Associations between Childhood Disadvantage and Adult Body Mass Index Trajectories: A Follow-Up Study among Midlife Finnish Municipal Employees

Abstract

<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.

Body Mass Index Trajectory–Specific Changes in Economic Circumstances: A Person-Oriented Approach Among Midlife and Ageing Finns

“…Even grandparents' chronic poverty has been associated with grandchildren's unfavorable weight gain [6], indicating that the cumulative effects of economic disadvantage on obesity can even reach over generations, for instance, through environmental, socio-psychological, and biological mediation. Our previous study [18] showed that most of the adulthood weight gain emerged during young adulthood, which emphasizes the importance of early recognition of and intervening on the risk factors of unhealthy weight gain.…”

“…Several studies have demonstrated the accumulation of adverse socioeconomic circumstances to be related to adulthood obesity, especially among women [47][48][49]. As in other chronic diseases, inequalities in the development of obesity often begin during early childhood [9], since several childhood social and economic circumstances are associated with adulthood obesity [4,18]. Even grandparents' chronic poverty has been associated with grandchildren's unfavorable weight gain [6], indicating that the cumulative effects of economic disadvantage on obesity can even reach over generations, for instance, through environmental, socio-psychological, and biological mediation.…”

“…We do that by using group-based trajectory modeling together with sequence analysis. Here, we build upon our previous study where we identified four ascending BMI trajectories from early to late adulthood among Finnish municipal employees [18]. Our aim is to demonstrate how changes in adulthood household income and current economic difficulties differ depending on a person's BMI trajectory, and to provide new insights to capture the heterogeneity in economic circumstances within BMI trajectories.…”

Body mass index trajectories during mid to late life and risks of mortality and cardiovascular outcomes: Results from four prospective cohorts

“…In articles published by Zeng H.et al and Zajacova et al., the authors used the same data but identified different patterns of BMI trajectory [ 20 , 26 ]. As of now, at least two to six patterns of BMI trajectories have been reported in the general population and majority of them were depicting an ascending trend or paralleling with each other [ 21 , 26 , 28 , [50] , [51] , [52] ]. It is unrealistic that all participants were going the same way over the life course.…”

Intergenerational social mobility and body mass index trajectories – A follow-up study from Finland

“…Although the intergenerational social mobility measure that we used captured social mobility before the follow-up (and so, before the BMI trajectories), we cannot verify causality between social mobility and BMI trajectories. Our previous study showed that most of the weight gain occurred before middle adulthood, and that lower childhood SEP was associated with higher BMI trajectories ( Salmela et al, 2019 ). Thus, SEP differences in BMI have probably existed long before the follow-up.…”