Centre for Health Equity Studies (CHESS), Stockholm University & Karolinska Institutet, Sveavägen 160, Floor 5, 106 91 Stockholm, Sweden.
Soc Sci Med. 2014 Nov;120:199-207. doi: 10.1016/j.socscimed.2014.09.024. Epub 2014 Sep 16.
The objective of this study was to investigate the impact of grandparental and parental education and parental educational trajectory on their adult offspring's overweight/obesity. We used register data from the Uppsala Birth Cohort Multigenerational Study, based on a representative cohort born in Sweden 1915-1929 (G1). Our sample included 5122 women and 11,204 men who were grandchildren of G1 (G3), their parents (G2), and grandparents. G3's overweight/obesity (BMI≥25 kg/m2) was based on pre-pregnancy weight/height for women before their first birth (average age=26 years), and measured weight/height at conscription for men (average age=18 years). G1's, G2's, and G3's highest educational attainment was obtained from routine registers and classified as low, intermediate, or high based on respective sample distributions. Parental (G2) educational trajectory was defined as change in education between their own and their highest educated parent (G1), classified into 5 categories: always advantaged (AA), upward trajectory (UT), stable-intermediate (SI), downward trajectory (DT), and always disadvantaged (AD). We used hierarchical gender-stratified logistic regression models adjusted for G3's age, education, year of BMI collection, lineage and G2's year of birth and income. Grandparental and parental education were negatively associated with men's odds of overweight/obesity and parental education affected women's overweight/obesity risk. Furthermore, men and women whose parents belonged to the UT, SI, DT, and AD groups had greater odds of overweight/obesity compared to men and women whose parents belonged to the AA group (adjusted for G3's age, year of BMI collection, lineage, and G2's year of birth). These associations were attenuated when further adjusting for parental income and G3's own education. Socioeconomic inequalities can have long-term consequences and impact the health of future generations. For overweight/obesity in concurrent young cohorts, this inequality is not fully offset by upward educational trajectory in their parent's generation.
本研究旨在探讨隔代和父母教育以及父母教育轨迹对其成年子女超重/肥胖的影响。我们使用了乌普萨拉出生队列多代研究的登记数据，该研究基于在瑞典出生的 1915-1929 年的代表性队列（G1）。我们的样本包括 5122 名女性和 11204 名男性，他们是 G1 的孙辈（G3）、他们的父母（G2）和祖辈。G3 的超重/肥胖（BMI≥25kg/m2）基于女性怀孕前第一次生育前的体重/身高（平均年龄=26 岁），以及男性征兵时的体重/身高（平均年龄=18 岁）。G1、G2 和 G3 的最高教育程度是从常规登记中获得的，并根据各自的样本分布分为低、中、高。父母（G2）的教育轨迹定义为他们自己和他们受教育程度最高的父母（G1）之间的教育变化，分为 5 类：始终有利（AA）、上升轨迹（UT）、稳定中等（SI）、下降轨迹（DT）和始终不利（AD）。我们使用了分层性别分层逻辑回归模型，调整了 G3 的年龄、教育程度、BMI 收集年份、血统以及 G2 的出生年份和收入。隔代和父母教育与男性超重/肥胖的几率呈负相关，而父母教育影响女性超重/肥胖的风险。此外，与父母属于 AA 组的男性和女性相比，父母属于 UT、SI、DT 和 AD 组的男性和女性超重/肥胖的几率更高（调整了 G3 的年龄、BMI 收集年份、血统以及 G2 的出生年份）。当进一步调整父母收入和 G3 自身教育时，这些关联会减弱。社会经济不平等可能会产生长期后果，并影响后代的健康。对于同期年轻队列的超重/肥胖，其父母一代的上升教育轨迹并不能完全弥补这种不平等。
