from 0 to 5.9% in males and from 0.8 to 6.6% in females at different ages. The mean BMI values for each age in both sexes were statistically significantly larger than those obtained in UAE children 30 years ago. Our study provides BMI and head circumference charts tailored to the growth patterns of UAE children.

Longitudinal DNA methylation profiles in saliva of offspring from mothers with gestational diabetes: associations with early childhood growth patterns

BackgroundThe prevalence of obesity and type 2 diabetes mellitus (T2DM) is rising globally, particularly among children exposed to adverse intrauterine environments, such as those associated with gestational diabetes mellitus (GDM). Epigenetic modifications, specifically DNA methylation, have emerged as mechanisms by which early environmental exposures can predispose offspring to metabolic diseases. This study aimed to investigate DNA methylation differences in children born to mothers with GDM compared to non-GDM mothers, using saliva samples, and to assess the association of these epigenetic patterns with early growth measurements.MethodsThis study analyzed saliva DNA methylation patterns in 30 children (15 born to GDM mothers and 15 to non-GDM mothers) from the EPIDG cohort. Samples were collected at two time points: 8–10 weeks postpartum and at one year of age. Epigenome-wide analysis of over 850,000 CpG sites was conducted using the Illumina Methylation EPIC Bead Chip. Differential methylation positions (DMPs) were identified with the limma package, using a significance threshold of p < 0.01 and delta β ≥ 5%. Correlation analysis examined associations between methylation and growth variables (weight, height, BMI and annual growth) using Spearman tests.ResultsWe identified 6,968 DMPs at the postpartum stage and 5,132 after one year, with 50 sites remaining differentially methylated over time, 16 of which maintained consistent methylation directionality. Functional analysis linked several of these DMPs to genes involved in inflammation and metabolic processes, including CYTH3 and FARP2, both implicated in growth and metabolic pathways. Significant correlations were found between specific CpG sites and growth-related variables such as weight, head circumference, height, and BMI.ConclusionsThis study’s longitudinal design reveals stable DNA methylation patterns in saliva samples that differentiate GDM-exposed children from controls across the first year of life, highlighting the feasibility of saliva as a minimally invasive biomarker source. The persistence of these epigenetic signatures underscores their potential as early indicators of metabolic risk, offering valuable insights into the long-term impact of maternal GDM on child health. Although the use of saliva offers a practical and non-invasive tool for pediatric epigenetic research, further studies are necessary to validate these findings in larger populations.

Household Income Moderates Longitudinal Relations Between Neighborhood Child Opportunity Index and BMI Growth.

Background: To examine longitudinal associations of early neighborhood Child Opportunity Index 2.0 (COI) with children's BMI trajectories and identify whether household economic resources moderate relations of COI in infancy/toddlerhood and the preschool years to longitudinal BMI growth between 2 and 12 years. Methods: Family data (n = 1091) were drawn from the Family Life Project, a longitudinal study of families residing in rural high-poverty areas. Neighborhood COI was obtained for each developmental period: infancy/toddlerhood (2-15 months) and the preschool years (2-5 years). BMIs were created from anthropometrics collected at six time points. Results: Higher neighborhood COIs during the infancy/toddlerhood (β = -0.0130, p < 0.01) and preschool years (β = -0.0093, p < 0.05) were associated with lower BMI at 5 years of age; although the latter became nonsignificant after adjusting for infancy/toddlerhood COI. Both household income and time spent in poverty moderated associations of infancy/toddlerhood exposure to neighborhood COI with BMI change. Among children residing in not poor households, higher neighborhood level child opportunity was associated with a slower increase in BMI from 2 to 12 years (β = -0.0369, p < 0.05), and a lower BMI at 12 years (β = -0.0395, p < 0.05). Conclusions: Neighborhood COI during the infant and toddler years is longitudinally associated with child growth, and long-term associations are evident among children residing in not poor households. Future work is needed to better understand how family and neighborhood-level resources interact to influence obesity risk, particularly for those at high risk.

GLP-1R gene polymorphisms and metabolic traits during childhood and adolescence: The EPOCH study.

