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Objectives. We assessed whether cumulative risk exposure underlies the relation between early childhood poverty and body mass index (BMI) trajectories.
Methods. We interviewed youths and their mothers in rural upstate New York (168 boys and 158 girls) from 1995 to 2006 when the youths were aged 9, 13, and 17 years. At each interview, we calculated their BMI-for-age percentile.
Results. Early childhood poverty predicted BMI growth trajectories from ages 9 to 17 years (b=3.64; SE=1.39; P<.01). Early childhood poverty also predicted changes in cumulative risk (b=0.31; SE=0.08; P<.001). Cumulative risk, in turn, predicted BMI trajectories (b=2.41; SE=0.75; P<.01). Finally, after we controlled for cumulative risk, the effect of early childhood poverty on BMI trajectories was no longer significant, indicating that cumulative risk exposure mediated the relation between early childhood poverty and BMI trajectories (b=2.01; SE=0.94).
Conclusions. We show for the first time that early childhood poverty leads to accelerated weight gain over the course of childhood into early adulthood. Cumulative risk exposure during childhood accounts for much of this accelerated weight gain. (Am J Public Health. 2010;100:2507-2512. doi:10.2105/AJPH. 2009.184291)
One of the most rapid and startling epidemics confronting contemporary society is obesity. The prevalence of overweight and obesity among US adults increased from 56% in 1988 to 1994 to 66.3% in 2003 to 2004. The rate of obesity alone rose from 22.9% to 32.2% among adults,1 and the incidence of overweight among adolescents aged12 to19 years increased from11% to 17% during the same period.2 Obesity has been linked to elevated rates of diabetes, cancer, coronary heart disease, and other ailments.3 Being obese in late adolescence is associated with an adult mortality risk comparable to heavy smoking (>10 cigarettes/day), and being overweight in late adolescence is comparable to the adult mortality risk associated with light smoking (1-10 cigarettes/day).4 Because of the obesity epidemic, future life expectancy in the United States may actually drop in this century for the first time ever.5
An important predictor of adult obesity is early childhood socioeconomic disadvantage. 6-13 This longitudinal association is even more consistent than are concurrent associations of socioeconomic status (SES) and obesity in adulthood.14,15 For example, Poulton et al. found that as childhood SES decreased, body mass index (BMI; defined as weight in kilograms divided by height...