Do childhood social circumstances affect overweight and obesity in early adulthood?

Abstract

Aims: The aim of the study was to examine the association of childhood circumstances with overweight and obesity in early adulthood, to analyse whether the respondent's education and current circumstances mediate these associations, and to explore whether the respondent's health behaviour affects these associations. Design: This was a cross-sectional study with retrospective inquiries. Methods: The study was based on a representative two-stage cluster sample (N= 1894, participation rate 79%) of young adults aged 18—29 years in Finland in 2000. The outcome measure was three-class body mass index (BMI) (normal weight, overweight, and obesity). Multinomial logistic regression was used as the main statistical tool. Results: In women, childhood circumstances (low parental education (relative risk ratio (RRR) = 2.43), parental unemployment (RRR= 2.09) and single-parent family (RRR= 1.99)) increased the risk of overweight (25 ≤ BMI<30), but the effects were largely attenuated by other childhood factors and early adult circumstances. In men, no significant childhood predictors of overweight were found. Single-parent family (RRR=2.32), parental alcohol problem (RRR= 2.71), parental mental health problems (RRR=2.28) and being bullied at school (RRR=3.13) predicted obesity (BMI ≥ 30) in women in the age-adjusted models, and being bullied at school remained a significant predictor after adjusting for all childhood and current determinants. In both genders, the strong association between parental education and obesity remained significant after adjusting for all other determinants (for the lowest educational category, RRR= 3.56 in women, and RRR= 6.55 in men). Conclusions: Childhood factors predict overweight and obesity in early adulthood. This effect is stronger on obesity than on overweight and in women than in men, and it seems to be partly mediated by adult circumstances. The results emphasize the lasting effect of childhood socioeconomic position on adult obesity. When preventive policies are being planned, social circumstances in childhood should be addressed.

Keywords

Childhood adversities education life-course obesity overweight socioeconomic position

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References

World Health Organization. Obesity: preventing, & managing the global epidemic. Report of a WHO consultation . Geneva: WHO; 2000.

Kark M. , Rasmussen F. Growing social inequalities in the occurrence of overweight and obesity among young men in Sweden. Scand J Public Health 2005;33:472-7.

Lahti-Koski M. , Harald K. , Maönnisto S. , Laatikainen T. , Jousilahti P. Fifteen-year changes in body mass index and waist circumference in Finnish adults. Eur J Cardiovasc Prev Rehabil 2007;14:398-404.

James WP What are the health risks? The medical consequences of obesity and its health risks. Exp Clin Endocrinol Diabetes 1998;106 Suppl 2:1-6.

Laaksonen M. , Piha K. , Sarlio-Laöhteenkorva S. Relative weight and sickness absence. Obesity (Silver Spring) 2007; 15:465-72.

Karnehed N. , Rasmussen F. , Kark M. Obesity in young adulthood and later disability pension: a population-based cohort study of 366,929 Swedish men. Scand J Public Health 2007;35:48-54.

Parsons TJ , Power C. , Logan S. , Summerbell CD Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999 ;23 Suppl 8:S1-107.

Ball K. , Mishra GD , Crawford D. Social factors and obesity: an investigation of the role of health behaviours . Int J Obes Relat Metab Disord 2003;27:394-403.

Power C. , Parsons T. Nutritional and other influences in childhood as predictors of adult obesity . Proc Nutr Soc 2000;59:267-72.

10.

Sobal J. , Stunkard AJ Socioeconomic status and obesity: a review of the literature. Psychol Bull 1989;105:260-75.

11.

Giskes K. , van Lenthe FJ , Turrell G. , Kamphuis CB , Brug J. , Mackenbach JP Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: a longitudinal study with 13-year follow-up. Obesity (Silver Spring) 2008;16:1377-81.

12.

Kuh D , Ben-Shlomo Y , editors. A life course approach to chronic disease epidemiology, 2nd edn. New York: Oxford University Press; 2004.

13.

Kaplan HI , Kaplan HS The psychosomatic concept of obesity. J Nerv Mental Dis 1957;125:181-201.

14.

French SA , Story M. , Perry CL Self-esteem and obesity in children and adolescents: a literature review. Obes Res 1995;3:479-90.

