Childhood obesity in Singapore: A Bayesian nonparametric approach

Abstract

Overweight and obesity in adults are known to be associated with increased risk of metabolic and cardiovascular diseases. Obesity has now reached epidemic proportions, increasingly affecting children. Therefore, it is important to understand if this condition persists from early life to childhood and if different patterns can be detected to inform intervention policies. Our motivating application is a study of temporal patterns of obesity in children from South Eastern Asia. Our main focus is on clustering obesity patterns after adjusting for the effect of baseline information. Specifically, we consider a joint model for height and weight over time. Measurements are taken every six months from birth. To allow for data-driven clustering of trajectories, we assume a vector autoregressive sampling model with a dependent logit stick-breaking prior. Simulation studies show good performance of the proposed model to capture overall growth patterns, as compared to other alternatives. We also fit the model to the motivating dataset, and discuss the results, in particular highlighting cluster differences. We have found four large clusters, corresponding to children sub-groups, though two of them are similar in terms of both height and weight at each time point. We provide interpretation of these clusters in terms of combinations of predictors.