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. 2026 Sep 7;14:1896650. doi: 10.3389/fpubh.2026.1896650

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Copyright © 2026 Bu, Zhu, Zhao, Xu and Song.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Histogram showing the distribution of class-year-specific within-class BMI slopes, measured in points per kilogram per square meter. The mean slope is marked by a vertical red line at negative zero point five one nine, with a black dashed curve illustrating the normal approximation and dotted lines indicating the ninety-five percent range from negative one point zero five to zero point zero one. The x-axis represents the BMI slope, and the y-axis shows density. — Distribution of class-specific within-class BMI slopes (Model 3, empirical-Bayes estimates). The mean slope is −0.52 and ≈95% of slopes fall between −1.05 and +0.01; fewer than 4% are positive.