Early childhood body mass index growth and school readiness: A longitudinal cohort study

Xuedi Li¹, Alyssa Kahane^{2

3}, Charles D G Keown-Stoneman^{4

5}, Jessica A Omand^{1

6}, Cornelia M Borkhoff^{1

7}, Gerald Lebovic^{4

7}, Jonathon L Maguire^{3

4

7

8

9}, Muhammad Mamdani^{4

10}, Patricia C Parkin^{1

2

3}, Janis Randall Simpson¹¹, Mark S Tremblay^{12

13}, Leigh M Vanderloo¹⁴, Eric Duku¹⁵, Caroline Reid-Westoby¹⁵, Magdalena Janus^{15

16}, Catherine S Birken^{1

2

3

7

9}; TARGet Kids! Collaboration

Collaborators, Affiliations

Collaborators

TARGet Kids! Collaboration:
Jonathon L Maguire, Christopher Allen, Laura N Anderson, Danielle D'Annunzio, Mateenah Jaleel, Sharon Thadani, Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Alice Charach, Katherine Cost, Curtis D'Hollander, Anne Fuller, Laura Kinlin, Michaela Kucab, Patricia Li, Pat Parkin, Nav Persaud, Sarah Rae, Izabela Socynska, Shelley Vanderhout, Peter Wong, Piyumi Konara Mudiyanselage, Michelle Mitchell, Yulika Yoshida-Montezuma, Nusrat Zaffar, Tiffany Bondoc, Trudy-Ann Buckley, Pamela Ruth Flores, Kardelen Kurt, Sangeetha Loganathan, Tarandeep Mali, Laurie Thompson, Jennifer Batten, Jennifer Chan, John Clark, Amy Craig, Kim De Castris-Garcia, Sharon Dharman, Sarah Kelleher, Salimah Nasser, Tammara Pabon, Michelle Rhodes, Rafael Salsa, Julie Skelding, Daniel Stern, Kerry Stewart, Erika Sendra Tavares, Shannon Weir, Maria Zaccaria Cho, Patricia Raso, Amanda Offord, Emy Abraham, Sara Ali, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Douglas Campbell, Sohail Cheema, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Viveka De Guerra, Mary Beth Derocher, Anh Do, Kathleen Doukas, Anne EggerN, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Karen Grewal, Charlie Guiang, Curtis Handford, Laura HansonN, Leah Harrington, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Lukas Keiswetter, Tara Kiran, Holly Knowles, Bruce Kwok, Piya Lahiry, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Denis Leduc, Fok-Han Leung, Alan Li, Patricia Li, Roy Male, Aleks Meret, Elise Mok, Rosemary Moodie, Katherine NashN, James Owen, Michael Peer, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Noor Ramji, Danyaal Raza, Katherine Rouleau, Caroline Ruderman, Janet Saunderson, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Farah Siam, Susan Shepherd, Cinntha Srikanthan, Carolyn Taylor, Stephen Treherne, Suzanne Turner, Fatima Uddin, Meta van den Heuvel, Thea Weisdorf, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman, Esmot Ara Begum, Peter Juni, Gurpreet Lakhanpal, Ifeayinchukwu Shawn Nnorom, Marc Denzel Nunez, Audra Stitt, Kevin Thorpe, Raya Assan, Homa Bondar, George S Charames, Andrea Djolovic, Chelsea Gorscak-Dunn, Mary Hassan, Rita Kandel

Affiliations

¹ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁵ Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁶ School of Nutrition, Toronto Metropolitan University, Toronto, Ontario, Canada.
⁷ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁸ Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁹ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Centre for Artificial Intelligence Education and Research in Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹¹ Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
¹² Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹³ Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
¹⁴ ParticipACTION, Toronto, Ontario, Canada.
¹⁵ Offord Centre for Child Studies, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
¹⁶ Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

PMID: 39607066
DOI: 10.1111/ppe.13114

Early childhood body mass index growth and school readiness: A longitudinal cohort study

Xuedi Li et al. Paediatr Perinat Epidemiol. 2024 Nov.

. 2024 Nov;38(8):733-744.

doi: 10.1111/ppe.13114.

