Identification of Critical Intervention Windows for Central Obesity from Childhood to Early Adulthood: A 30-year...

To characterize long-term transition probabilities in waist circumference (WC) status from childhood into early adulthood and identify critical age windows for the development, persistence, and reversal of central obesity.

Using the China Health and Nutrition Survey data (1993-2022), 7,007 WC measurements from 2,440 participants aged 6-17 years at baseline were analyzed. Participants were grouped by baseline age: 6-11, 12-14, and 15-17 years. Generalized linear mixed-effects models were used to estimate WC transition probabilities, adjusting for sociodemographic factors.

Central obesity prevalence increased from age 6, declined in early adulthood (approximately 22 years), and subsequently increased again. The 6-14-year age window exhibited dynamic, bidirectional transitions; specifically, the 10-year reversal probabilities from central obesity to normal WC were 44.19% (ages 6-11) and 41.39% (ages 12-14), decreasing to 26.93% for ages 15-17. Among those aged 15-17 years with central obesity, boys had a > 80% probability of maintaining increased WC for 20 years.

Ages 6-14 years represent a critical "reversal period" for central obesity. Interventions should prioritize this window using age- and sex-specific strategies to maximize normalization and curb long-term obesity risk.