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Pediatrics

Looking backwards and forwards: tracking and persistence of weight status between early childhood and adolescence

International Journal of Obesity volume 45, pages 870–878 (2021)Cite this article

Subjects

Abstract

Background/objective

Many studies have shown that child BMI or weight status tracks over time, but the demographic predictors of high tracking have not been investigated. Our objective was to identify demographic predictors of persistence (duration) of healthy weight and overweight/obesity throughout childhood, and to examine whether tracking was age dependent.

Methods

We conducted secondary data analysis of 4606 children from the Birth cohort and 4983 children from the Kindergarten cohort of the Longitudinal Study of Australian Children with follow-up to age 12/13 and 16/17 years, respectively. Retrospective and prospective tracking were examined descriptively. Time-to-event analysis determined demographic predictors of persistence of healthy weight and overweight/obesity beyond age 4–5 years, after controlling for child BMI z-score. Weight status was determined using WHO methods.

Results

Tracking of healthy weight was consistently higher than that of overweight/obesity, and incident overweight was equally likely throughout childhood and adolescence. Tracking of overweight was lower for children under 7 years than in middle childhood and adolescence (2-year probability 65%, compared with 80%; 2-year resolution of overweight 35 and 20%). Children of lower socioeconomic position, those from culturally and linguistically diverse backgrounds, and girls were more likely to move into overweight (hazard ratios [95%CI] for incident overweight: 1.39 [1.26–1.52], 1.16 [1.02–1.31] and 1.12 [1.02–1.23], respectively) and less likely to resolve their overweight (hazard ratios for resolution of overweight/obesity: 0.77 [0.69–0.85], 0.8 [0.69–0.92] and 0.79 [0.71–0.81], respectively) during childhood. However, persistence of weight status was not significantly affected by rurality or Indigenous status (P > 0.05).

Conclusions

Lowest tracking and highest natural resolution of overweight in children under 7 years suggests this may be an opportune time for interventions to reduce overweight. Primary and secondary prevention programmes during the school years should be designed with special consideration for lower socioeconomic communities, for culturally and linguistically diverse populations and for girls.

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Fig. 1: Retrospective tracking of weight status between adolescence and early childhood in the LSAC K cohort.
Fig. 2: Prospective tracking of weight status over adjacent waves of data (LSAC B & K cohorts).
Fig. 3: Hazard ratios of demographic predictors of weight status transition.
Fig. 4: Heat map of the predicted probabilities of remaining in baseline weight status by age 10/11 years and 16/17 years, according to sex, SEP and CALD status.

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Acknowledgements

This research is a part of a program of work of the National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (#1101675). The authors would like to thank the parents and children who took part in the Longitudinal Study of Australian Children, and the Australian Institute of Family Studies for providing the data. JC was supported by a Postgraduate Research Scholarship from The Australian Prevention Partnership Centre. AK was supported by NHMRC PhD scholarship (#1169039).

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Authors and Affiliations

  1. Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, NSW, Australia

    Alison J. Hayes, Joseph P. Carrello, Patrick J. Kelly, Anagha Killedar & Louise A. Baur

  2. Speciality of Child and Adolescent Health, Clinical School, University of Sydney, Sydney, NSW, Australia

    Louise A. Baur

  3. The Children’s Hospital at Westmead, Sydney, NSW, Australia

    Louise A. Baur

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Contributions

AH, LAB and PK conceived the study design. AH, JC and AK carried out data analysis. All authors contributed to data interpretation and the writing and critical review of the final manuscript. All authors have agreed to be accountable for all aspects of the work.

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Correspondence to Alison J. Hayes.

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Hayes, A.J., Carrello, J.P., Kelly, P.J. et al. Looking backwards and forwards: tracking and persistence of weight status between early childhood and adolescence. Int J Obes 45, 870–878 (2021). https://doi.org/10.1038/s41366-021-00751-3

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