Is attained height associated with overnutrition measures in adolescents? : A cross-sectional analysis of 15 years’ follow-up data in the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) study in rural Bangladesh

Background: As overnutrition rises along with nutrition transition in low- and middle-income settings such as Bangladesh, evaluating metabolic risk factors using overnutrition measures in adolescents is important. Before doing such evaluation, a preliminary step should be taken to attest the independence of overnutrition measures from total height. Moreover, sitting height measures are recognized as important metabolic risk indicators. This study aims to understand the association of attained height –total and sitting– with overnutrition measures including body mass index (BMI), percent body fat (PBF), fat mass index (FMI) and fat free mass index (FFMI) and to assess modification by sex. Methods: Cross-sectional analysis of the MINIMat study’s 15-year follow-up data from October 2017 to December 2018 was undertaken. The associations of attained height –total and sitting– with each of the overnutrition measures were analysed using multiple linear regressions. Results: Overnutrition measures were non-independent of total height among male adolescents. The taller they were, the higher their BMI would be. This increase of BMI along with the height would have been contributed relatively more by the increase of fat free mass (FFM) than that of fat mass (FM). When total heights of both sexes were kept equal at the median, female adolescents had lower lean mass (FFMI) and higher fat mass (FMI) than the males although there was no difference in BMI on average between them. Sitting height was associated with all overnutrition measures with varying extents depending on the sex. Conclusion: When assessing overnutrition measures, it is important to examine beyond BMI and into FMI and FFMI. Again, when assessing the metabolic risks using overnutrition measures among adolescents, normalizing those indices for height is important to be considered to avoid inferring the implication from growth as risks.