Shifts in BMI category and associated cardiometabolic risk: Prospective results from HEALTHY study

Marsha D. Marcus, Gary D. Foster, Laure El Ghormli, Tom Baranowski, Linn Goldberg, Russell Jago, Barbara Linder, Allan Steckler, Roberto Treviño

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate shifts across BMI categories and associated changes in cardiometabolic risk factors over 2.5 years in an ethnically diverse middle school sample. METHODS: As part of HEALTHY, a multisite school-based study designed to mitigate risk for type 2 diabetes, 3993 children participated in health screenings at the start of sixth and end of eighth grades. Assessments included anthropometric measures, blood pressure, and glucose, insulin, and lipids. Students were classified as underweight, healthy weight, overweight, obese, or severely obese. Mixed models controlling for school intervention status and covariates were used to evaluate shifts in BMI category over time and the relation between these shifts and changes in risk factors. RESULTS: At baseline, students averaged 11.3 (±0.6) years; 47.6% were boys, 59.6% were Hispanic, and 49.8% were overweight or obese. Shifts in BMI category over time were common. For example, 35.7% of youth who were overweight moved to the healthy weight range, but 13% in the healthy weight range became overweight. BMI shifts were not associated with school intervention condition, household education, or youth gender, race/ethnicity, pubertal status, or changes in height. Increases in BMI category were associated with worsening of cardiometabolic risk factors, and decreases were associated with improvements. Boys who increased BMI category were more vulnerable to negative risk factor changes than girls. CONCLUSIONS: There are substantial shifts across BMI categories during middle school that are associated with clinically meaningful changes in cardiometabolic risk factors. Programs to promote decreases in BMI and prevent increases are clearly warranted.

Original languageEnglish (US)
JournalPediatrics
Volume129
Issue number4
DOIs
StatePublished - Apr 2012

Fingerprint

Weights and Measures
Students
Thinness
Hispanic Americans
Type 2 Diabetes Mellitus
Blood Glucose
Insulin
Blood Pressure
Lipids
Education
Risk Factors
Health
Boys
Middle School
Anthropometrics
Ethnic Groups
Type 2 Diabetes
Screening
Household

Keywords

  • Blood pressure
  • BMI
  • Glucose
  • Insulin
  • Lipids
  • Obesity
  • Obesity trends
  • Overweight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Marcus, M. D., Foster, G. D., El Ghormli, L., Baranowski, T., Goldberg, L., Jago, R., ... Treviño, R. (2012). Shifts in BMI category and associated cardiometabolic risk: Prospective results from HEALTHY study. Pediatrics, 129(4). https://doi.org/10.1542/peds.2011-2696

Shifts in BMI category and associated cardiometabolic risk : Prospective results from HEALTHY study. / Marcus, Marsha D.; Foster, Gary D.; El Ghormli, Laure; Baranowski, Tom; Goldberg, Linn; Jago, Russell; Linder, Barbara; Steckler, Allan; Treviño, Roberto.

In: Pediatrics, Vol. 129, No. 4, 04.2012.

Research output: Contribution to journalArticle

Marcus, MD, Foster, GD, El Ghormli, L, Baranowski, T, Goldberg, L, Jago, R, Linder, B, Steckler, A & Treviño, R 2012, 'Shifts in BMI category and associated cardiometabolic risk: Prospective results from HEALTHY study', Pediatrics, vol. 129, no. 4. https://doi.org/10.1542/peds.2011-2696
Marcus, Marsha D. ; Foster, Gary D. ; El Ghormli, Laure ; Baranowski, Tom ; Goldberg, Linn ; Jago, Russell ; Linder, Barbara ; Steckler, Allan ; Treviño, Roberto. / Shifts in BMI category and associated cardiometabolic risk : Prospective results from HEALTHY study. In: Pediatrics. 2012 ; Vol. 129, No. 4.
@article{ae75ed2ce0934427a0deac17d441a993,
title = "Shifts in BMI category and associated cardiometabolic risk: Prospective results from HEALTHY study",
abstract = "OBJECTIVES: To evaluate shifts across BMI categories and associated changes in cardiometabolic risk factors over 2.5 years in an ethnically diverse middle school sample. METHODS: As part of HEALTHY, a multisite school-based study designed to mitigate risk for type 2 diabetes, 3993 children participated in health screenings at the start of sixth and end of eighth grades. Assessments included anthropometric measures, blood pressure, and glucose, insulin, and lipids. Students were classified as underweight, healthy weight, overweight, obese, or severely obese. Mixed models controlling for school intervention status and covariates were used to evaluate shifts in BMI category over time and the relation between these shifts and changes in risk factors. RESULTS: At baseline, students averaged 11.3 (±0.6) years; 47.6{\%} were boys, 59.6{\%} were Hispanic, and 49.8{\%} were overweight or obese. Shifts in BMI category over time were common. For example, 35.7{\%} of youth who were overweight moved to the healthy weight range, but 13{\%} in the healthy weight range became overweight. BMI shifts were not associated with school intervention condition, household education, or youth gender, race/ethnicity, pubertal status, or changes in height. Increases in BMI category were associated with worsening of cardiometabolic risk factors, and decreases were associated with improvements. Boys who increased BMI category were more vulnerable to negative risk factor changes than girls. CONCLUSIONS: There are substantial shifts across BMI categories during middle school that are associated with clinically meaningful changes in cardiometabolic risk factors. Programs to promote decreases in BMI and prevent increases are clearly warranted.",
keywords = "Blood pressure, BMI, Glucose, Insulin, Lipids, Obesity, Obesity trends, Overweight",
author = "Marcus, {Marsha D.} and Foster, {Gary D.} and {El Ghormli}, Laure and Tom Baranowski and Linn Goldberg and Russell Jago and Barbara Linder and Allan Steckler and Roberto Trevi{\~n}o",
year = "2012",
month = "4",
doi = "10.1542/peds.2011-2696",
language = "English (US)",
volume = "129",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "4",

