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Age-period-cohort projection of trends in blood pressure and body mass index in children and adolescents in Hong Kong.

ABSTRACT: BACKGROUND:Blood pressure (BP) and body mass index (BMI) trends during childhood and adolescence are complex, making context-specific projections necessary to inform prevention and presage changes. OBJECTIVE:This study aimed to project BP and BMI in Hong Kong Chinese children and adolescents from 2015 to 2024 based on trends in BP and BMI observed from 1996/99 to 2014. METHODS:We decomposed recent trends into sex-specific contributions of age, period and cohort using age-period-cohort linear regression with Bayesian inference and autoregressive priors based on BP in children and adolescents aged 9-18?years from 1999 to 2014 and BMI in those aged 6-18?years from 1996 to 2014. We then used the resultant models to project BP and BMI from 2015 to 2024. RESULTS:During the study period, systolic BP decreased from 1999 to 2004/5 before gradually increasing to 2014 during childhood (for boys: from 104.6 to 101.9 and then to 103.4?mmHg) and during adolescence. Similar patterns were observed for diastolic BP. BMI generally increased from 1996 to 2009 before falling to 2014 during childhood (e.g. for boys: from 17.2 to 18.0 and then to 17.1?kg/m2). From 2015 onwards, systolic BP was projected to increase in girls, but remain stable in boys. For both sexes, diastolic BP was projected to increase, whereas BMI was projected to decrease to 2024. CONCLUSIONS:In this economically developed Chinese setting, future trends in BP and BMI in children and adolescents are predicted to be divergent, consistent with prior discordant trends in BP and BMI.

SUBMITTER: Kwok MK

PROVIDER: S-EPMC6990538 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Age-period-cohort projection of trends in blood pressure and body mass index in children and adolescents in Hong Kong.

Kwok Man Ki MK Wong Irene Oi Ling IOL Schooling C Mary CM

BMC pediatrics 20200129 1

<h4>Background</h4>Blood pressure (BP) and body mass index (BMI) trends during childhood and adolescence are complex, making context-specific projections necessary to inform prevention and presage changes.<h4>Objective</h4>This study aimed to project BP and BMI in Hong Kong Chinese children and adolescents from 2015 to 2024 based on trends in BP and BMI observed from 1996/99 to 2014.<h4>Methods</h4>We decomposed recent trends into sex-specific contributions of age, period and cohort using age-pe ...[more]

PMID: 31996164

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Project description:CONTEXT:The prevalence of childhood obesity increased in the 1980s and 1990s but there were no significant changes in prevalence between 1999-2000 and 2007-2008 in the United States. OBJECTIVES:To present the most recent estimates of obesity prevalence in US children and adolescents for 2009-2010 and to investigate trends in obesity prevalence and body mass index (BMI) among children and adolescents between 1999-2000 and 2009-2010. DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional analyses of a representative sample (N = 4111) of the US child and adolescent population (birth through 19 years of age) with measured heights and weights from the National Health and Nutrition Examination Survey 2009-2010. MAIN OUTCOME MEASURES:Prevalence of high weight-for-recumbent length (?95th percentile on the growth charts) among infants and toddlers from birth to 2 years of age and obesity (BMI ?95th percentile of the BMI-for-age growth charts) among children and adolescents aged 2 through 19 years. Analyses of trends in obesity by sex and race/ethnicity, and analyses of trends in BMI within sex-specific age groups for 6 survey periods (1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, and 2009-2010) over 12 years. RESULTS:In 2009-2010, 9.7% (95% CI, 7.6%-12.3%) of infants and toddlers had a high weight-for-recumbent length and 16.9% (95% CI, 15.4%-18.4%) of children and adolescents from 2 through 19 years of age were obese. There was no difference in obesity prevalence among males (P = .62) or females (P = .65) between 2007-2008 and 2009-2010. However, trend analyses over a 12-year period indicated a significant increase in obesity prevalence between 1999-2000 and 2009-2010 in males aged 2 through 19 years (odds ratio, 1.05; 95% CI, 1.01-1.10) but not in females (odds ratio, 1.02; 95% CI, 0.98-1.07) per 2-year survey cycle. There was a significant increase in BMI among adolescent males aged 12 through 19 years (P = .04) but not among any other age group or among females. CONCLUSION:In 2009-2010, the prevalence of obesity in children and adolescents was 16.9%; this was not changed compared with 2007-2008.

Project description:Rates of childhood obesity have increased since the mid-1970s. Research into behavioural determinants has focused on physical inactivity and unhealthy diets. Cross-sectional studies indicate an association between psychological stress experienced by parents and obesity in pre-adolescents.We provide evidence of a prospective association between parental psychological stress and increased weight gain in pre-adolescents. Family-level support for those experiencing chronic stress might help promote healthy diet and exercise behaviours in children.We examined the impact of parental psychological stress on body mass index (BMI) in pre-adolescent children over 4?years of follow-up.We included 4078 children aged 5-10?years (90% were between 5.5 and 7.5?years) at study entry (2002-2003) in the Children's Health Study, a prospective cohort study in southern California. A multi-level linear model simultaneously examined the effect of parental stress at study entry on the attained BMI at age 10 and the slope of change across annual measures of BMI during follow-up, controlled for the child's age and sex. BMI was calculated based on objective measurements of height and weight by trained technicians following a standardized procedure.A two standard deviation increase in parental stress at study entry was associated with an increase in predicted BMI attained by age 10 of 0.287?kg?m(-2) (95% confidence interval 0.016-0.558; a 2% increase at this age for a participant of average attained BMI). The same increase in parental stress was also associated with an increased trajectory of weight gain over follow-up, with the slope of change in BMI increased by 0.054?kg?m(-2) (95% confidence interval 0.007-0.100; a 7% increase in the slope of change for a participant of average BMI trajectory).We prospectively demonstrated a small effect of parental stress on BMI at age 10 and weight gain earlier in life than reported previously. Interventions to address the burden of childhood obesity should address the role of parental stress in children.

Dataset Information

Age-period-cohort projection of trends in blood pressure and body mass index in children and adolescents in Hong Kong.

Publications

Age-period-cohort projection of trends in blood pressure and body mass index in children and adolescents in Hong Kong.

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