Abstract
ObjectiveTo determine the association between local environmental factors with child weight status in a longitudinal study, using a semi-parametric, group-based method, while also considering social and early life factors.MethodsStandardized, directly measured BMI from 4–10 y of age, and group-based trajectory modeling (PROC TRAJ) were used to estimate developmental trajectories of weight change in a Québec birth cohort (n = 1,566). Associations between the weight trajectories and living location, social cohesion, disorder, and material and social deprivation were estimated after controlling for social and early life factors.ResultsFour weight trajectory groups were estimated: low-increasing (9.7%); low-medium, accelerating (36.2%); medium-high, increasing (43.0%); and high-stable (11.1%). In the low-increasing and medium-high trajectory groups, living in a semi-urban area was inversely related to weight, while living in a rural area was positively related to weight in the high-stable group. Disorder was inversely related to weight in the low-increasing group only. Other important risk factors for high-stable weight included obesity status of the mother, smoking during pregnancy, and overeating behaviors.ConclusionsIn this study, associations between local environment factors and weight differed by trajectory group. Early life factors appear to play a more consistent role in weight status. Further work is needed to determine the influence of place on child weight.
Highlights
The prevalence of childhood obesity has been increasing globally in the last few decades and is a problem in both the developing and developed world [1]
The QLSCD is a government-funded cohort study conducted by the Institut de la Statistique du Quebec (ISQ) in the province of Quebec, Canada
When fitting the trajectory shapes for the 5-group model, the prevalence of the fifth group was approximately 2%, which reduces interpretability and power. This model was graphically compared to the best fitting 3and 4-group models
Summary
The prevalence of childhood obesity has been increasing globally in the last few decades and is a problem in both the developing and developed world [1]. In North America, childhood obesity has more than doubled from 1978/79 to 2004 among Canadian children aged 2–17 y [2] and almost tripled among American children aged 2–19 y in a similar time period [3] Given this increasing prevalence and associations with adverse health outcomes, being at excess weight in childhood has become a major public health concern [4], with potentially far-reaching and long-lasting social and economic consequences [5]. There have been recent calls by the obesity research community to consider the environments in which people live [7] This ecological, more holistic understanding of excess weight development will likely be necessary to develop interventions that are effective, and sustainable at the population-level
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