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



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


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.


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).


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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  1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.

    Article  Google Scholar 

  2. Lobstein T, Jackson-Leach R. Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025. Pediatr Obes. 2016;11:321–5.

    Article  CAS  Google Scholar 

  3. Ahrens W, Pigeot I, Pohlabeln H, De Henauw S, Lissner L, Molnar D, et al. Prevalence of overweight and obesity in European children below the age of 10. Int J Obes. 2014;38(Suppl 2):S99–107.

    Article  Google Scholar 

  4. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17:56–67.

    Article  CAS  Google Scholar 

  5. Comission on Ending Childhood Obesity. Facts and figures on childhood obesity. World Health Organisation. 2018. Accessed 24 Mar 2018.

  6. Olafsdottir S, Berg C, Eiben G, Lanfer A, Reisch L, Ahrens W, et al. Young children’s screen activities, sweet drink consumption and anthropometry: results from a prospective European study. Eur J Clin Nutr. 2014;68:223–8.

    Article  CAS  Google Scholar 

  7. Pala V, Lissner L, Hebestreit A, Lanfer A, Sieri S, Siani A, et al. Dietary patterns and longitudinal change in body mass in European children: a follow-up study on the IDEFICS multicenter cohort. Eur J Clin Nutr. 2013;67:1042–9.

    Article  CAS  Google Scholar 

  8. te Velde SJ, van Nassau F, Uijtdewilligen L, van Stralen MM, Cardon G, De Craemer M, et al. Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. Obes Rev. 2012;13(Suppl 1):56–74.

    Article  Google Scholar 

  9. Jackson SL, Cunningham SA. The stability of children’s weight status over time, and the role of television, physical activity, and diet. Prev Med. 2017;100:229–34.

    Article  Google Scholar 

  10. Kerr JA, Long C, Clifford SA, Muller J, Gillespie AN, Donath S, et al. Early-life exposures predicting onset and resolution of childhood overweight or obesity. Arch Dis Child. 2017;102:915–22.

    Article  Google Scholar 

  11. Dietz WH. Critical periods in childhood for the development of obesity. Am J Clin Nutr. 1994;59:955–9.

    Article  CAS  Google Scholar 

  12. Wijnhoven TM, van Raaij JM, Spinelli A, Rito AI, Hovengen R, Kunesova M, et al. WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6−9-year-old children. Pediatr Obes. 2013;8:79–97.

    Article  CAS  Google Scholar 

  13. Wijnhoven T, Branca F. WHO European Childhood Obesity Surveillance Initiative. Protocol, Version January 2008.. Copenhagen: WHO Regional Office for Europe; 2008.

    Google Scholar 

  14. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.

    Article  CAS  Google Scholar 

  15. Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335:194.

    Article  Google Scholar 

  16. Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995;73:17–24.

    Article  CAS  Google Scholar 

  17. Central Statistics Office. Profile 1—Town and Country. Dublin: Central Office Statistics, Dublin; 2012.

    Google Scholar 

  18. Department of Education and Skills. DEIS: delivering equality of opportunity in schools. Dublin: Department of Education and Skills. 2017. Accessed 6 Jul 2018.

  19. Archer P, Sofroniou N. The assessment of levels of disadvantage in primary schools for DEIS. Dublin: Educational Research Centre. 2018. Accessed 6 Jul 2018.

  20. Dunkler D, Plischke M, Leffondre K, Heinze G. Augmented backward elimination: a pragmatic and purposeful way to develop statistical models. PLoS ONE. 2014;9:e113677.

    Article  Google Scholar 

  21. Niclasen BV, Petzold MG, Schnohr C. Overweight and obesity at school entry as predictor of overweight in adolescence in an Arctic child population. Eur J Public Health. 2007;17:17–20.

    Article  Google Scholar 

  22. Chen TA, Baranowski T, Moreno JP, O’Connor TM, Hughes SO, Baranowski J, et al. Obesity status transitions across the elementary years: use of Markov chain modelling. Pediatr Obes. 2016;11:88–94.

    Article  CAS  Google Scholar 

  23. Kamath CC, Vickers KS, Ehrlich A, McGovern L, Johnson J, Singhal V, et al. Clinical review: behavioral interventions to prevent childhood obesity: a systematic review and metaanalyses of randomized trials. J Clin Endocrinol Metab. 2008;93:4606–15.

    Article  CAS  Google Scholar 

  24. Stuart B, Panico L. Early-childhood BMI trajectories: evidence from a prospective, nationally representative British cohort study. Nutr Diabetes. 2016;6:e198.

    Article  CAS  Google Scholar 

  25. Ziyab AH, Karmaus W, Kurukulaaratchy RJ, Zhang H, Arshad SH. Developmental trajectories of Body Mass Index from infancy to 18 years of age: prenatal determinants and health consequences. J Epidemiol Community Health. 2014;68:934–41.

    Article  Google Scholar 

  26. Taveras EM, Rifas-Shiman SL, Sherry B, Oken E, Haines J, Kleinman K, et al. Crossing growth percentiles in infancy and risk of obesity in childhood. Arch Pediatr Adolesc Med. 2011;165:993–8.

    Article  Google Scholar 

  27. Wu S, Ding Y, Wu F, Li R, Hu Y, Hou J, et al. Socio-economic position as an intervention against overweight and obesity in children: a systematic review and meta-analysis. Sci Rep. 2015;5:11354.

    Article  CAS  Google Scholar 

  28. Ruijsbroek A, Wijga AH, Kerkhof M, Koppelman GH, Smit HA, Droomers M. The development of socio-economic health differences in childhood: results of the Dutch longitudinal PIAMA birth cohort. BMC Public Health. 2011;11:225.

    Article  Google Scholar 

  29. Li X, Memarian E, Sundquist J, Zoller B, Sundquist K. Neighbourhood deprivation, individual-level familial and socio-demographic factors and diagnosed childhood obesity: a nationwide multilevel study from Sweden. Obes Facts. 2014;7:253–63.

    Article  Google Scholar 

  30. Emmett PM, Jones LR. Diet, growth, and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children. Nutr Rev. 2015;73(Suppl 3):175–206.

    Article  Google Scholar 

  31. Leech RM, McNaughton SA, Timperio A. Clustering of diet, physical activity and sedentary behaviour among Australian children: cross-sectional and longitudinal associations with overweight and obesity. Int J Obes. 2015;39:1079–85.

    Article  CAS  Google Scholar 

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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.


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.

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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.

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Correspondence to Silvia Bel-Serrat.

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Bel-Serrat, S., Heinen, M.M., Mehegan, J. et al. Predictors of weight status in school-aged children: a prospective cohort study. Eur J Clin Nutr 73, 1299–1306 (2019).

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