A longitudinal study investigating change in BMI z-score in primary school-aged children and the association of child BM
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RESEARCH ARTICLE
Open Access
A longitudinal study investigating change in BMI z-score in primary school-aged children and the association of child BMI zscore with parent BMI R. Mears1,2* , R. Salway2, D. Sharp1, J. P. H. Shield3,4 and R. Jago2
Abstract Background: This paper aims to explore change in BMI z-score through childhood and the association between parent BMI and child BMI z-score. This is important to understand for the development of effective obesity interventions. Methods: Data from the longitudinal B-ProAct1v study (1837 participants) were analysed. A paired sample t-test examined changes in child BMI z-score between Year 1 and 4. Multivariable linear regression models examined the cross-sectional associations between child BMI z-score and parent BMI in Year 1 and 4. The influence of change in parental BMI between Year 1 and Year 4 on child BMI z-score in Year 4 was explored through regression analyses, adjusted for baseline BMI z-score. Results: There was a strong association between child BMI z-score at Year 1 and 4. Child mean BMI z-score score increased from 0.198 to 0.330 (p = < 0.005) between these timepoints. For every unit increase in parent BMI, there was an increase in child BMI z-score of 0.047 in Year 1 (p = < 0.005) and of 0.059 in Year 4 (p = < 0.005). Parental BMI change was not significantly associated with Year 4 child BMI z-score. Conclusion: The key indicator of higher child BMI at Year 4 is high BMI at Year 1. Further studies are needed to explore the impact of parental weight change on child BMI z-score and whether interventions targeted at overweight or obese parents, can improve their child’s BMI z-score. Keywords: Obesity, Parents, Children, Public health
Background The global prevalence of overweight and obese children has risen in the past four decades from 4% in 1975 to 18% in 2016 [1, 2].Within the 34 Organisation for Economic Cooperation and Development (OECD) countries, the UK is ranked 9th for childhood overweight * Correspondence: [email protected] 1 Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK 2 Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK Full list of author information is available at the end of the article
prevalence [3, 4] In England, the National Child Measurement Programme (NCMP) assesses weight status in Reception (aged 4–5 years) and Year 6 (aged 10–11 years) of primary school [5] and local analyses have shown a rise in child BMI z-score between these ages [6]. Overweight children are more likely to become overweight adults [7], with the associated socioeconomic and health related consequences presenting a major public health challenge [8]. Parental obesity is a known risk factor for childhood obesity [9–13] though the literature is less clear whether
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distributi
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