Original article
Body Mass Index and Waist-to-Height Changes During Teen Years in Girls Are Influenced by Childhood Body Mass Index

https://doi.org/10.1016/j.jadohealth.2009.06.023Get rights and content

Abstract

Purpose

This study examined longitudinal changes in waist-to-height ratio and components of body mass index (BMI) among young and adolescent girls of black and white race/ethnicity.

Methods

Girls were recruited at age 9 years through the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) and were followed annually over 10 years. Girls were grouped into low (<20th percentile), middle, and high (>80th percentile) BMI on the basis of race-specific BMI percentile rankings at age 9, and low, middle, and high waist-to-height ratio, on the basis of waist-to-height ratio at age 11. BMI was partitioned into fat mass index (FM) and fat-free mass index (FMI).

Results

Girls accrued fat mass at a greater rate than fat-free mass, and the ratio of fat mass to fat-free mass increased from ages 9 through 18. There was a significant increase in this ratio after age at peak height velocity. Participants with elevated BMI and waist-to-height ratios at age 18 tended to have been elevated at ages 9 and 11, respectively. There were strong correlations between BMI at age 9 with several outcomes at age 18: BMI (.76) and FMI (.72), weaker but significant with FFMI (.37), and ratio of fat mass to fat-free mass (.53). In addition, there was significant tracking of elevated BMI from ages 9 through 18.

Conclusions

In girls, higher BMI levels during childhood lead to greater waist-to-height ratios and greater than expected changes in BMI by age 18, with disproportionate increases in fat mass. These changes are especially evident in adolescent girls of black race/ethnicity and after the pubertal growth spurt.

Section snippets

Methods

The National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) was a 10-year cohort study that recruited a socio-economically diverse group of girls aged 9 and 10 years at entry. Participants were recruited from public and parochial schools in metropolitan Cincinnati, Ohio; the Richmond, California Unified School District; and a random sample of participants from a health maintenance organization in Washington, DC [10]. Eligibility was restricted to girls (and parents) who

Results

There were 610 white and 531 black participants included in the analysis; cohort retention was 89.4% at year 10 of the study. Among white participants, the lowest quintile of BMI at age 9 was less than 14.2, and the highest quintile was greater than 22.4. Early menarche was defined as less than 11.73 years of age, and late menarche as greater than 13.58 years. Among black participants, the lowest quintile of BMI at age 9 was less than 14.6, and the highest quintile was greater than 24.8. Early

Discussion

This study has provided longitudinal comparisons between elevated BMI and waist-to-height ratio. Although the girls experienced a greater increase in fat mass than fat-free mass, regardless of BMI, the data indicate that the changes in BMI and its components during the teen years in girls are dependent upon childhood BMI levels. Greater levels of BMI during childhood led to greater than expected changes in BMI, and those changes in BMI were driven by disproportionate increases in fat mass,

Acknowledgments

This work was supported in part through Puberty and Cancer Initiation: Environment, Diet, and Obesity, grant U01-ES12770/subaward P021-040-L529-1095; and through contracts HC55023-26 and cooperative agreements U01-HL-48941-44 from the National Heart, Lung, and Blood Institute (NHLBI), and Taft Research Grant at the University of Cincinnati. The authors acknowledge clerical assistance from Lynn Hanrahan, and the time and effort of the staff and families of the NHLBI Growth and Health Study.

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