Oral Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Early clinical markers of overweight/obesity onset and resolution by adolescence: Longitudinal Study of Australian Children (#43)

Kate Lycett 1 2 , Markus Juonala 3 4 , Ted Lau 1 2 , Anneke Grobler 1 2 , Jessica A Kerr 1 2 , Costan Magnussen 3 5 , Matthew A Sabin 2 6 , David P Burgner 2 6 , Melissa Wake 1 2 7
  1. Department of Paediatrics, The University of Melbourne, Parkville, VICTORIA, Australia
  2. Murdoch Children's Research Institute, Parkville, VICTORIA, Australia
  3. University of Turku, Turku, Finland
  4. Division of Medicine, Turku University Hospital, Turku, Finland
  5. Menzies Institute for Medical Research, University of Tasmania, Hobart, TASMANIA, Australia
  6. The Royal Children’s Hospital, Parkville, VICTORIA, Australia
  7. Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand

Background: Clinical prediction tools could assist with prevention and treatment of adolescent overweight/obesity. We examined how combinations of clinical indicators at various ages predict overweight/obesity development, as well as resolution, by 10-11 and 14-15 years of age.

Methods: Data were derived from Birth (N=3469) and Kinder (N=3276) cohorts of the Longitudinal Study of Australian Children, followed from ages 2-3 and 4-5 years, respectively. Potential obesity-relevant clinical indicators included six historic factors (eg mode of delivery, birthweight z-score) and 18 concurrent factors (eg sleep problems, BMI, sugary drink consumption) that were assessed every two years (Birth cohort: 2-3, 4-5, 6-7, 8-9 years of age; Kinder cohort: 4-5, 6-7, 8-9, 10-11, 12-13 years of age). Overweight/obesity was defined using International Obesity Taskforce cutpoints at 10-11 years and 14-15 years.  

Results: In both cohorts, only three factors consistently predicted development or resolution of overweight/obesity in multivariable models. Among normal weight children, an increased odds of developing overweight/obesity was associated with higher child (odds ratio (OR) 1.7-3.8 across all study waves) and maternal (OR 1.05-1.09) BMI, and inversely with higher maternal education (OR 0.60-0.62, when assessed at age 2-7 years). Among overweight/obesity children, a lower odds of resolving to normal weight was associated with higher child (OR 0.51-0.79 across all study waves) and maternal (OR 0.89-0.95) BMI, and inversely with maternal education (OR 1.6-1.9, when assessed at age 2-5 years). The prevalence of overweight/obesity at the age of 14-15 years was 13% among children with none of these risk factors at age 6-7 years, compared with 71% among those with all three risk factors (P<0.001).

Conclusions: From early childhood onwards, child and maternal BMI and maternal education predict overweight/obesity onset and resolution by adolescence. These risk factors, easily available to clinicians, could help better target treatment or prevention of child overweight/obesity.