Abstract
BackgroundThe objective of this study was to identify 10-year longitudinal predictors of overweight incidence during the transition from adolescence to young adulthood.MethodsData were from Project EAT (Eating and Activity in Teens and Young Adults). A diverse, population-based cohort (N = 2,134) completed baseline surveys in 1998–1999 (mean age = 15.0±1.6, ‘adolescence’) and follow-up surveys in 2008–2009 (mean age = 25.4±1.7, ‘young adulthood’). Surveys assessed personal, behavioral and socio-environmental factors hypothesized to be of relevance to obesity, in addition to height and weight. Multivariable logistic regression was used to estimate the adjusted odds for each personal, behavioral and socio-environmental factor at baseline, and 10-year changes for these factors, among non-overweight adolescents (n = 1,643) being predictive of the incidence of overweight (BMI ≥ 25) at 10-year follow-up.ResultsAt 10-year follow-up, 51% of young adults were overweight (26% increase from baseline). Among females and males, higher levels of body dissatisfaction, weight concerns, unhealthy weight control behaviors (e.g., fasting, purging), dieting, binge eating, weight-related teasing, and parental weight-related concerns and behaviors during adolescence and/or increases in these factors over the study period predicted the incidence of overweight at 10-year follow-up. Females with higher levels of whole grain intake and breakfast and dinner consumption frequency during adolescence were protected against becoming overweight. Among males, increases in vegetable intake protected against the incidence of overweight 10 years later.ConclusionsFindings suggest that obesity prevention interventions for adolescents should address weight-specific factors from within the domains of personal, behavioral, and socio-environmental factors such as promoting positive body image, decreasing unhealthy weight control behaviors, and limiting negative weight talk.
Highlights
The objective of this study was to identify 10-year longitudinal predictors of overweight incidence during the transition from adolescence to young adulthood
Among the non-overweight adolescents at baseline, 34.2% of the females and 45.4% of the males became overweight by young adulthood 10 years later, using ageappropriate definitions
10-year changes in unhealthy weight control behaviors significantly predicted overweight incidence but endorsement of unhealthy weight control behaviors during adolescence was not predictive of overweight incidence in young adulthood. These findings among males may indicate that we are unable to predict if male adolescents will be become overweight based on their adolescent unhealthy weight control behaviors; instead what matters is where these males are ending up with endorsement of these behaviors as a young adult. These findings indicate that regardless of gender, initiating the endorsement of unhealthy weight control behaviors will place individuals at increased risk for weight gain and odds for becoming overweight as a young adult compared to those who never endorse these behaviors, and discontinuing these behaviors during the transition from adolescence to young adulthood may help to prevent the onset of overweight
Summary
The objective of this study was to identify 10-year longitudinal predictors of overweight incidence during the transition from adolescence to young adulthood. Most longitudinal studies are short-term [5,6], and have included a limited number of predictors of overweight and obesity onset [7,8] Existing evidence from these studies suggests that personal (e.g., weight concerns, depression), behavioral (e.g., weight control behaviors) and socioenvironmental (e.g., decreased availability of healthy food) factors are associated with obesity [6,7,9] and may influence changes in weight status during this transitional period. Among adolescent girls (11–15 years) followed for over four years, depressive symptoms, weight control behaviors, and perceived parental obesity predicted obesity onset [7] While these previous studies have provided important information, research that follows adolescents over a longer period of time into early adulthood and assesses a broad array of potential risk and protective factors using a theoretical framework is needed
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