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Title: Ethnic differences in the trajectories of physical growth in contemporary children in the United Kingdom : development and early life influences
Author: Lu, Yi
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Background: Child growth has important health and socio-economic implications. Cross-sectional studies suggest that there are marked ethnic differences in children's height and body mass index (BMI) in the United Kingdom (UK). This thesis aimed to investigate ethnic differences in growth trajectories in height and adiposity of contemporary UK children and the potential explanatory role of early life factors. Methods: Using longitudinal data from the UK Millennium Cohort Study (total n=18,107 singletons), mixed effects fractional polynomial models were applied to estimate height and BMI trajectories (3-14 years) and several early life factors were examined. Multiple imputation as well as attrition weights were used to handle missing data. Results: Compared with White children, South Asians had a comparable height growth and lower BMI in childhood with the BMI difference reducing with age; in adolescence, South Asian boys had similar height and BMI to White children, while girls were slightly shorter and remained to have a slightly lower BMI. Notwithstanding, body fat measure revealed that South Asians had much greater levels of body adiposity, especially in boys. Black African-Caribbeans had the highest height and BMI trajectories. The BMI difference between Black African-Caribbean and White children emerged at 5 years and increased to 0.5 kg/m² (95% confidence interval (CI)0.02, 1.01) in boys and 1.46 kg/m² (0.90, 2.02) in girls at 14 years; similar patterns were also seen in the other adiposity measures. Their greater BMI was largely explained by maternal pre-pregnancy BMI and infant weight gain. Socio-economic patterns in BMI also differed by ethnicity. Contrary to the White and South Asian groups, lower socio-economic position was associated with lower BMI in Black African-Caribbean children. Conclusions: Public health policies need to take a whole-system and life course approach to improve health disparities and reduce childhood obesity, with an emphasis on early intervention and the consideration of varying needs of their target population especially in areas of high ethnic diversity.
Supervisor: Li, L. ; Pearce, A. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available