Authors

Collaborators

TARGet Kids! Collaboration:
Jonathon L Maguire, Christopher Allen, Laura N Anderson, Danielle D'Annunzio, Mateenah Jaleel, Sharon Thadani, Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Alice Charach, Katherine Cost, Curtis D'Hollander, Anne Fuller, Laura Kinlin, Michaela Kucab, Patricia Li, Pat Parkin, Nav Persaud, Sarah Rae, Izabela Socynska, Shelley Vanderhout, Peter Wong, Piyumi Konara Mudiyanselage, Michelle Mitchell, Yulika Yoshida-Montezuma, Nusrat Zaffar, Tiffany Bondoc, Trudy-Ann Buckley, Pamela Ruth Flores, Kardelen Kurt, Sangeetha Loganathan, Tarandeep Mali, Laurie Thompson, Jennifer Batten, Jennifer Chan, John Clark, Amy Craig, Kim De Castris-Garcia, Sharon Dharman, Sarah Kelleher, Salimah Nasser, Tammara Pabon, Michelle Rhodes, Rafael Salsa, Julie Skelding, Daniel Stern, Kerry Stewart, Erika Sendra Tavares, Shannon Weir, Maria Zaccaria Cho, Patricia Raso, Amanda Offord, Emy Abraham, Sara Ali, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Douglas Campbell, Sohail Cheema, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Viveka De Guerra, Mary Beth Derocher, Anh Do, Kathleen Doukas, Anne EggerN, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Karen Grewal, Charlie Guiang, Curtis Handford, Laura HansonN, Leah Harrington, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Lukas Keiswetter, Tara Kiran, Holly Knowles, Bruce Kwok, Piya Lahiry, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Denis Leduc, Fok-Han Leung, Alan Li, Patricia Li, Roy Male, Aleks Meret, Elise Mok, Rosemary Moodie, Katherine NashN, James Owen, Michael Peer, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Noor Ramji, Danyaal Raza, Katherine Rouleau, Caroline Ruderman, Janet Saunderson, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Farah Siam, Susan Shepherd, Cinntha Srikanthan, Carolyn Taylor, Stephen Treherne, Suzanne Turner, Fatima Uddin, Meta van den Heuvel, Thea Weisdorf, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman, Esmot Ara Begum, Peter Juni, Gurpreet Lakhanpal, Ifeayinchukwu Shawn Nnorom, Marc Denzel Nunez, Audra Stitt, Kevin Thorpe, Raya Assan, Homa Bondar, George S Charames, Andrea Djolovic, Chelsea Gorscak-Dunn, Mary Hassan, Rita Kandel

Affiliations

¹ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁵ Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁶ School of Nutrition, Toronto Metropolitan University, Toronto, Ontario, Canada.
⁷ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁸ Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁹ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Centre for Artificial Intelligence Education and Research in Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹¹ Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
¹² Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹³ Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
¹⁴ ParticipACTION, Toronto, Ontario, Canada.
¹⁵ Offord Centre for Child Studies, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
¹⁶ Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

PMID: 39607066
DOI: 10.1111/ppe.13114

Abstract

Background: Child growth influences future health and learning. School readiness refers to a child's ability to meet developmental expectations at school entry. The association of early growth rate and patterns with school readiness remains unknown.

Objective: To determine the association of child body mass index (BMI) growth with school readiness in a cohort of young children.

Methods: A prospective cohort study (2015-2022) was conducted in children 0-6 years enrolled in the TARGet Kids! research network in Toronto, Canada. Two analytical approaches were used to measure growth using child weight and height/length data between 0 and 4 years: (i) age- and sex-standardised BMI (zBMI) growth rate per year using a piecewise linear model; and (ii) distinct zBMI trajectories using latent class mixed models. School readiness (4-6 years) was measured using teacher-completed Early Development Instrument (EDI). Robust Poisson models and marginal linear models using generalised estimating equations were used adjusting for confounders identified a priori.

Results: In this study of 1077 children (mean age at EDI completion: 4.8 years; 52.6% male) with 6415 zBMI measurements, mean growth rate was 0.65 zBMI units/year (0-2 years) and -0.11 zBMI units/year (2-4 years). Two distinct zBMI trajectories were identified: the stable trajectory and the catch-up trajectory. There was insufficient evidence that zBMI growth rates (risk ratio 1.10, 95% confidence interval 0.78, 1.55 for 0-2 years; risk ratio 0.71, 95% confidence interval 0.32, 1.57 for 2-4 years) or trajectories (risk ratio 1.05, 95% confidence interval 0.82, 1.35, catch-up trajectory vs. stable trajectory) were associated with school readiness.

Conclusions: No association was found between BMI growth and school readiness. School readiness may be more impacted by factors directly related to obesity or adiposity at the time of EDI measurement rather than growth.

Keywords: early childhood; growth; obesity; school readiness.

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References

REFERENCES

1. Peterson JW, Loeb S, Chamberlain LJ. The intersection of health and education to address school readiness of all children. Pediatrics. 2018;142(5):e20181126. doi:10.1542/PEDS.2018-1126
1. Janus M, Offord DR. Development and psychometric properties of the early development instrument (EDI): a measure of children's school readiness. Can J Behav Sci. 2007;39(1):1‐22. doi:10.1037/cjbs2007001
1. Duncan GJ, Dowsett CJ, Claessens A, et al. School readiness and later achievement. Psychol Assoc. 2007;43(6):1428‐1446. doi:10.1037/[0012-1649.43.6.1428].supp
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Early childhood body mass index growth and school readiness: A longitudinal cohort study

Collaborators

Affiliations

Early childhood body mass index growth and school readiness: A longitudinal cohort study

Authors

Collaborators

Affiliations

Abstract

References

REFERENCES

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical