Lifestyle choices mediate the association between educational attainment and BMI in older adults in China: A cross-sectional study

Abstract

As the Chinese population ages, unhealthfully high body mass index (BMI) levels in older adults are becoming a public health concern as an unhealthfully high BMI is an ill-being condition and can contribute to the risk of disease. Education and lifestyle choices affect BMI; however, the evidence on the relationships and interactions among these factors remains unclear. This study aimed to investigate the mediating effect of lifestyle choices on educational attainment and BMI among older adults in China. Using the Chinese Family Panel Studies (CFPS) 2018 panel data, this study integrated personal- and family-level economic data libraries, including 7,359 adults aged ≥60 years. Lifestyle parameters included smoking amount and screen time. Height and weight values were used to calculate BMI. The chi-square test, binary logistic regression analysis, stepwise regression analysis, and bootstrapping mediating effect tests were used for data analysis. Single-factor chi-square test revealed differences in BMI levels among groups defined by sex, age, residence, marital status, per capita annual household income, education years, and lifestyle choices. Binary logistic regression showed that age, residence, education years, smoking amount, and screen time influenced BMI. Stepwise regression results showed that education years, smoking amount, and screen time were associated with BMI (t = 3.907, −4.902, 7.491, P < 0.001). The lifestyle variables had partial mediating effects on BMI. The mediating effect of lifestyle on BMI was 0.009, while smoking amount was 0.003, and screen time was 0.006. Unhealthfully high BMI levels are increasing among older adults in China and are affected by many factors. Lifestyle factors and educational attainment can interact, affecting BMI. Interventions should consider lifestyle factors and education attainment to help maintain healthy BMI and reduce unhealthfully high BMI incidence.

Obesity-Related Traits Mediate the Effects of Educational Attainment on the Risk of Varicose Veins, Venous Thromboembolism, and Phlebitis

“…The present study demonstrated a 43% reduction in the risk of phlebitis for every 1 SD increase in EA, data that have not been similarly reported. Previous observational studies have focused more on the fact that higher EA is associated with a lower risk of obesity and its traits (including body mass index, basal metabolic rate, waist circumference, and waist-to-hip ratio), [11][12][13][14][15][16][17] and that obesity and its traits were also the risk factors for VV, VTE, and phlebitis, 8,9,[19][20][21][22] which is in line with the results of the present study, which, however, further uncovered the importance of hip circumference in the mediator pathway, which has been given less attention. Previous studies have failed to systematically assess the important role of obesity and its traits in the pathway of the effect of EA on the risk of VV, VTE, and phlebitis.…”

“…8 Lower educational attainment (EA) and socioeconomic status have been found to be associated with an increased risk of vascular disease (such as VTE 9 ) in a global context. 10 Observational studies have suggested that higher EA was protective against obesity 11 and obesity-related traits such as body mass index, 12,13 waist circumference, 14,15 and waistto-hip ratio, 15,16 and was also independently associated with the basal metabolic rate 17 and that there may be an interconnection between these traits as well. [16][17][18] Obesity was considered the risk factor for VV due to its contribution to elevated central venous pressure.…”

Smoking and BMI mediate the causal effect of education on lower back pain: observational and Mendelian randomization analyses

“…Another possibility is that there may exist a non-linear relationship between BMI and education, which would not be captured by standard multivariable regression analysis ( 52 ). Furthermore, it is important to take into account factors such as diet and levels of physical activity that may influence the relationship between BMI and education ( 53 ). In summary, while our analysis did not find a significant correlation between education and BMI, this does not conclusively disprove a potential relationship.…”

Association between pelvic floor muscle strength and sexual function based on PISQ-12—an analysis of data from a multicenter cross-sectional study on 735 nulliparae during pregnancy

“…To distinguish different age stages, we divided every 5 years from 20 to 40 years old into one category. According to the Chinese classification, BMI values of <18.5 kg/m 2 , 18.5 ≤ BMI <24 kg/m 2 , 24 ≤ BMI <28 kg/m 2 , and BMI≥28 kg/m 2 represent underweight, normal weight, overweight, and obesity, respectively ( 15 ). Defecation posture refers to the posture that a woman adopted for most of her defecations and is categorized according to the potential impact on the PFM as squatting posture, sitting posture, or not specified ( 16 ).…”