}

TY - JOUR

T1 - Shifts in BMI category and associated cardiometabolic risk

T2 - Prospective results from HEALTHY study

AU - Marcus, Marsha D.

AU - Foster, Gary D.

AU - El Ghormli, Laure

AU - Baranowski, Tom

AU - Goldberg, Linn

AU - Jago, Russell

AU - Linder, Barbara

AU - Steckler, Allan

AU - Treviño, Roberto

PY - 2012/4

Y1 - 2012/4

N2 - OBJECTIVES: To evaluate shifts across BMI categories and associated changes in cardiometabolic risk factors over 2.5 years in an ethnically diverse middle school sample. METHODS: As part of HEALTHY, a multisite school-based study designed to mitigate risk for type 2 diabetes, 3993 children participated in health screenings at the start of sixth and end of eighth grades. Assessments included anthropometric measures, blood pressure, and glucose, insulin, and lipids. Students were classified as underweight, healthy weight, overweight, obese, or severely obese. Mixed models controlling for school intervention status and covariates were used to evaluate shifts in BMI category over time and the relation between these shifts and changes in risk factors. RESULTS: At baseline, students averaged 11.3 (±0.6) years; 47.6% were boys, 59.6% were Hispanic, and 49.8% were overweight or obese. Shifts in BMI category over time were common. For example, 35.7% of youth who were overweight moved to the healthy weight range, but 13% in the healthy weight range became overweight. BMI shifts were not associated with school intervention condition, household education, or youth gender, race/ethnicity, pubertal status, or changes in height. Increases in BMI category were associated with worsening of cardiometabolic risk factors, and decreases were associated with improvements. Boys who increased BMI category were more vulnerable to negative risk factor changes than girls. CONCLUSIONS: There are substantial shifts across BMI categories during middle school that are associated with clinically meaningful changes in cardiometabolic risk factors. Programs to promote decreases in BMI and prevent increases are clearly warranted.

AB - OBJECTIVES: To evaluate shifts across BMI categories and associated changes in cardiometabolic risk factors over 2.5 years in an ethnically diverse middle school sample. METHODS: As part of HEALTHY, a multisite school-based study designed to mitigate risk for type 2 diabetes, 3993 children participated in health screenings at the start of sixth and end of eighth grades. Assessments included anthropometric measures, blood pressure, and glucose, insulin, and lipids. Students were classified as underweight, healthy weight, overweight, obese, or severely obese. Mixed models controlling for school intervention status and covariates were used to evaluate shifts in BMI category over time and the relation between these shifts and changes in risk factors. RESULTS: At baseline, students averaged 11.3 (±0.6) years; 47.6% were boys, 59.6% were Hispanic, and 49.8% were overweight or obese. Shifts in BMI category over time were common. For example, 35.7% of youth who were overweight moved to the healthy weight range, but 13% in the healthy weight range became overweight. BMI shifts were not associated with school intervention condition, household education, or youth gender, race/ethnicity, pubertal status, or changes in height. Increases in BMI category were associated with worsening of cardiometabolic risk factors, and decreases were associated with improvements. Boys who increased BMI category were more vulnerable to negative risk factor changes than girls. CONCLUSIONS: There are substantial shifts across BMI categories during middle school that are associated with clinically meaningful changes in cardiometabolic risk factors. Programs to promote decreases in BMI and prevent increases are clearly warranted.

KW - Blood pressure

KW - BMI

KW - Glucose

KW - Insulin

KW - Lipids

KW - Obesity

KW - Obesity trends

KW - Overweight

UR - http://www.scopus.com/inward/record.url?scp=84859385794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859385794&partnerID=8YFLogxK

U2 - 10.1542/peds.2011-2696

DO - 10.1542/peds.2011-2696

M3 - Article

C2 - 22430457

AN - SCOPUS:84859385794

VL - 129

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 4

ER -