Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland.
Int J Environ Res Public Health. 2020 May 22;17(10):3668. doi: 10.3390/ijerph17103668.
Economic disadvantage is related to a higher risk of adulthood obesity, but few studies have considered whether changes in economic circumstances depend on a person's body mass index (BMI) trajectory. We identified latent BMI trajectories among midlife and ageing Finns and captured individual-level changes in economic circumstances within the BMI trajectories utilizing sequence analysis. We used the Helsinki Health Study cohort data of initially 40-60-year-old Finnish municipal employees, with four survey questionnaire phases (2000-2017). Each survey included identical questions on height and weight, and on economic circumstances incorporating household income and current economic difficulties. Based on computed BMI, we identified participants' ( = 7105; 82% women) BMI trajectories over the follow-up using group-based trajectory modeling. Four BMI trajectories were identified: stable healthy weight (34% of the participants), stable overweight (42%), overweight to class I obesity (20%), and stable class II obesity (5%). Lower household income level and having economic difficulties became more common and persistent when moving from lower- to higher-level BMI trajectories. Differences in household income widened over the follow-up between the trajectory groups, whereas economic difficulties decreased equally in all trajectory groups over time. Our study provides novel information on the dynamic interplay between long-term BMI changes and economic circumstances
经济劣势与成年肥胖风险较高有关,但很少有研究考虑经济状况的变化是否取决于个人的体重指数 (BMI) 轨迹。我们在中年和老年芬兰人中确定了潜在的 BMI 轨迹,并利用序列分析在 BMI 轨迹内捕捉个体经济状况的变化。我们使用了最初为 40-60 岁芬兰市员工的赫尔辛基健康研究队列数据,共有四个调查问卷阶段(2000-2017 年)。每个调查都包含相同的身高和体重问题,以及包含家庭收入和当前经济困难的经济状况问题。基于计算出的 BMI,我们使用基于群组的轨迹建模来识别参与者(=7105;82%为女性)在随访期间的 BMI 轨迹。确定了四种 BMI 轨迹:稳定的健康体重(34%的参与者)、稳定的超重(42%)、超重至 I 级肥胖(20%)和稳定的 II 级肥胖(5%)。从较低的 BMI 轨迹到较高的 BMI 轨迹,家庭收入水平较低和有经济困难的情况变得更加普遍和持续。在随访过程中,各轨迹组之间的家庭收入差距扩大,而所有轨迹组的经济困难都随着时间的推移而同等减少。我们的研究提供了有关长期 BMI 变化和经济状况之间动态相互作用的新信息。