15.

Wardle J. , Volz C. , Golding C. Social variation in attitudes to obesity in children. Int J Obes Relat Metab Disord 1995 ; 19:562-9.

16.

Jeffery RW , French SA Socioeconomic status and weight control practices among 20- to 45-year-old women. Am J Public Health 1996;86:1005-10.

17.

Huerta M. , Bibi H. , Haviv J. , Scharf S. , Gdalevich M. Parental smoking and education as determinants of overweight in Israeli children. Prev Chronic Dis 2006;3:A48.

18.

Power C. , Moynihan C. Social class and changes in weight-for-height between childhood and early adulthood. Int J Obes 1988;12:445-53.

19.

Power C. , Graham H. , Due P. , Hallqvist J. , Joung I. , Kuh D. , et al. The contribution of childhood and adult socioeconomic position to adult obesity and smoking behaviour: an international comparison. Int J Epidemiol 2005;34:335-44.

20.

Huurre T. , Aro H. , Rahkonen O. Well-being and health behaviour by parental socioeconomic status: a follow-up study of adolescents aged 16 until age 32 years. Soc Psychiatry Psychiatr Epidemiol 2003; 38:249-55.

21.

Whitaker RC , Wright JA , Pepe MS , Seidel KD , Dietz WH Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869-73.

22.

Bachman KH Adverse childhood experiences, obesity, and liver disease. Arch Intern Med 2004;164:460-1.

23.

Johnson JG , Cohen P. , Kasen S. , Brook JS Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. Am J Psychiatry 2002;159:394-400.

24.

Thomas C. , Hypponen E. , Power C. Obesity and type 2 diabetes risk in midadult life: the role of childhood adversity . Pediatrics 2008;121:e1240-9.

25.

Lissau I. , Soörensen TI Parental neglect during childhood and increased risk of obesity in young adulthood . Lancet 1994;343:324-7.

26.

Williamson DF , Thompson TJ , Anda RF , Dietz WH , Felitti V. Body weight and obesity in adults and self-reported abuse in childhood. Int J Obes Relat Metab Disord 2002;26:1075-82.

27.

Felitti VJ Childhood sexual abuse, depression, and family dysfunction in adult obese patients: a case control study. South Med J 1993;86:732-6.

28.

Lissau I. , Sorensen TI School difficulties in childhood and risk of overweight and obesity in young adulthood: a ten year prospective population study. Int J Obes Relat Metab Disord 1993;17:169-75.

29.

Lissau I. , Soörensen TI Prospective study of the influence of social factors in childhood on risk of overweight in young adulthood. Int J Obes Relat Metab Disord 1992;16:169-75.

30.

Aromaa A , Koskinen S , editors. Health and functional capacity in finland. Baseline results of the Health 2000 Health Examination Survey: Publications of the National Public Health Institute B12/2004. Available at: www.ktl.fi/health2000

31.

Statistics Finland. Municipalities and regional divisions based on municipalities. Handbook 28. Statistics Finland; Helsinki 2000.

32.

Pate RR , Pratt M. , Blair SN , Haskell WL , Macera CA , Bouchard C. , et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995;273:402-7.

33.

Steingrimsdottir L. , Ovesen L. , Moreiras O. , Jacob S. Selection of relevant dietary indicators for health. Eur J Clin Nutr 2002;56 Suppl 2:S8-11.

34.

Joutsenniemi K. , Martelin T. , Kestilaö L. , Martikainen P. , Pirkola S. , Koskinen S. Living arrangements, heavy drinking and alcohol dependence. Alcohol Alcohol 2007;42:480-91.

35.

Joutsenniemi K. , Martelin T. , Martikainen P. , Pirkola S. , Koskinen S. Living arrangements and mental health in Finland . J Epidemiol Community Health 2006;60:468-75.

36.

Sainio P. , Martelin T. , Koskinen S. , Heliovaara M. Educational differences in mobility: the contribution of physical workload, obesity, smoking and chronic conditions. J Epidemiol Community Health 2007;61:401-8.

37.

Lehtonen R. , Pahkinen EJ Practical methods for design and analysis of complex surveys, 2nd edn. Chichester: John Wiley & Sons; 1994.

