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American Journal of Clinical Nutrition, Vol. 72, No. 4, 1018-1024, October 2000
© 2000 American Society for Clinical Nutrition


Original Research Communication

Tracking of body mass index from childhood to adolescence: a 6-y follow-up study in China1,2,3

Youfa Wang, Keyou Ge and Barry M Popkin

1 From the Department of Nutrition and the Carolina Population Center, University of North Carolina at Chapel Hill, and the Institute of Food and Nutrition, Chinese Academy of Preventive Medicine, Beijing.

Background: Although extensive descriptive research shows that childhood obesity predisposes a person to adult obesity, little is understood about the dynamics of weight during childhood and the predictors of weight tracking.

Objective: Our objective was to examine tracking patterns of body mass index (BMI) as well as their predictors between childhood and adolescence.

Design: A cohort of 975 Chinese children aged 6–13 y was followed for 6 y (1991–1997). Tracking of BMI was defined as an individual maintaining a certain status (overweight or underweight) or relative position (relative BMI quartile) over time. Relative BMI related BMI to age- and sex-specific BMI cutoffs.

Results: After 6 y, {approx}40% of the subjects had maintained their relative positions, but 30% had moved into a lower or higher quartile. The BMIs of thin and fat children were more likely to track: 51% and 46% remained in the bottom and upper quartiles, respectively. Nearly one-third of the underweight children remained underweight in 1997. Overweight children were 2.8 times as likely as all other children to become overweight adolescents; underweight children were 3.6 times as likely to remain underweight as adolescents. Parental obesity and underweight, individuals' initial BMIs, dietary fat intake, and family income helped predict tracking and changes in BMI.

Conclusion: In a society undergoing enormous changes in diet and activity, BMI tracking is still very important between childhood and adolescence in China.

Key Words: Child • adolescent • BMI • body mass index • body composition • body weight • obesity • overweight • underweight • tracking • China • dietary intakes




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