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A longitudinal cohort study examining determinants of overweight and obesity in adulthood

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Abstract

OBJECTIVES: Adulthood overweight and obesity are multifaceted conditions influenced by a combination of biological, environmental and socio-cultural factors across the lifespan. Using a longitudinal study design, we aimed to identify determinants of adulthood overweight and obesity, in relation to: 1) childhood and life course factors, 2) geographical differences in air quality, and 3) gender-specific factors, in a cohort followed from childhood into adulthood.

METHODS: Childhood data were acquired (1978–1986) from children residing in four distinct Hamilton neighbourhoods (Ontario, Canada), including air-quality assessments. Adulthood data were obtained (2006–2007) from successfully retraced participants (n = 315) using comprehensive self-administered questionnaires. Multivariate logistic regressions were used to evaluate determinants of adulthood overweight (BMI: 25–29.9 kg/m2) and obesity (BMI: ≥30).

RESULTS: The prevalence of normal weight decreased drastically at follow-up in adulthood, while that of overweight and obesity increased. Both overweight and obesity in adulthood were associated with male gender and occupational exposures to contaminants. Childhood residence in Hamilton neighbourhoods with better air quality was associated with lesser odds of adulthood overweight, whereas adulthood obesity was strongly linked to childhood weight gain (overweight or obesity). Among females, childhood weight status predicted overweight and obesity in adulthood, with always living in Hamilton, lack of additional health insurance, negative self-appraisal and high blood pressure during adulthood identified as other significant predictors. Among males, prolonged occupational exposures to contaminants emerged as a unique determinant of adulthood weight gain.

CONCLUSION: Adulthood overweight and obesity are associated with childhood and life course determinants, including childhood weight status, residential air quality and occupational contaminant exposures, in a gender-specific manner.

Résumé

OBJECTIFS: Le surpoids et l’obésité à l’âge adulte sont des conditions multidimensionnelles influencées par une combinaison de facteurs biologiques, environnementaux et socioculturels au long de la vie. À l’aide d’un protocole d’étude longitudinale, nous avons cherché à identifier dans une cohorte suivie de l’enfance à l’âge adulte les déterminants du surpoids et de l’obésité à l’âge adulte par rapport: 1) aux facteurs durant l’enfance et dans le parcours de vie, 2) aux écarts géographiques dans la qualité de l’air et 3) à des facteurs sexospécifiques.

MÉTHODE: Les données sur l’enfance, y compris des analyses de qualité de l’air, ont été acquises (1978–1986) pour des enfants vivant dans quatre quartiers de Hamilton (Ontario, Canada). Les données sur l’âge adulte ont été obtenues (2006–2007) auprès de participants retracés avec succès (n = 315) à l’aide de questionnaires exhaustifs à remplir soi-même. Nous avons procédé par régression logistique multivariée pour évaluer les déterminants du surpoids (IMC: 25–29,9 kg/m2) et de l’obésité (IMC: ≥30) à l’âge adulte.

RÉSULTATS: La prévalence du poids normal a baissé de façon radicale lors du suivi à l’âge adulte, tandis que celles du surpoids et de l’obésité ont augmenté. Le surpoids et l’obésité à l’âge adulte étaient tous deux associés au sexe masculin et aux expositions professionnelles aux contaminants. Le fait d’avoir habité pendant l’enfance dans un quartier de Hamilton où la qualité de l’air était meilleure était associé à une moindre probabilité de surpoids à l’âge adulte, tandis que l’obésité à l’âge adulte était fortement liée au gain de poids (surpoids ou obésité) durant l’enfance. Chez les femmes, le statut pondéral durant l’enfance a prédit le surpoids et l’obésité à l’âge adulte, les autres variables prédictives significatives étant le fait d’avoir toujours vécu à Hamilton, l’absence d’assurance-santé complémentaire, l’appréciation négative de sa propre valeur et l’hypertension artérielle à l’âge adulte. Chez les hommes, l’exposition professionnelle prolongée à des contaminants s’est révélée être un déterminant unique du gain de poids à l’âge adulte.

CONCLUSION: Le surpoids et l’obésité à l’âge adulte sont associés, de façon sexospécifique, avec des déterminants de l’enfance et du parcours de vie, dont le statut pondéral durant l’enfance, la qualité de l’air dans le quartier résidentiel et l’exposition professionnelle aux contaminants.

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Authors and Affiliations

  1. Faculty of Health Sciences, University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, ON, L1H 7K4, Canada

    Caroline Barakat-Haddad PhD

  2. Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Usman Saeed (Hon) BSc

  3. Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada

    Susan Elliott PhD

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  1. Caroline Barakat-Haddad PhD
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  2. Usman Saeed (Hon) BSc
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  3. Susan Elliott PhD
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Correspondence to Caroline Barakat-Haddad PhD.

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Conflict of Interest: None to declare.

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Barakat-Haddad, C., Saeed, U. & Elliott, S. A longitudinal cohort study examining determinants of overweight and obesity in adulthood. Can J Public Health 108, e27–e35 (2017). https://doi.org/10.17269/CJPH.108.5772

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