The association between body mass index, primary healthcare use and morbidity in early childhood: findings from the Born In Bradford cohort study

ABSTRACTBackgroundFaster growth velocity during childhood may increase blood pressure (BP) in adults, but there are little data from African-origin populations. We evaluated the effect of postnatal linear growth (increase in height) and change in body mass index (BMI) from birth to adolescence on systolic and diastolic blood pressure (SBP and DBP) in Afro-Caribbean youth.MethodsWe used data from the Vulnerable Windows Birth Cohort Study in Jamaica. Children were followed from birth, with periodic anthropometric measurements. BP measurements started at age 1-year and every six months thereafter. Analyses used BP measurements (mmHg) from age 15-21 years. Linear growth and change in BMI measurements were calculated for: early infancy (0-6 months), late infancy (6 months - 2 years), early childhood (2-8 years), and later childhood (8-15 years). Conditional analyses were used to compute growth rates (as z-scores). Linear mixed models were used to estimate the effect of growth rates on BP.ResultsAnalyses included 365 individuals (162 males, 203 females) with mean age 16.7 years. In multivariable models, after adjustment for age, sex, birth length, gestational age and BMI at age 15 years, faster linear growth for early infancy (β=1.06, p=0.010) was significantly associated with higher SBP. For change in BMI, after adjustment for age, sex, gestational age, height and SES at birth, significant associations of higher SBP were seen for greater increase in BMI in late infancy (β=1.41, p=0.001), early childhood (β=1.22, p=0.001) and later childhood (β=0.74, p=0.035). Faster post-natal linear growth had no significant associations with DBP, but greater increase in BMI for each of the late infancy to late childhood periods was significantly associated with higher DBP. When both growth rates were modeled together, rate of change of BMI and faster linear growth in early infancy retained significance for SBP, but only change in BMI retained significance for DBP.ConclusionFaster linear growth and greater rate of increase in BMI were associated with higher SBP and DBP in Afro-Caribbean youth, but the BMI effect was stronger.

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Faculty Opinions recommendation of A longitudinal cohort study of body mass index and childhood exposure to secondhand tobacco smoke and air pollution: the Southern California Children's Health Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725233321.793523296 ◽

2016 ◽

Author(s):

Sundeep Salvi

Keyword(s):

Body Mass Index ◽

Air Pollution ◽

Cohort Study ◽

Body Mass ◽

Tobacco Smoke ◽

Longitudinal Cohort Study ◽

Health Study ◽

Childhood Exposure ◽

Longitudinal Cohort ◽

Secondhand Tobacco Smoke

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Longitudinal Body Mass Index Trajectories and Incident Chronic Kidney Disease in the General Population: Community-Based Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3541109 ◽

2020 ◽

Author(s):

Hae-Ryong Yun ◽

Hyung Woo Kim ◽

Tae Ik Chang ◽

Ea Wha Kang ◽

HyeonSeon Lim ◽

...

Keyword(s):

Body Mass Index ◽

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

General Population ◽

Body Mass ◽

Community Based ◽

Incident Chronic Kidney Disease ◽

Body Mass Index Trajectories

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Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

BMC Public Health ◽

10.1186/s12889-021-10606-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Barbara Iyen ◽

Stephen Weng ◽

Yana Vinogradova ◽

Ralph K. Akyea ◽

Nadeem Qureshi ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Cohort Study ◽

Body Mass ◽

World Health ◽

Obese Adults ◽

Bmi Trajectories ◽

The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

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