A longitudinal causal graph analysis investigating modifiable risk factors and obesity in a European cohort of children and adolescents.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Pediatric Obesity*/epidemiology ; Insulin Resistance*; Humans ; Child ; Adolescent ; Longitudinal Studies ; Risk Factors ; Diet ; Body Mass Index

Childhood obesity is a complex disorder that appears to be influenced by an interacting system of many factors. Taking this complexity into account, we aim to investigate the causal structure underlying childhood obesity. Our focus is on identifying potential early, direct or indirect, causes of obesity which may be promising targets for prevention strategies. Using a causal discovery algorithm, we estimate a cohort causal graph (CCG) over the life course from childhood to adolescence. We adapt a popular method, the so-called PC-algorithm, to deal with missing values by multiple imputation, with mixed discrete and continuous variables, and that takes background knowledge such as the time-structure of cohort data into account. The algorithm is then applied to learn the causal structure among 51 variables including obesity, early life factors, diet, lifestyle, insulin resistance, puberty stage and cultural background of 5112 children from the European IDEFICS/I.Family cohort across three waves (2007-2014). The robustness of the learned causal structure is addressed in a series of alternative and sensitivity analyses; in particular, we use bootstrap resamples to assess the stability of aspects of the learned CCG. Our results suggest some but only indirect possible causal paths from early modifiable risk factors, such as audio-visual media consumption and physical activity, to obesity (measured by age- and sex-adjusted BMI z-scores) 6 years later.
(© 2024. The Author(s).)

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DI 2372/1-1 Deutsche Forschungsgemeinschaft; No. 016181 (FOOD) Sixth Framework Programme; No. 266044 (KBBE 2010-14) Seventh Framework Programme; BMBF; grant no. 01EA2102A Joint Programming Initiative A healthy diet for a healthy life; ERA-NET Cofund action No. 727565 Horizon 2020 Framework Programme

Keywords: Audio-visual media consumption; Causal structure learning; DAG; Healthy diet; IDEFICS/I.Family cohort; Multiple imputation; PC-algorithm; Physical activity; Sleep; Well-being

Date Created: 20240322 Date Completed: 20240325 Latest Revision: 20240325

20240325

PMC10957936

10.1038/s41598-024-56721-y

38514750