Predicting the onset of overweight in Chinese high school students: a machine-learning approach in a one-year prospective cohort study.

Objective: This study aimed to develop and evaluate machine-learning models for predicting the onset of overweight in adolescents aged 14‒17, utilizing easily collectible personal information.

Methods: This study was a one-year prospective cohort study. Baseline data were collected through anthropometric measurements and questionnaires, and the incidence of overweight was calculated one year later via anthropometric measurements. Predictive factors were selected through univariate analysis. Six machine-learning models were developed for predicting the onset of overweight. The SHapley Additive exPlanations (SHAP) was used for global and local interpretation of the models.

Results: Out of 1,241 adolescents, 204 (16.4%) were identified as overweight after one year. Nineteen features were associated with the overweight incidence in univariable analysis. Participants were randomly divided into a training group and a testing group in a 7:3 ratio. The Light Gradient Boosting Machine (LGBM) algorithm achieved outperformed other models, achieving the following metrics: Accuracy (0.956), Recall (0.812), Specificity (0.983), F1-score (0.855), AUC (0.961). Importance ranking revealed that the top 11 minimal feature set can maintain the stability of model performance.

Conclusions: The onset of overweight in adolescents was accurately predicted using easily collectible personal information. The LGBM-based model exhibited superior performance. Oversampling technique notably improved model performance. The model interpretation technique provided innovative strategies for managing adolescent overweight/obesity.