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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #293605
Title: Longitudinal associations between BMI, waist circumference, and cardiometabolic risk in US youth: Monitoring implications

Author
item JAGO, RUSS - University Of Bristol
item MENDOZA, JASON - Children'S Nutrition Research Center (CNRC)
item CHEN, T - Children'S Nutrition Research Center (CNRC)
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)

Submitted to: Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/16/2012
Publication Date: 3/1/2013
Citation: Jago, R., Mendoza, J.A., Chen, T.A., Baranowski, T. 2013. Longitudinal associations between BMI, waist circumference, and cardiometabolic risk in US youth: Monitoring implications. Obesity. 21(3):E271-E279.

Interpretive Summary: Obesity has been related to increased risk of heart disease through increased cardiovascular disease (CVD) risk factors (e.g. blood pressure, fasting triglycerides, etc.). Some studies have indicated that waist circumference (WC, an indicator of abdominal fat) was more strongly related to CVD risks than body mass index (BMI). Most of this research with children has been conducted in cross sectional studies. If the relationships are true, change in obesity status as determined from longitudinal research should be related to change in CVD risk factors. This study took data from a large longitudinal sample of children studied in 6th grade and again in the 8th grade. The results showed that change in BMI was most strongly related to change in most CVD risks, but not fasting glucose. Change in WC was more strongly related to change in fasting glucose. Thus, BMI and WC were associated with different CVD risk factors, and thereby give different information about a child’s health status.

Technical Abstract: This study examined whether change in body mass index (BMI) or waist circumference (WC)is associated with change in cardiometabolic risk factors and differences between cardiovascular disease specific and diabetes specific risk factors among adolescents. We also sought to examine any differences by gender or baseline body mass status. The article is a longitudinal analysis of pre- and post-data collected in the HEALTHY trial. Participants were 4,603 ethnically diverse adolescents who provided complete data at 6th and 8th grade assessments. The main outcome measures were percent change in the following cardiometabolic risk factors: fasting triglycerides, systolic and diastolic blood pressure, high density lipoprotein cholesterol, and glucose as well as a clustered metabolic risk score. Main exposures were change in BMI or WC z-score. Models were run stratified by gender; secondary models were additionally stratified by baseline BMI group (normal, overweight, or obese). Analysis showed that when cardiometabolic risk factors were treated as continuous variables,there was strong evidence (P < 0.001) that change in BMI z-score was associated with change in the majority of the cardiovascular risk factors, except fasting glucose and the combined risk factor score for both boys and girls. There was some evidence that change in WC z-score was associated with some cardiovascular risk factors, but change in WC z-score was consistently associated with changes in fasting glucose. In conclusion, routine monitoring of BMI should be continued by health professionals, but additional information on disease risk may be provided by assessing WC.