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. 2021 May 13:9:615483.
doi: 10.3389/fped.2021.615483. eCollection 2021.

Sex-Specific Temporal Trends in Overweight and Obese Among Schoolchildren From 2009 to 2018: An Age Period Cohort Analysis

Yung-Chieh Chang  1 , Wan-Hua Hsieh  2 , Sen-Fang Huang  3 , Hsinyi Hsiao  4 , Ying-Wei Wang  5   6 , Chia-Hsiang Chu  1   7 , Shu-Hui Wen  2
Affiliations

Sex-Specific Temporal Trends in Overweight and Obese Among Schoolchildren From 2009 to 2018: An Age Period Cohort Analysis

Yung-Chieh Chang et al. Front Pediatr. .

Abstract

Background: Our study examined the age, period, and cohort effects on overweight and obesity in children using a 10-year dataset collected from schoolchildren in Hualien, Taiwan. Methods: We used data from the annual health checkup of a total of 94,661 schoolchildren in primary schools and junior high schools in Hualien from 2009 to 2018. Children were defined as overweight or obese by the gender- and age-specific norm of the body mass index. We conducted the age-period-cohort (APC) analysis in boys and girls separately. Results: From 2009 to 2018, the rates of children overweight and obese were 12.78 and 14.23%, respectively. Boys had higher rates of overweight and obesity than girls (29.73 vs. 24.03%, P < 0.001). Based on APC analysis results, positive age effect existed regardless of gender. The risk of overweight or obesity of children aged 9 or 12 years was significantly higher compared to the average rate. As for period effect, a fluctuating downward trend in overweight was evident in 2016, and a similar trend in obesity was seen in 2017 across gender groups. The birth cohort of 2007 to 2009 had a significant higher proportion of overweight and obese than other birth cohorts. This indicated that the proportion of children overweight and obese in the young generation is higher than that in the old generation. Conclusion: An increased risk of children overweight or obese was associated with age and later birth cohort. For the period effect, the trend in the prevalence of overweight and obesity fluctuated downward slowly from 2016 to 2017.

Keywords: age-period-cohort analysis; body mass index; childhood obesity; gender; poisson regression.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Age-specific prevalence of overweight and obese from 2009 to 2018. (A) overweight, (B) obesity, and (C) overweight/obesity.
Figure 2
Figure 2
Sex-specific prevalence of overweight and obese from 2009 to 2018. (A) overweight and (B) obesity.
Figure 3
Figure 3
Age, period, and cohort effect of the rate ratio (RR) of overweight by sex group, for boys (A–C) and girls (D–F). (A,D): age effect; (B,E): period effect; (C,F): cohort effect. Results are RR (solid line) and 95% confidence interval (dotted line). The solid horizontal line represents RR = 1.
Figure 4
Figure 4
Age, period, and cohort effect of the rate ratio (RR) of obesity by sex group, for boys (A–C) and girls (D–F). (A,D): age effect; (B,E): period effect; (C,F): cohort effect. Results are RR (solid line) and 95% confidence interval (dotted line). The solid horizontal line represents RR = 1.
See this image and copyright information in PMC

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