Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
BMC Med. 2024 Nov 5;22(1):507. doi: 10.1186/s12916-024-03721-4.
The prevalence of high body mass index (BMI) is increasing in both children and adults worldwide. However, it is unclear whether vulnerabilities to maintenance and transition of weight status vary throughout the lifespan.
We aimed to characterize dynamic transitions of weight statuses across different life stages and to identify the sensitive periods for maintenance, onset, and resolution of obesity.
This longitudinal study included a total of 23,179 participants aged 6-80 years with 95,994 BMI measurements from the China Health and Nutrition Survey 1989-2015. To examine the heterogeneity in transitions of weight statuses across different life stages, we divided participants into 8 sub-cohorts based on baseline ages by 10-year intervals, i.e., 6-10 years, 11-20 years, 21-30 years, 31-40 years, 41-50 years, 51-60 years, 61-70 years, and 71-80 years. We estimated the probabilities of transitioning between weight statuses at a given follow-up year by baseline age using generalized linear mixed-effects models.
The predicted prevalence of obesity decreased from 6 years, bottomed at around 20 years, increased thereafter, peaked at around 55 years, and then decreased gradually. In general, participants with underweight had lower probabilities of maintaining the same status compared to those with normal weight, overweight, or obesity for all age groups. For 10-year follow-up, individuals aged 21-30 years had the highest probabilities of transitioning from normal weight to obesity and transitioning from overweight to obesity compared to those in other age groups. Individuals aged 6-20 years had the highest probabilities of transitioning from obesity to normal weight and transitioning from overweight to normal weight. Individuals in all adult age groups had higher probabilities of maintaining obesity status than children and adolescents.
Young adulthood is the most sensitive period for obesity onset, whereas childhood and adolescence are the most sensitive periods for obesity resolution. The findings suggest the heterogeneity of susceptibilities to weight status transitions across different life stages and highlight the importance of the development of age-appropriate approaches for the prevention and intervention of obesity.
全球范围内，儿童和成年人的高身体质量指数（BMI）患病率都在增加。然而，尚不清楚体重状况维持和转变的脆弱性是否会在整个生命周期中发生变化。
我们旨在描述不同生命阶段体重状况的动态转变，并确定肥胖维持、起始和缓解的敏感时期。
这项纵向研究共纳入了来自中国健康与营养调查 1989-2015 年的 23179 名 6-80 岁参与者，共进行了 95994 次 BMI 测量。为了研究不同生命阶段体重状况转变的异质性，我们根据基线年龄将参与者分为 8 个亚组，每个亚组间隔 10 年，即 6-10 岁、11-20 岁、21-30 岁、31-40 岁、41-50 岁、51-60 岁、61-70 岁和 71-80 岁。我们使用广义线性混合效应模型估计了在给定随访年份下，基线年龄与体重状况转变之间的概率。
预测肥胖的患病率从 6 岁开始下降，在 20 岁左右达到最低点，此后逐渐上升，在 55 岁左右达到峰值，然后逐渐下降。总的来说，与体重正常、超重或肥胖的参与者相比，体重不足的参与者维持同一状态的可能性较低。对于 10 年随访，与其他年龄组相比，21-30 岁的参与者从正常体重转变为肥胖以及从超重转变为肥胖的概率最高。6-20 岁的参与者从肥胖转变为正常体重以及从超重转变为正常体重的概率最高。所有成年年龄组的参与者维持肥胖状态的概率均高于儿童和青少年。
青年期是肥胖起始的最敏感时期，而儿童和青少年期是肥胖缓解的最敏感时期。这些发现表明，体重状况转变的易感性在不同的生命阶段存在异质性，并强调了为肥胖的预防和干预制定适合年龄的方法的重要性。
