Stability of body mass index in Australian children: a prospective cohort study across the middle childhood years

Public Health Nutr. 2004 Apr;7(2):303-9. doi: 10.1079/phn2003537.


Objective: To investigate the prevalence and incidence of overweight and obesity, the frequency of overweight resolution and the influence of parental adiposity during middle childhood.

Design: As part of a prospective cohort study, height and weight were measured in 1997 and 2000/2001. Children were classified as non-overweight, overweight or obese based on standard international definitions. Body mass index (BMI) was transformed into age- and gender-specific Z-scores employing the LMS method and 2000 growth chart data of the Centers for Disease Control and Prevention. Parents self-reported height and weight, and were classified as underweight, healthy weight, overweight or obese based on World Health Organization definitions.

Setting: Primary schools in Victoria, Australia.

Subjects: In total, 1438 children aged 5-10 years at baseline.

Results: The prevalence of overweight and obesity increased between baseline (15.0 and 4.3%, respectively) and follow-up (19.7 and 4.8%, respectively; P<0.001 for increase in overweight and obesity combined). There were 140 incident cases of overweight (9.7% of the cohort) and 24 of obesity (1.7% of the cohort); only 3.8% of the cohort (19.8% of overweight/obese children) resolved to a healthy weight. The stability of child adiposity as measured by BMI category (84.8% remained in the same category) and BMI Z-score (r=0.84; mean change=-0.05) was extremely high. Mean change in BMI Z-score decreased with age (linear trend beta=0.03, 95% confidence interval 0.01-0.05). The influence of parental adiposity largely disappeared when children's baseline BMI was adjusted for.

Conclusions: During middle childhood, the incidence of overweight/obesity exceeds the proportion of children resolving to non-overweight. However, for most children adiposity remains stable, and stability appears to increase with age. Prevention strategies targeting children in early childhood are required.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Australia / epidemiology
  • Body Mass Index*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Forecasting
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Obesity / epidemiology*
  • Parents*
  • Prevalence
  • Prospective Studies
  • Risk Assessment
  • Sex Distribution