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Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries: pooled analysis of 2,182 population-based studies with 65 million participants

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries: pooled analysis of 2,182 population-based studies with 65 million participants
Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries: pooled analysis of 2,182 population-based studies with 65 million participants
Background: comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.

Methods: for this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.

Findings: we pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls.

Interpretation: the height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks.

Funding: Wellcome Trust, AstraZeneca Young Health Programme, EU.
0140-6736
1511-1524
Rodriguez-Martinez, Andrea
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Zhou, Bin
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Di Cesare, Mariachiara
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Miranda, J. Jaime
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Popovic, Stevo R.
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Sorensen, Thorkild I. A.
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Soric, Maroje
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Starc, Gregor
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Zainuddin, Ahmad A.
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Bhutta, Zulfiqar A.
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Black, Robert
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Ezzati, Majid
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Abarca-Gomez, Leandra
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Bennett, James E.
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Cheng, Ching-Yu
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Cooper, Cyrus
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Dennison, Elaine
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Fall, Caroline H.
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He, Yuan
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Hill, Allan G.
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Kim, Dong Wook
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Liu, Jing
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Morgan, Karen
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Osmond, Clive
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Syddall, Holly E.
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Taylor, Anne
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Wang, Xiangjun
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Zhao, Dong
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NCD Risk Factor Collaboration (NCD-RisC)
Rodriguez-Martinez, Andrea
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Zhou, Bin
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Sophiea, Marisa K.
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Bentham, James
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Paciorek, Christopher J.
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Iurilli, Maria L. C.
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Carrillo-Larco, Rodrigo M.
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Bennett, James E.
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Di Cesare, Mariachiara
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Taddei, Cristina
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Bixby, Honor
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Stevens, Gretchen A.
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Riley, Leanne M.
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Cowan, Melanie J.
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Savin, Stefan
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Danaei, Goodarz
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Chirita-Emandi, Adela
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Kengne, Andre P.
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Malekzadeh, Reza
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Miranda, J. Jaime
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Moon, Jin Soo
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Popovic, Stevo R.
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Sorensen, Thorkild I. A.
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Soric, Maroje
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Black, Robert
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Ezzati, Majid
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Dennison, Elaine
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Fall, Caroline H.
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He, Yuan
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Hill, Allan G.
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Kim, Dong Wook
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Wang, Xiangjun
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Rodriguez-Martinez, Andrea, Zhou, Bin and Sophiea, Marisa K. , NCD Risk Factor Collaboration (NCD-RisC) (2020) Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries: pooled analysis of 2,182 population-based studies with 65 million participants. The Lancet, 396 (10261), 1511-1524, [10261]. (doi:10.1016/S0140-6736(20)31859-6).

Record type: Article

Abstract

Background: comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.

Methods: for this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.

Findings: we pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls.

Interpretation: the height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks.

Funding: Wellcome Trust, AstraZeneca Young Health Programme, EU.

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NCDRisC Height BMI trends Lancet 2020 08 02 clean final accepted version - Accepted Manuscript
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Accepted/In Press date: 28 August 2020
e-pub ahead of print date: 5 November 2020
Published date: 7 November 2020

Identifiers

Local EPrints ID: 443811
URI: http://eprints.soton.ac.uk/id/eprint/443811
ISSN: 0140-6736
PURE UUID: 9f94ba7c-018e-49f2-975c-ae0bb3ebc248
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Caroline H. Fall: ORCID iD orcid.org/0000-0003-4402-5552
ORCID for Yuan He: ORCID iD orcid.org/0000-0003-3768-519X
ORCID for Allan G. Hill: ORCID iD orcid.org/0000-0002-4418-0379
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655

Catalogue record

Date deposited: 14 Sep 2020 16:31
Last modified: 30 Oct 2023 02:57

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Contributors

Author: Andrea Rodriguez-Martinez
Author: Bin Zhou
Author: Marisa K. Sophiea
Author: James Bentham
Author: Christopher J. Paciorek
Author: Maria L. C. Iurilli
Author: Rodrigo M. Carrillo-Larco
Author: James E. Bennett
Author: Mariachiara Di Cesare
Author: Cristina Taddei
Author: Honor Bixby
Author: Gretchen A. Stevens
Author: Leanne M. Riley
Author: Melanie J. Cowan
Author: Stefan Savin
Author: Goodarz Danaei
Author: Adela Chirita-Emandi
Author: Andre P. Kengne
Author: Young-Ho Khang
Author: Avula Laxmaiah
Author: Reza Malekzadeh
Author: J. Jaime Miranda
Author: Jin Soo Moon
Author: Stevo R. Popovic
Author: Thorkild I. A. Sorensen
Author: Maroje Soric
Author: Gregor Starc
Author: Ahmad A. Zainuddin
Author: Edward W. Gregg
Author: Zulfiqar A. Bhutta
Author: Robert Black
Author: Majid Ezzati
Author: Leandra Abarca-Gomez
Author: James E. Bennett
Author: Ching-Yu Cheng
Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD
Author: Yuan He ORCID iD
Author: Allan G. Hill ORCID iD
Author: Dong Wook Kim
Author: Jing Liu
Author: Karen Morgan
Author: Clive Osmond ORCID iD
Author: Holly E. Syddall
Author: Anne Taylor
Author: Xiangjun Wang
Author: Ying-Wei Wang
Author: Yang Yang
Author: Dong Zhao
Corporate Author: NCD Risk Factor Collaboration (NCD-RisC)

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