This is the first study to examine the association between variants of the glucagon-like-peptide-1 receptor gene (GLP-1R) and metabolic characteristics among youth. We explored separate associations of three GLP-1R polymorphisms (rs10305420, rs6923761, and rs1042044) with BMI trajectories and markers of glucose-insulin homeostasis. Mixed models examined associations between GLP-1R polymorphisms and trajectories of BMI. Linear models examined associations of GLP-1R polymorphisms with glucose and insulin concentrations across OGTT, insulin sensitivity (HOMA2-IR), insulin secretion (insulinogenic index and HOMA2-%B), and beta cell function (oral disposition index). Rs10305420 and rs6923761, but not rs1042044, were associated with growth and metabolic characteristics in early life. Rs6923761 genotype GG was associated with faster BMI growth velocity, when compared to carriers of the minor allele (difference in velocity [95% CI]: 0.16 kg/m2/year [0.07, 0.24] at age 10), which led to significantly higher average BMI by age 16 (average difference [95% CI]: 1.29 kg/m2 [0.22, 2.37]). Rs10305420 CC and rs6923761 GG genotypes had higher HOMA2-IR (β[95% CI]: 1.19%[1.06, 1.32] and 1.13%[1.01, 1.26], respectively) compared to minor allele carriers. Rs10305420 CC had higher HOMA2-%B (β[95% CI]: 1.09%[1.01, 1.17]), and higher stimulated insulin secretion at 30-minutes (β[95% CI]: 27.62 uIU/mL [3.00, 25.24]) and 120-minutes (β[95% CI]: 18.94 uIU/mL [1.04, 36.84), when compared to carriers of the minor allele. GLP-1R polymorphisms were associated with faster BMI growth across development, and lower estimated insulin sensitivity and higher compensatory insulin secretion during adolescence. GLP-1R polymorphisms should be considered in future pediatric studies of genetic susceptibility for obesity and diabetes.

Telemedicine Integrated Care Versus In-Person Care Mode for Patients With Short Stature: Comprehensive Comparison of a Retrospective Cohort Study.

Telemedicine has demonstrated efficacy as a supplement to traditional in-person care when treating certain diseases. Nevertheless, more investigation is needed to comprehensively assess its potential as an alternative to in-person care and its influence on access to care. The successful treatment of short stature relies on timely and regular intervention, particularly in rural and economically disadvantaged regions where the disease is more prevalent. This study evaluated the clinical outcomes, health-seeking behaviors, and cost of telemedicine integrated into care for children with short stature in China. Our study involved 1241 individuals diagnosed with short stature at the pediatric outpatient clinic of Peking University Third Hospital between 2012 and 2023. Patients were divided into in-person care (IPC; 1183 patients receiving only in-person care) and telemedicine integrated care (TIC; 58 patients receiving both in-person and virtual care) groups. For both groups, the initial 71.43% (average of 58 percentages, with each percentage representing the ratio of patients in the treatment group) of visits were categorized into the pretelemedicine phase. We used propensity score matching to select individuals with similar baseline conditions. We used 7 variables such as age, gender, and medical insurance for the 1:5 closest neighbor match. Eventually, 115 patients in the IPC group and 54 patients in the TIC group were selected. The primary clinical outcome was the change in the standard height percentage. Health-seeking behavior was described by visit intervals in the pre- and post-telemedicine phases. The cost analysis compared costs both between different groups and between different visit modalities of the TIC group in the post-telemedicine phase. In terms of clinical effectiveness, we demonstrated that the increase in height among the TIC group (ΔzTIC=0.74) was more substantial than that for the IPC group (ΔzIPC=0.51, P=.01; paired t test), while no unfavorable changes in other endpoints such as BMI or insulin-like growth factor 1 (IGF-1) levels were observed. As for health-seeking behaviors, the results showed that, during the post-telemedicine phase, the IPC group had a visit interval of 71.08 (IQR 50.75-90.73) days, significantly longer than the prior period (51.25 [IQR 34.75-82.00] days, P<.001; U test), whereas the TIC group's visit interval remained unchanged. As for the cost per visit, there was no difference in the average cost per visit between the 2 groups nor between the pre- and post-telemedicine phases. During the post-telemedicine phase, within the TIC group, in-person visits had a higher average total cost, elevated medical and labor expenses, and greater medical cost compared with virtual visits. We contend that the rise in medical visits facilitated by integrating telemedicine into care effectively restored the previously constrained number of medical visits to their usual levels, without increasing costs. Our research underscores that administering prompt treatment may enable physicians to seize a crucial treatment opportunity for children with short stature, thus attaining superior results.

