Sociodemographic associations of 4-year overweight and obese incidence among a racially diverse cohort of healthy weight 18-year-olds.

Abstract

Emerging adulthood is a critical time for excess weight gain. Risk can be masked if recommended overweight and obesity cut-points for Asians are not employed. To determine the associations among sociodemographic factors and occurrence of overweight and obesity among normal weight 18-year olds. Normal weight (body mass index < 25 kg m-2 ; <23 kg m-2 for Asians) 18-year-old (9037 boys, 13 786 girls, 36% Hispanic, 34% non-Hispanic Whites, 10% Black, 5% Asian) members of a healthcare organization in 2008 were followed through 2012 to identify incidence of overweight and obesity. Hazard ratios (HR) and 95% confidence intervals (CI) were determined controlling for sex, race/ethnicity, neighbourhood education, neighbourhood income and smoking status. After 3 years of follow-up, the HR for overweight was 1.28 (95% CI: 1.12, 1.45) in the lowest quartile of neighbourhood education compared with the highest. Asians and Pacific Islanders had greater risk of overweight (HR 2.89, 95% CI: 2.55, 3.28; HR 3.13, 95% CI 2.23, 4.38) than non-Hispanic Whites. Girls and Blacks were more likely to become obese than boys and non-Hispanic Whites, as were those living in the lowest neighbourhood education quartile and lower neighbourhood income quartiles. Girls, Asians, Blacks and those living in low education and income neighbourhoods during adolescence are at risk for excessive weight gain trajectories.