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Author Notes:

Address for correspondence: Professor AD Stein, Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Emory University, Mail: Mailstop 1518‐002‐7BB, Emory University, Atlanta GA 30322, USA. E‐mail: aryeh.stein@emory.edu

LMR and SAN were involved in the design and implementation of the Birth‐to‐Twenty study in South Africa. EAL, SAN and ADS oversaw the initial design of the analysis, wrote the paper and had primary responsibility for the final content.

EAL analysed the data. All authors interpreted the data, helped prepare the manuscript and approved the final version.

EAL and ADS had full access to the data in the study and final responsibility for the decision to submit for publication.

No conflict of interest was declared.


Research Funding:

This work was supported by the Laney Graduate School, Emory University.

The Birth‐to‐Twenty Study receives support from Wellcome Trust (UK), South African Medical Research Council, University of the Witwatersrand, Johannesburg, the Human Sciences Research Council and the UK MRC/DfID Africa Research Leader Scheme.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • Body mass index
  • child growth
  • childhood overweight and obesity

Sex differences in obesity incidence: 20-year prospective cohort in South Africa


Journal Title:

Pediatric Obesity


Volume 11, Number 1


, Pages 75-80

Type of Work:

Article | Final Publisher PDF


Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity. Background: Prospective data spanning childhood and adolescence are needed to better understand obesity incidence among children and to identify important periods for intervention. Objective: To describe gender differences in overweight and obesity from infancy to late adolescence in a South African cohort. Methods: We analysed body mass index at 1-2 years, 4-8 years, 11-12 years, 13-15 years and 16-18 years among 1172 participants in the South African Birth-to-Twenty cohort. Results: Among boys, overweight and obesity prevalence declined from age 1-2 years to 16-18 years. Among girls, overweight and obesity prevalence increased from 4-8 years to 16-18 years. Obesity incidence was highest from 4-8 years to 11-12 years in boys (6.8 cases per 1000 person-years) and from 11-12 years to 13-15 years in girls (11.2 cases per 1000 person-years). Among girls, obesity at 16-18 years was associated with overweight (odds ratio [OR] = 3.6; 95% confidence interval [CI] 1.8-7.2) or obesity (OR = 8.0; 95% CI 3.7-17.6) at 1-2 years and overweight (OR = 6.8; 95% CI 3.3-13.9) or obesity (OR = 42.3; 95% CI 15.0-118.8) at 4-8 years; for boys, obesity at 16-18 years was associated with overweight at 1-2 years (OR = 5.6; 95% CI 1.7-18.0) and obesity at 4-8 years (OR = 19.7; 95% CI 5.1-75.9). Conclusions: Among girls, overweight and obesity increased throughout childhood. Overweight and obesity were not widely prevalent among boys. Early childhood and post-puberty may be important periods for intervention among girls.

Copyright information:

© 2015 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).

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