Economic disadvantage is related to a higher risk of adulthood obesity, but few studies have considered whether changes in economic circumstances depend on a person’s body mass index (BMI) trajectory. We identified latent BMI trajectories among midlife and ageing Finns and captured individual-level changes in economic circumstances within the BMI trajectories utilizing sequence analysis. We used the Helsinki Health Study cohort data of initially 40–60-year-old Finnish municipal employees, with four survey questionnaire phases (2000–2017). Each survey included identical questions on height and weight, and on economic circumstances incorporating household income and current economic difficulties. Based on computed BMI, we identified participants’ (n = 7105; 82% women) BMI trajectories over the follow-up using group-based trajectory modeling. Four BMI trajectories were identified: stable healthy weight (34% of the participants), stable overweight (42%), overweight to class I obesity (20%), and stable class II obesity (5%). Lower household income level and having economic difficulties became more common and persistent when moving from lower- to higher-level BMI trajectories. Differences in household income widened over the follow-up between the trajectory groups, whereas economic difficulties decreased equally in all trajectory groups over time. Our study provides novel information on the dynamic interplay between long-term BMI changes and economic circumstances.

Evidence remains unclear on how intergenerational social mobility is associated with body mass index (BMI) and its long-term changes. Our study identified BMI trajectories from middle to older age by intergenerational social mobility groups and stratified the analyses by gender and two birth cohorts (birth years 1940‒1947 and 1950–1962). We used questionnaire-based cohort data that consists of four survey phases: 2000–2002, 2007, 2012, and 2017. In Phase 1, participants were 40–60-year-old employees of the City of Helsinki, Finland. Our analytical sample consisted of 6,971 women and 1,752 men. Intergenerational social mobility was constructed based on self-reported parental and own education—both divided into high and low—yielding four groups: stable high socioeconomic position (SEP) (high-high), upward social mobility (low-high), downward social mobility (high-low), and stable low SEP (low-low). BMI was calculated from self-reported height and weight from all four phases. Using mixed-effects linear regression, we found increasing BMI trajectories in all four social mobility groups until the age of 65. Women and men with stable high SEP had lower BMI trajectories compared to those with stable low SEP. In the younger birth cohort, women with upward social mobility had a lower BMI trajectory than women with stable low SEP. Additionally, women and men with downward social mobility had higher BMI trajectories than those with stable high SEP. In the older birth cohort, however, the BMI trajectories of upward and downward social mobility groups were somewhat similar and settled between the BMI trajectories of stable high and stable low SEP groups. Our results indicate that the associations between intergenerational social mobility and BMI may depend on gender and birth cohort. Nevertheless, to reduce socioeconomic inequalities in unhealthy weight gain, obesity prevention actions that focus on people who are likely to remain in low SEP might be worthwhile.

<b><i>Objective:</i></b> Childhood disadvantage is associated with a higher risk of adult obesity, but little is known about its associations with body mass index (BMI) trajectories during adulthood. This study aimed first to identify adulthood BMI trajectories, and second to investigate how childhood disadvantage is associated with trajectory group membership. <b><i>Methods:</i></b> Data from the Helsinki Health Study, a longitudinal cohort study of initially 40- to 60-year-old employees of the City of Helsinki in Finland, were used. The baseline survey was conducted in 2000–2002, and similar follow-up surveys in 2007, 2012, and 2017. Based on self-reported BMI, participants’ (<i>n =</i>5,266; 83% women) BMI trajectories, including their retrospectively reported BMI at the age of 25 years, were examined. Data on childhood disadvantage, including parental education and 7 types of childhood adversity (their own serious illness; parental divorce, death, mental disorder, or alcohol problems; economic difficulties at home; and peer group bullying) before the age of 16 years, were obtained from the baseline survey. Group-based trajectory modeling was used to identify BMI trajectories, and multinomial logistic regression to analyze the odds for trajectory group membership for the disadvantage variables. <b><i>Results:</i></b> Four ascending BMI trajectories in women and men were found: persistent normal weight (trajectory 1; women 35% and men 25%), normal weight to overweight (trajectory 2; women 41% and men 48%), normal weight to class I obesity (trajectory 3; women 19% and men 23%) and overweight to class II obesity (trajectory 4; women 5% and men 4%). Compared to trajectory 1, women with multiple adversities and repetitive peer bullying in childhood had greater odds of belonging to trajectories 3 and 4, whereas men with parental alcohol problems had greater odds of belonging to trajectory 4. For women and men, a low level of parental education was associated with a higher-level BMI trajectory. <b><i>Conclusions:</i></b> Low parental education for both genders, multiple adversities and repetitive peer bullying in childhood among women, and parental alcohol problems among men increased the odds of developing obesity during adulthood. Further studies are needed to clarify how gender differences modify the effects of childhood disadvantage on adult BMI trajectories.

Several unhealthy lifestyles are associated with increased sickness absence (SA). This study examined the associations of changes in diet and leisure-time physical activity (LTPA) with employer's direct cost of subsequent short-term (< 10 working days) SA. The survey data from phases 1 (2000−02) and 2 (2007) of the Helsinki Health Study (HHS), a longitudinal cohort study of initially 40−60-year-old employees of the City of Helsinki, Finland, were linked with SA register data. Final data consisted of 4157 employees. Dietary habits were inquired with a short food frequency questionnaire. Consumption of fruits (F) and vegetables (V) was used to indicate healthiness of diet. LTPA was measured with a series of questions on the intensity and the amount of LTPA. Data on shortterm SA and salaries (2008−12) were received from the employers' registers. A two-part model was used to analyse the associations. Those who improved their F&V consumption from non-daily to daily and persevered physically active got 620 € (95% CI-1194,-47) lower cost than those remaining non-daily F&V consumers and physically inactive. When examining LTPA only, those who persevered physically active or improved from moderately active to active got 19% less cost for the employer than those remaining inactive. Dietary changes were not independently associated with the cost. Improving employees' diet and LTPA may reduce employer's direct cost of SA. Although the associations of diet with SA cost were not statistically significant, improvements in diet may contribute to the beneficial associations of LTPA and employer's cost of SA.

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