Accumulated exposure to rural areas of residence over the life course is associated with overweight and obesity in adulthood: a 25-year prospective cohort study

Journal article

This prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood.Participants aged 7-15 years in 1985 (n = 8498) were followed up in 2004-2006 (n = 3999, aged 26-36 years) and 2009-2011 (n = 3049, aged 31-41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009-2011). We tested which of three life-course models ("accumulation," "sensitive period," "mobility") best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework.Accumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m2 per time in a rural area, P = .005) and were more likely obese (relative risk = 1.13 per time in a rural area, P = .002). Living in rural areas at ages 26-30 years was also associated with a higher BMI and obesity in mid-adulthood.Greater cumulative exposure to rurality and exposure during the "sensitive period" of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.

Authors: Patterson, K; Gall, S; Venn, A; Otahal, P; Blizzard, L

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Annals of Epidemiology
• Volume: 27
• Issue: 3
• Pages: 169-175.e2
• Publication date: 2017-02-03
• Acceptance date: 2017-01-18
• DOI: 10.1016/j.annepidem.2017.01.007
• EISSN: 1873-2585
• ISSN: 1047-2797
• Pmid: 28317611
• Language: English
• Keywords: longitudinal studies; obesity; body weight; life course; body mass index; rural health