Epidemiology and Global Health, Umeå University, Umeå, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Br J Health Psychol. 2018 May;23(2):496-518. doi: 10.1111/bjhp.12301. Epub 2018 Feb 18.
To date, no longitudinal, community-based studies have examined the association between disordered eating emerging in adolescence and long-term physical well-being. This study sought to explore the longitudinal associations between risk for restrictive disordered eating (DE-R; those not presenting with binge-purge symptoms) in adolescence and trajectories of functional somatic symptoms (FSS) and body mass index (BMI), and several indicators of poor physical well-being across early- to mid-adulthood, including medication, number of doctor visits, and sick leave.
Data were obtained from the Northern Swedish Cohort Study (N = 1,001), a prospective longitudinal study including four time points from age 16 to 42 years.
A cumulative measure of DE-R risk was computed. Latent class growth analysis was used to identify subpopulation trajectories of FSS and BMI. The three-step method for auxiliary variables and logistic regressions were used to assess associations between DE-R and the trajectory classes as well as indicators of poor physical well-being.
Three trajectories were identified for FSS. A gender by BMI interaction led to a classification of four BMI trajectories in men, but three in women. The presence of DE-R risk in adolescence increased odds of unfavourable FSS development, increasing BMI in women, and continually low BMI in men. Indicators of poor physical well-being at ages 21, 30, and 42 years were associated with DE-R risk in adolescence.
Data spanning nearly three decades suggest that physical well-being impairment is related to DE-R risk measured earlier in life, underscoring the urgency for targeted, gender-sensitive preventive interventions for teenagers. Statement of contribution What is already known on this subject? Disordered eating is linked to poor physical and mental well-being and quality of life. No longitudinal studies have examined long-term physical well-being consequences of adolescent disordered eating risk. What does this study add? Non-purging disordered eating symptoms in adolescence predict adverse physical well-being outcomes in middle-aged men and women. Targeted interventions and preventative work during adolescence are needed.
迄今为止，尚无基于社区的纵向研究探讨青春期出现的饮食失调与长期身体健康之间的关系。本研究旨在探讨青春期限制型饮食失调（DE-R；无暴食-清肠症状者）风险与功能性躯体症状（FSS）和体重指数（BMI）以及成年早期到中期几个身体健康不良指标（包括用药、就诊次数和病假）的纵向关联。
数据来自于北欧队列研究（N=1001），这是一项包括从 16 岁到 42 岁四个时间点的前瞻性纵向研究。
计算了 DE-R 风险的累积指标。潜类别增长分析用于识别 FSS 和 BMI 的亚人群轨迹。辅助变量的三步法和逻辑回归用于评估青春期 DE-R 与轨迹类别以及身体健康不良指标之间的关联。
鉴定出 FSS 有三个轨迹。性别与 BMI 的交互作用导致男性 BMI 轨迹分为四组，而女性则分为三组。青春期存在 DE-R 风险会增加出现不良 FSS 发展的几率，使女性 BMI 增加，而男性 BMI 持续较低。21 岁、30 岁和 42 岁时的身体健康不良指标与青春期的 DE-R 风险相关。
近三十年的数据表明，身体不适与生命早期测量的 DE-R 风险有关，这凸显了针对青少年进行有针对性的、性别敏感的预防干预的紧迫性。