Growth Status of Bangladeshi Children in Functional Constipation: Experience From A Tertiary Care Hospital

Background: Constipation is one of the common complaints of children with long-term hazardous consequences. It is a frequent cause of hospital visit in both primary and specialized care which needs proper evaluation and management. Recently in few studies, impairment of growth status has been reported as a result of functional constipation. But the relation is not well evaluated, especially in the pediatric population of our country. Aim: To assess the growth status of Bangladeshi children in functional constipation. Methods: This analytical study was conducted at the department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka. A total 150 children aged 2-18 years were enrolled in this study. Children were divided into two groups, 75 having functional constipation (FC) and 75 healthy children with no constipation. Samples were collected randomly from pediatric out-patient department of BSMMU with consent of parents and child’s approval. Diagnosis of functional constipation was made by Rome IV criteria. Children with any red flag sign, chronic disease and on treatment of constipation were excluded from the study. Growth status (weight, height &amp; BMI) was evaluated by using growth charts. Data collected in semi-structured questionnaire and analyzed by SPSS 23.0. Results: We evaluated 75 constipated children with the mean age of 7.61±3.50 years and 75 healthy children with the mean age of 7.40±3.88 years. The mean weight of children with functional constipation was 22.8±10.01 kg, mean height 117.7 ±18.4 cm and BMI 15.6±2.3 kg/m2. The mean weight of children with no constipation was 28.6± 13.72 kg, mean height 124.49±23.3 cm and BMI 18.11±2.9 kg/m2,demonstrated significant difference between two sets. In functional constipation group, on weight for age and height for age chart, 28% and 24% children were below the 3rd centile respectively and 18.6% children had BMI below 5th centile. All these parameters (weight, height, BMI) were statistically significant in compare to children without constipation and p value is &lt;.05. Presenting features of functional constipation were anorexia (64%), abdominal pain (73.3%), hard stool (84%), blood mixed hard stool (13.3%) and nausea (34%). Conclusion: Growth impairment occurs in children with functional constipation in comparison to children without constipation. Children aged 2 to 18 years with functional constipation may have decelerated weight, height and BMI growth. And this observation needs further large-scale multicenter study for ensuring optimal growth of children with constipation. J Shaheed Suhrawardy Med Coll 2023; 15(1): 73-77

Change in Child Opportunity Index in Early Childhood Is Associated with Youth BMI Growth.

Background: The neighborhood-level child opportunity index (COI) has been used in policy-based initiatives to identify and improve low-resource neighborhoods in order to impact child health. Understanding of how changes in COI can impact child growth, however, is lacking. Methods: Participants were 1124 children from the Family Life Project, a longitudinal birth cohort of families in rural, high-poverty areas. Youth anthropometrics were measured at eight assessments (ages 2 months through 12 years). Neighborhood COI was obtained at seven assessments (ages 2 months through 5 years) and used to create seven trajectory groups representing a change in COI: stayed low on all seven assessments, stayed moderate, stayed high, left low, declined from moderate, declined from high, and bounced around. Results: As hypothesized, moving from high COI neighborhoods into lower COI neighborhoods was associated with greater BMI growth and increased risk for obesity and severe obesity at 12 years. As hypothesized, the opposite effect, which approached significance at p = 0.056, was found among children who moved from low COI neighborhoods into higher COI neighborhoods. Specifically, moving into higher COI neighborhoods was associated with reduced BMI growth, and lower risk for severe obesity at 12 years. Conclusions: Moving into higher COI neighborhoods may be associated with healthier BMI growth, while the opposite effect may occur when moving into lower COI neighborhoods. Given the use of the COI in public health initiatives and growing evidence for its potential positive impact on child growth, future work is needed to replicate our findings among larger diverse samples.

The role of child BMI growth in neurodevelopment and school readiness-Current landscape and future directions.

The role of child BMI growth in neurodevelopment and school readiness-Current landscape and future directions.

Early childhood executive control modulates negative affectivity's role in increasing adolescent body mass index trajectories.

