Longitudinal BMI trajectories and adolescent dietary patterns in the RIGHT Track research project

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Ashley Lauren Paynter (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Lenka Shriver

Abstract: Obesity represents a public health epidemic affecting an increasing number of children as well as adults (Hales, Carroll, Fryar, & Ogden, 2017). Obesity is associated with a multitude of negative health implications, and excessive adiposity can also weaken mental health through increasing risk of depression, anxiety, and low self-esteem (Fruh, 2017). Obese children and adolescents are more likely to become severely obese adults, making prevention and early intervention extremely important for minimizing the negative effects of obesity over time (The, Suchindran, North, Popkin, & Gordon-Larsen, 2010). Thus, identification of obesity-related modifiable behaviors can help target future obesity prevention research efforts and in turn, has the potential to improve the quality of life for many children and adolescents. Emerging adulthood, a developmental period during 18 to 25y (Nelson, Story, Larson, Neumark-Sztainer, & Lytle, 2008), is becoming increasingly important as a time when not only initial changes in markers of chronic disease risk can be seen, but as a unique opportunity for behavior change interventions (Gilmore, 2019). Currently there is little research describing how longitudinal BMI and adolescent dietary patterns relate to obesity-related biomarkers in emerging adulthood. Furthermore, despite the evidence that children’s self-regulation skills may play a role in obesity development, there is inadequate longitudinal research on how self-regulatory behaviors in childhood may affect longitudinal BMI growth. Thus, the specific aims of the proposed research included to i) characterize unique trajectories of BMI from childhood through adolescence (4 to 18 year) and describe the association between BMI trajectory membership and body composition and biomarkers in emerging adulthood; ii) determine the prospective association between pre-school self-regulation and BMI trajectory membership; and iii) describe unique patterns of adolescent dietary consumption and determine the corresponding association between adolescent dietary pattern membership and later anthropometrics and biomarkers including BMI, percent body fat, fasting glucose, fasting insulin, and HOMA-IR collected in emerging adulthood. Data from the RIGHT Track Parent and RIGHT Track Health longitudinal studies were used to address the study aims. The combination of data from the two studies provided the necessary data to address the study aims and included baseline sociodemographic information, childhood behavioral data, longitudinal anthropometrics throughout childhood and adolescence, adolescent dietary intake, and biomarker and body composition data collected in emerging adulthood. Participants in the RIGHT Track studies could be characterized into two unique longitudinal BMI trajectories: i) stable normal weight and ii) normal weight to overweight transition. Compared to the stable normal weight group, membership in the normal weight to overweight transition group was positively associated with fasting glucose, fasting insulin, HOMA-IR, waist circumference, and percent body fat, even after controlling for sex, race, and socioeconomic status. Results were attenuated when each model additionally controlled for adult waist circumference or adult percent body fat. Importantly, higher childhood self-regulatory behavior, as measured by a gift-delay task, decreased the likelihood of a child being in the “higher-risk”, that is “normal weight to overweight transition” group. Higher childhood self-regulation as measured by a food-related task was not associated with BMI trajectory membership. However, moderate food-related self-regulation was suggestive of decreased risk of membership in the BMI transition group compared to those who were considered unregulated (p=0.09). Even though this relation was not statistically significant, this finding supports exploration of “consuming any foods in moderation” as a useful technique when educating children on nutrition. Finally, two unique patterns of adolescent dietary intake were found in our sample: i) balanced (higher consumption of unsweetened beverages, fruits, and non-starchy vegetables) and ii) unbalanced (greater consumption of sugar-sweetened beverages, fried potatoes, and full fat/fried meats). While there were differences in types of foods consumed by those in each of these patterns, adolescents in both patterns had an overall poor diet quality. No significant associations were found between adolescent dietary patterns and any of the adult health measures (i.e., fasting glucose, fasting insulin, HOMA-IR, percent body fat or BMI), which could possibly partially be explained by our limited number of individuals who had both dietary and biomarker data. This study provides insight into longitudinal growth patterns for children and adolescents and corresponding childhood behavioral predictors that could serve as targets for public health interventions to decrease obesity-related health risks. Additional research is needed to examine self-regulatory behaviors at different time points during childhood to determine the best age at which implementation of behavioral interventions would be most effective in minimizing future adiposity-related health risks.

Additional Information

Language: English
Date: 2021
Adolescence, BMI Trajectories, Cardiometabolic risk factors, Dietary Patterns, Obesity, Self-Regulation
Body mass index
Obesity $x Prevention
Teenagers $x Nutrition
Self-control in adolescence

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