5% of weights and heights, and those with heights less than 1.25 m were excluded. Adolescents with a BMI less than 10 kg/m2 and greater than 45 kg/m2 were excluded. Following sequential application of the exclusion and data cleaning criteria described above, 72 900 children (30 centres/17 countries) and 199 135 adolescents selleck (74 centres/36 countries) were included in the final analysis (figure 1). Parents provided heights and weights for 60 027 children, while 12 873 children had their

heights and weights measured. In total, 154 624 adolescents provided self-reported height and weight while 44 511 adolescents had measured heights and weights. Figure 1 Flow of participants through the study. Children are represented in (A) and adolescents in (B) (BMI, body mass index). Statistical analysis BMI was assessed separately for each age group using a general linear mixed model with centre as a random effect and GNI for each country (low

and high), the individual’s age, sex, measurement type (reported or measured) and fast-food consumption (‘infrequent’, ‘frequent’, ‘very frequent’) as fixed effects. The BMI values reported are the modelled means for those who reported infrequent fast-food consumption in the children and adolescent groups, respectively. In the adolescent group, statistically significant interactions were found between sex and fast-food consumption, and measurement type and fast-food consumption. There was also an interaction found between country GNI and fast-food consumption. Consequently, analyses were conducted separately for each sex, measured height and weight data only, and GNI categories. No similar interactions were found in the children’s group, but there were sufficient numbers to analyse each sex separately, which we elected to do. Results Fast-food consumption Only 22.6% of children reported frequent fast-food consumption and 4.2% reported very frequent fast-food consumption. Combined frequent and very frequent fast-food consumption in each country ranged from 10% in Poland to

63% in South Korea (figure 2A). Figure 2 Reported frequency of fast-food consumption by study participants. Children are represented in (A) and adolescents in (B). In total, 38.7% of adolescents reported frequent fast-food consumption and 12.6% reported very frequent consumption. Frequent and very frequent fast-food consumption ranged from 15% in Indonesia to 79% in South Africa (figure 2B). Fast-food consumption and BMI Children Figure 3A GSK-3 shows the difference in BMI between children with infrequent fast-food consumption and those with frequent and very frequent fast-food consumption in each centre. Figure 3 The difference in body mass index (BMI) of study participants who consumed fast-food frequently and very frequently compared to infrequent fast-food consumption. Children are represented in (A) and adolescents in (B). For each country, the proportion … The estimated mean BMIs in children reporting infrequent fast-food consumption were 16.