Khlat Myriam, Jusot Florence, Ville Isabelle
INED, 133 boulevard Davout, 75980 Paris Cedex 20, France.
Soc Sci Med. 2009 May;68(9):1692-9. doi: 10.1016/j.socscimed.2009.02.024. Epub 2009 Mar 18.
This study investigates the relation between early life conditions and adult obesity in France, using a rich data set collected through the 2003 nationally representative Life History Survey. No salient factor emerged in men, while in women, after controlling for current socio-demographic characteristics, a relation was found between obesity and the following factors: father's occupation (OR=3.2 for women whose father was a clerical worker, versus those whose father was in a higher-level occupation); experience of economic hardship in childhood (OR=2.0), and; high parity (OR=2.1 for parities of more than 3 versus parity of 1). Neither early family history nor mother's working status surfaced as significant factors. Those findings highlight a definite gender pattern, with a strong association between early disadvantage and obesity in women, but not in men. Potential mechanisms are discussed, particularly the "habitus", the "thrifty phenotype" and the "feast-famine" hypotheses, and possible interactions with childbearing and motherhood. An integration of social and biological perspectives is needed to reach a better understanding of the processes involved, and to achieve progress in primary and secondary prevention.
本研究利用通过2003年全国代表性生命史调查收集的丰富数据集，调查了法国早期生活状况与成人肥胖之间的关系。在男性中未出现显著因素，而在女性中，在控制了当前的社会人口特征后，发现肥胖与以下因素之间存在关联：父亲的职业（父亲是文职人员的女性与父亲是高级职业的女性相比，OR = 3.2）；童年时期的经济困难经历（OR = 2.0），以及；多产（产次超过3次的女性与产次为1次的女性相比，OR = 2.1）。早期家族史和母亲的工作状况均未成为显著因素。这些发现凸显了一种明确的性别模式，即早期劣势与女性肥胖之间存在强烈关联，而男性则不存在。文中讨论了潜在机制，特别是“惯习”、“节俭表型”和“盛宴-饥荒”假说，以及与生育和母亲身份可能存在的相互作用。需要整合社会和生物学观点，以更好地理解其中涉及的过程，并在一级和二级预防方面取得进展。
