Title: thLongitudinal modelling of adiposity, its determinants and its health consequences across childhood and adolescence
Funder: Medical Research Council

Abstract: Aim To determine how adiposity changes from birth to adolescence and risk factors for, and consequences of, different patterns of adiposity change. Objectives 1. To characterise patterns of change in adiposity (BMI 0-18 years, waist-circumference 7-18 years, and DXA-determined fat mass 9-18 years) and its associated cardiovascular risk factors (blood pressure 7-18 years, lipids, insulin and inflammatory markers 9-18 years) across childhood and adolescence 2. To identify genetic, lifestyle (longitudinal patterns of diet and physical activity), socioeconomic (including differential socioeconomic position between family generations) and ethnic determinants of adiposity changes across childhood and adolescence 3. To identify how adiposity changes relate to changes in cardiovascular risk factors in childhood and adolescence, and whether there is a time lag between adiposity changes and changes in cardiovascular risk factors 4. To identify characteristics associated with 1) extreme obesity in adolescence (ages 15-18) and 2) metabolic resilience to obesity Methodology The Avon Longitudinal Study of Parents and Children is a prospective cohort study; >14,000 pregnant women were recruited between 1991-1992. Follow-up continues, and has involved clinics, links to routine data, and questionnaires to the mother, her partner, and the child. Adiposity measures include repeat measures of BMI, waist circumference, and DXA-determined fat mass. Cardiovascular risk factors include repeat measures of blood pressure, lipids, insulin and inflammatory markers. Diet data are available from food frequency questionnaires and diet-diaries. Physical activity and sedentary behaviours data were collected using accelerometers and questionnaires. Family socioeconomic factors are available from questionnaires and participants‘ own educational attainment from links to routine data. Additional analyses will be conducted on the Born in Bradford cohort; 5000 European- and 5000 Pakistani-origin families will have been recruited by December 2010. Detailed lifestyle, socioeconomic and obstetric data are collected; growth from birth to 5-years will be available from health visitor assessments and research clinic measurements. Relevant statistical methods - multivariable regression, structural equation modelling, multilevel/multivariate models, Bayesian analysis, etc - will be used as appropriate. Scientific/medical opportunities To design obesity prevention/treatment interventions, improved understanding of life-course influences on obesity is essential. The proposed research addresses this by characterising patterns of adiposity change from birth to adolescence in the most detailed dataset currently available. Hence it will potentially identify sensitive periods for developing adverse levels and patterns of adiposity, risk factors for adverse adiposity changes, how different patterns relate to cardiovascular risk, and which factors are associated with both extreme obesity and metabolic resilience to obesity.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS;2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT;2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL