New perspectives for understanding the developmental trajectory of metabolic syndrome and obesity.

摘要

Developmental frameworks and person-centered approaches have the potential to broaden our understanding of the development of disease risk in children. Few studies examining the etiology of metabolic syndrome and obesity during childhood have adopted these frameworks and approaches. The present research aims to address these limitations. Data used in the present research were from a longitudinal study of 197 girls and their parents. In the first study, we used a latent profile approach to identify a metabolic syndrome risk typology based on girls’ age 13 values for six metabolic syndrome indicators. Statistical support was strongest for a four group solution: (1) Lower MetS Risk, (2) Dyslipidemia Risk, (3) Hypertension Risk, and (4) Higher MetS Risk. Examination of the antecedents of this risk typology revealed girls in the Higher MetS Risk group consumed significantly more sweetened beverages and girls in the Dyslipidemia Risk group had the lowest levels of physical activity across ages 5 to 13 years. In the second study, we used a growth mixture model approach to identify latent growth trajectories for girls’ patterns of BMI change across ages 5 to 15 years. Statistical support was strongest for four patterns of BMI change: (1) Upward Percentile Crossing (UPC); (2) Delayed Downward Percentile Crossing (DDPC); (3) 60th Percentile Tracking (60PT) and 4) 50 th Percentile Tracking (50PT). Girls in the UPC group had more overweight mothers, were breastfed for a shorter duration, under-reported dietary intake to a greater degree and presented the worst metabolic outcomes. In the third study, we explored psychosocial correlates of heterogeneity for girls’ BMI trajectories. Our findings illustrated that girls in the UPC group developed in a distinct ecology compared to other girls in our sample, characterized by higher maternal weight status, weight concern, and higher levels of maternal restriction of daughter’s diet, and encouragement of daughter’s weight loss. Overall, the present research illustrates that girls do not follow a single pathway toward metabolic and weight status outcomes and the psychosocial influences associated with these pathways are multifactorial. Our findings suggest several modifiable behaviors that may serve as successful targets for obesity and metabolic syndrome prevention efforts.