Executive control and temperament have been associated with pediatric obesity. However, interactions between these constructs in relation to future weight outcomes have not been investigated. This longitudinal study examined early childhood executive control, early temperament (negative affectivity and surgency), and their interactions as predictors of adolescent BMI trajectories. At age 5.25, children (N = 229) completed executive control tasks, and parents completed the Child Behavior Questionnaire to assess temperament. BMI was calculated annually between ages 14-17. Greater early negative affectivity predicted more positive BMI growth. Although early childhood executive control was not associated with BMI growth, greater negative affectivity predicted greater BMI escalation at average and below average executive control abilities. For children without robust executive control abilities early in development, negative affectivity may be a risk factor for accelerated adolescent BMI growth. Targeted assessment of early risk factors may be useful for childhood obesity prevention efforts.

Exploring the importance of family socio-economic position on the association between parental BMI and offspring BMI trajectories

PurposeWe aimed to investigate the associations between parental BMI and offspring BMI trajectories and to explore whether the parent-offspring BMI growth trajectory association differed according to family SEP or social mobility. MethodsWe used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Children’s weight and height were collected from 1 to 18 years. Parents’ height and weight were reported pre-pregnancy. We assessed family SEP by measuring parents’ and grandparents’ educational attainment, social class, and social mobility by changes in education attainment across generations. Multilevel models were used to develop trajectories and assess patterns of change in offspring BMI, to associate parental BMI with these trajectories, and explore whether these associations differed by family SEP and social mobility. Results13,612 children were included in the analyses. The average BMI of offspring whose parents were overweight or obese was higher throughout childhood and adolescence, compared to those with parents of normal BMI. Parental and grandparental low SEP were associated with higher child BMI, but there was little evidence of modification of parent-offspring associations. For example, at age 15 years the predicted mean BMI difference between children of overweight or obese mothers versus normal-weight mothers was 12.5 % (95 %CI: 10.1 % to 14.7 %) and 12.2 % (95 %CI: 10.3 % to 13.7 %) for high and low grandparental SEP, respectively. DiscussionThese findings strengthen the evidence that higher parental BMI and lower family SEP were associated with higher offspring BMI, but we did not observe strong evidence that family SEP modifies the parental-offspring BMI association.

BMI Growth Profiles Among Black Children from Immigrant and US-Born Families.

A large body of research has documented racial/ethnic disparities in childhood obesity in the United States (US) but less work has sought to understand differences within racial groups. Longitudinal studies are needed to describe BMI trajectories across development, particularly for Black children from immigrant families who have been underrepresented in childhood obesity research. The current study utilizes BMI data collected longitudinally from ages 5 to 8 years and growth mixture modeling to (1) identify and visualize growth patterns among Black children from primarily Caribbean immigrant families, and (2) to compare these patterns to growth trajectories among Black children from US-born families. First, we identified four classes or trajectories of growth for Black children from immigrant families. The largest trajectory (70% of the sample) maintained non-overweight throughout the study period. A second trajectory developed overweight by age 8 (25%). Two small trajectory groups demonstrated high rates of moderate and severe obesity-i.e., specifically, a trajectory of accelerated weight gain ending in moderate/severe obesity (3%), and a trajectory of early severe obesity with BMI decreasing slightly with age (2%). We identified a very similar four class/trajectory model among Black children from US-born families, and compared the model to the one for children from immigrant families using multi-group growth mixture modeling. We found that the patterns of growth did not differ significantly between the populations, with two notable exceptions. Among Black children from immigrant families, ∼ 5% were classified into the two heavier BMI trajectories, compared to ∼ 11% of children from US-born families. Additionally, among children with an accelerated weight gain trajectory, children from immigrant families had lower BMIs on average at each time point than children from US-born families. These findings describe the multiple trajectories of weight gain among Black children from immigrant families and demonstrate that although these trajectories are largely similar to those of Black children from US-born families, the differences provide some evidence for lower obesity risk among Black children from immigrant families compared to Black children from US-born families. As this study is the first to describe BMI trajectories for Black children from immigrant families across early and middle childhood, future work is needed to replicate these results and to explore differences in heavier weight trajectories between children from immigrant and US-born families.

Development of specific growth charts for children with Fanconi anemia.

Patients with Fanconi anemia (FA) are often perceived to have poor growth when general population growth curves are utilized. We hypothesize that FA patients have unique growth and aimed to create FA-specific growth charts. Height and weight data from ages 0 to 20 years were extracted from medical records of patients treated at the Fanconi Anemia Comprehensive Care Clinic at the University of Minnesota. Height, weight, and BMI growth curves were generated and fitted to reference percentiles using the Lambda-Mu-Sigma method. FA-specific percentiles were compared to WHO standards for ages 0-2 and CDC references for ages 2-20. In FA males, the 50th height- and weight-for-age percentiles overlap with the 3rd reference percentile. In FA females, only the 50th height-for-age percentile overlaps with the 3rd reference percentile. For weight, FA females show progressive growth failure between 6 and 24 months followed by stabilization around the 50th percentile. The FA BMI-for-age percentiles show similar patterns to the weight-for-age percentiles but have different timing of onset of adiposity rebound and broader variability in females. Growth in FA patients follows a different trajectory than available normative curves. FA-specific growth charts may be useful to better guide accurate growth expectations, evaluations, and treatment.

Limitations of BMI z scores for assessing weight change: A clinical tool versus individual risk.

Although pediatric growth curves provide clinical utility, using these metrics for within-person change over time can be misleading. As research is focused on understanding cardiometabolic consequences of weight gain, it is important to use precise metrics to analyze these longitudinal research questions. Despite several foundational recommendations to limit the use of reference pediatric growth curves (e.g., BMI z scores) for within-person longitudinal research, it has evolved into the "gold standard" for using growth curves for pediatric weight gain analyses. Therefore, the objective of this paper is to discuss (A) the methodology used to create reference growth curves; (B) the appropriate use of reference pediatric BMI growth curves within the context of cross-sectional and longitudinal analyses in research; and (C) how to select metrics based on desired evaluations. Careful consideration using standardized references scores is essential when assessing obesity-related questions and comorbid risk over time in pediatric populations.

Changes in the Morphological Development of Youth aged 16-18 from Eastern Poland in the Years 2006 - 2016 – 2021

On the one hand, the number of individuals with excess body weight is increasing, while on the other, the issue of malnutrition among adolescents is becoming increasingly noticeable. Aim: To determine differences in the magnitude of secular trends in height and body mass, BMI, and the occurrence of underweight, normal weight-to-height proportions, overweight, and obesity in adolescents. Materials and Methods: The study was conducted from 2006 to 2021. Height and body mass were measured, and BMI was calculated. The results were statistically analyzed. Results: In the examined girls and boys in the decade from 2006 to 2016, a slowdown in height growth and slight positive changes in body mass and BMI were observed. The results from 2016 to 2021 confirmed a continued trend of increasing somatic characteristics, mainly body mass. Considering the BMI value in both observation periods, a slight decrease in the frequency of underweight and normal BMI was noted in all groups, while a significant increase in the prevalence of overweight and obesity was observed. Conclusions: The temporal trends presented in this study emphasize the need for regular monitoring of the development of adolescents in eastern Poland, as well as the implementation of proactive public health strategies.

Establishing Body Mass Index growth charts for Pakistani children and adolescents using the lambda-mu-sigma (LMS) and quantile regression method.

Assessment of growth and nutritional status is an essential part of clinical evaluation and care in pediatrics. Therefore, we aimed to establish age and gender specific smoothed BMI growth reference charts of Pakistani children and adolescents aged 2-18 years and to compare our LMS median percentile values with WHO 2007 international references and with references from other foreign studies. A representative cross-sectional sample of 10,668 healthy Pakistani subjects aged 2 to 18 years was studied. For calculation of BMI (kg/m2), height (cm) and weight (kg) were measured using standard procedures. Age and gender specific smoothed BMI growth reference values and associated charts were obtained using lambda-mu-sigma (LMS) as well as quantile regression (QR) statistical methods. In the sample studied, the mean (±SD) BMI of all subjects was 16.50 (±2.83 kg/m2). Smoothed BMI percentile curves (5th, 10th, 25th, 50th, 75th, 90th and 95th) obtained by using LMS and QR methods, showed that BMI increased with age in both sexes. During pubertal age, girls had larger percentiles than boys. Centile values estimated by the LMS and QR procedure had small variability from the empirical centiles. Comparison of LMS BMI 50th percentile with references from WHO 2007 and data from other countries demonstrated that Pakistani children had substantially lower BMI percentiles than their counterparts in the reference population. This comprehensive study suggests that WHO 2007 references are not suitable for Pakistani children. The QR method should be considered as an alternative method to develop growth charts.