Shaping childhood obesity: behavioral and environmental risk factors associated with body mass index trajectories between 2 and 9 years in Samoan children
Authors' conclusion
High, centile-crossing BMI trajectories suggest that obesity prevention and intervention are needed among Samoan children before age 9 years. Positive associations between high modern dietary pattern adherence, greater asset ownership, and urbanization offer initial insights into who, and which behavioral risk factors, should be prioritized in implementing public health solutions.
Study context
- Population
- Children from 'Upolu, Samoa, followed from ages 2–4 (2015) to 5.5–11 years (2019–20)
- Participants
- 485 children
- Exposure
- Behavioral and environmental risk factors and body mass index (BMI) trajectories
- Outcome
- Predicted weight, height and BMI (at 1-year intervals and velocity)
- Follow-up
- Ages 2–9 years
Methodological detailsmultilevel cubic spline regressions, Modern dietary pattern by factor analysis of caregiver-reported FFQ; physical activity by Netherlands Physical Activity Questionnaire; 18-item household asset score; urbanicity by village residence
- Multilevel cubic spline regressions
- Modern dietary pattern by factor analysis of caregiver-reported FFQ; physical activity by Netherlands Physical Activity Questionnaire; 18-item household asset score; urbanicity by village residence
Main finding
As reported in the abstract
Females: greater adjusted weight velocity with high vs low modern dietary pattern adherence (p for interaction with age spline term 1 / term 2)
0.028 / 0.007
Males, very high vs low household assets: higher BMI from age 2 to 4 years
0.26-1.53
95% CI kg/m²p = 0.006
Males, very high vs low household assets: greater BMI velocity (p for interaction with age spline term 2)
0.001
Males, urban vs rural region: greatest BMI gain after age 5 (p for interaction with age spline term 2)
0.014
Observational data: associations, not effects.
Original publication
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