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Body-mass index trajectories from childhood to mid-adulthood and their sociodemographic predictors: evidence from the International Childhood Cardiovascular Cohort (i3C) Consortium


Cleland, V and Tian, J and Buscot, M-J and Magnussen, CG and Bazzano, L and Burns, TL and Daniels, S and Dwyer, T and Hutri-Kahonen, N and Ikonen, J and Jacobs, D and Juonala, M and Prineas, R and Raitakari, O and Sinaiko, A and Steinberger, J and Urbina, EM and Woo, JG and Venn, A, Body-mass index trajectories from childhood to mid-adulthood and their sociodemographic predictors: evidence from the International Childhood Cardiovascular Cohort (i3C) Consortium, EClinicalMedicine, 48 Article 101440. ISSN 2589-5370 (2022) [Refereed Article]

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Copyright 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license (

DOI: doi:10.1016/j.eclinm.2022.101440


Background: Understanding lifecourse trajectories of body-mass index (BMI) is important for identifying groups at high risk of poor health and potential target points for intervention. This study aimed to describe BMI trajectories from childhood to mid-adulthood in four population-based cohorts established in the 1970s and 1980s and to identify childhood sociodemographic factors related to trajectory membership.

Methods: Between Dec 17, 1970 and Dec 15, 1994, data were collected at the first visit from 9830 participants from the International Childhood Cardiovascular Cohort (i3C) Consortium, which includes participants from Australia (1985), Finland (1980) and the USA (1970-1994). Participants had at least three measures of height and weight, including one in childhood (6-18 years) and one in adulthood (>18 years), and were aged 30-49 years at last measurement. Latent Class Growth Mixture Modelling was used to identify lifecourse BMI trajectory groups and log multinomial regression models were fit to identify their childhood sociodemographic predictors.

Findings: Five consistent BMI trajectory groups were identified amongst the four cohorts: persistently low (35.9-58.6%), improving from high (0.7-4.8%), progressing to moderate (9.3-43.7%), progressing to high (1.1-6.0%), and progressing to very high (0.7-1.3%). An additional three BMI trajectory groups were identified in some, but not all, cohorts: adult onset high (three cohorts; 1.8-20.7%), progressing to moderate-high (two cohorts; 5.2-13.8%), and relapsing yo-yoers (alternating upward and downward; one cohort; 1.3%). In pooled analyses, each predictor variable in childhood, including age, gender, parental education and race, was associated with increased likelihood of belonging to the most (e.g., improving from high) and least (e.g., progressing to very high) favourable BMI trajectory groups, suggesting a U-shaped (or inverse U-shaped) pattern of association.

Interpretation: Five consistent BMI trajectory groups were identified across four cohorts from Australia, Finland, and the USA, mainly across two eras of birth. While most participants remained on a persistently low trajectory (50%), many demonstrated worsening BMI trajectories (47%), with only few demonstrating improving trajectories (<5%). Age, gender, parental education, and race appear to be important predictors of BMI trajectory group membership and need consideration in preventive and management strategies.

Item Details

Item Type:Refereed Article
Keywords:BMI, body mass index, trajectory, trajectories, childhood, adulthood, cohort study, predictor, sociodemographic predictors, cardiovascular
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiovascular medicine and haematology not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Cleland, V (Associate Professor Verity Cleland)
UTAS Author:Tian, J (Dr Jing Tian)
UTAS Author:Buscot, M-J (Dr Marie-Jeanne Buscot)
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
UTAS Author:Venn, A (Professor Alison Venn)
ID Code:150858
Year Published:2022
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-07-04
Last Modified:2022-09-30
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