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Epidemiology

Predictors of weight status in school-aged children: a prospective cohort study

Abstract

Background/Objectives

To prospectively investigate the predictors of overweight/obesity and of body mass index (BMI) change in schoolchildren.

Subjects/Methods

A cohort of 2755 Irish children (53.7% girls), aged 6−10 years at baseline, participating in the Childhood Obesity Surveillance Initiative were included. Height and weight were objectively measured and BMI was calculated. Overweight/obesity were defined according to the International Obesity Task Force cut-offs. Prevalence of overweight/obesity at baseline and follow-up, incidence of overweight/obesity and changes in BMI over time were computed. Lifestyle indicators were parentally reported with a questionnaire. Predictors of overweight/obesity were investigated by multivariate mixed logistic regression models.

Results

Baseline BMI (OR = 6.46, 95% CI = 4.56−9.17) and school socioeconomic level (OR = 2.12, 95% CI = 1.16−3.86) were associated with higher risk of becoming overweight/obese. Children with no savoury snacks consumption (OR = 0.22, 95% CI = 0.07−0.69), or with frequent sports/dancing clubs attendance (OR = 0.41, 95% CI = 0.19−0.88) had lower odds of overweight/obesity at follow-up. Poor fruit intake was associated with higher risk of overweight/obesity (OR = 2.16, 95% CI = 1.23−3.78).

Conclusions

Initial BMI was the main predictor of subsequent overweight/obesity in schoolchildren, followed, to a lesser extent, by school socioeconomic status. Although lifestyle behaviours appeared to have lower effect as compared with prior BMI, children with healthier lifestyle behaviours were at reduced risk of overweight/obesity at follow-up. Programmes that aim at preventing the onset of overweight and obesity need to be a priority given the existing difficulties to reverse this condition later in life.

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Acknowledgements

We gratefully acknowledge all participating children, and their parents, and school staff for their cooperation. We thank the members of the Steering Committee for overseeing the project and the fieldworkers who collected the data.

Funding

This work was supported by the Health Service Executive (HSE) of Ireland. The funder contributed to the preparation of the manuscript; however, the funder had no role in the design and analyses of this article.

Author information

CCK and NE contributed to the conception and design of the study; MMH and CMM participated in the coordination of the study; MMH and JM conducted research and collected data; SB-S wrote the manuscript, analysed the data and generated figures; MMH, CMM and CCK participated in data interpretation. SBS, MMH, JM, SOB, NE, CMM, and CCK critically reviewed the manuscript. All authors read and approved the final manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Correspondence to Silvia Bel-Serrat.

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