38.

StataCorp. Stata statistical software: Release 8.0. TX: Stata Corporation; 2003.

39.

Garn S. , Leonard W. , Hawthorne V. Three limitations of the body mass index. Am J Clin Nutr 1986;44:996-7.

40.

Lawlor DA , Batty GD , Morton SM , Clark H. , Macintyre S. , Leon DA Childhood socioeconomic position, educational attainment, and adult cardiovascular risk factors: the Aberdeen children of the 1950s cohort study. Am J Public Health 2005;95:1245-51.

41.

Poulton R. , Caspi A. , Milne BJ , Thomson WM , Taylor A. , Sears MR , et al. Association between children's experience of socioeconomic disadvantage and adult health: a life-course study. Lancet 2002;360:1640-5.

42.

Blane D. , Hart CL , Smith GD , Gillis CR , Hole DJ , Hawthorne VM Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood. BMJ 1996;313:1434-8.

43.

Danielzik S. , Czerwinski-Mast M. , Langnase K. , Dilba B. , Muller MJ Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7 y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 2004;28:1494-502.

44.

Jeffery RW , French SA , Forster JL , Spry VM Socioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project. Int J Obes 1991;15:689-96.

45.

Lissau I. , Sorensen TI Parental neglect during childhood and increased risk of obesity in young adulthood. Lancet 1994;343:324-7.

46.

Magarey AM , Daniels LA , Boulton TJ , Cockington RA Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord 2003; 27:505-13.

47.

McLaren L. Socioeconomic status and obesity. Epidemiol Rev 2007;29:29-48.

48.

Stunkard AJ , Sorensen TI Obesity and socioeconomic status - a complex relation. N Engl J Med 1993;329:1036-7.

49.

Gortmaker SL , Must A. , Perrin JM , Sobol AM , Dietz WH Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 1993; 329:1008-12.

50.

Laitinen J. , Power C. , Ek E. , Sovio U. , Jarvelin MR Unemployment and obesity among young adults in a northern Finland 1966 birth cohort. Int J Obes Relat Metab Disord 2002;26:1329-38.

51.

Wardle J. , Griffith J.

Socioeconomic status and weight control practices in

British adults. J Epidemiol Community Health 2001;55:185-90.

52.

Seidell JC Dietary fat and obesity: an epidemiologic perspective . Am J Clin Nutr 1998;67(3 Suppl):546S-50S.

53.

Pirkola S. , Isometsa E. , Aro H. , Kestila L. , Hamalainen J. , Veijola J. , et al. Childhood adversities as risk factors for adult mental disorders: results from the Health 2000 study. Soc Psychiatry Psychiatr Epidemiol 2005;40:769-77.

54.

Kestilaö L. , Koskinen S. , Martelin T. , Rahkonen O. , Pensola T. , Pirkola S. , et al. Influence of parental education, childhood adversities, and current living conditions on daily smoking in early adulthood . Eur J Public Health 2006;16:617-26.

55.

Dube SR , Williamson DF , Thompson T. , Felitti VJ , Anda RF Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse Negl 2004;28:729-37.

56.

Hardt J. , Rutter M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 2004;45:260-73.

57.

O'Malley SS , Carey KB , Maisto SA Validity of young adults' reports of parental drinking practices. J Studies Alcohol 1986 ;47:433-5.

58.

James PT Obesity: the worldwide epidemic. Clin Dermatol 2004;22:276-80.

59.

Engstroöm JL , Paterson SA , Doherty A. , Trabulsi M. , Speer KL Accuracy of self-reported height and weight in women: an integrative review of the literature. J Midwifery Womens Health 2003;48:338-45.

60.

Bolton-Smith C. , Woodward M. , Tunstall-Pedoe H. , Morrison C. Accuracy of the estimated prevalence of obesity from self reported height and weight in an adult Scottish population. J Epidemiol Community Health 2000;54:143-8.

61.

Koskinen S. , Laiho J. , Rinne S. , Kuosmanen N. , Alha P. , Rissanen H. , et al. Participation, complementary data collection and other measures to increase participation rate. In: Heistaro S , ed. Methodology Report Health 2000 Survey. Helsinki: National Public Health Institute; 2008.