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Getting heavier, younger: trajectories of obesity over the life course

International Journal of Obesity volume 34, pages 614–623 (2010)Cite this article

Abstract

Context:

Although recent trends in obesity have been well documented, generational patterns of obesity from early childhood through adulthood across birth cohorts, which account for the recent epidemic of childhood obesity, have not been well described. Such trends may have implications for the prevalence of obesity-associated conditions among population subgroups, including type 2 diabetes.

Objective:

Our objective was to evaluate trajectories of obesity over the life course for the US population, overall and by gender and race.

Design, Setting and Participants:

We conducted an age, period and birth cohort analysis of obesity for US individuals who participated in the National Health and Nutrition Examination Surveys (NHANES) (1971–2006).

Main Outcome Measures:

Obesity was defined as a body mass index ⩾95th percentile for individuals aged 2–16 years or ⩾30 kg m–2 among individuals older than 16 years. Age was represented by the age of the individual at each NHANES, period was defined by the year midpoint of each survey, and cohort was calculated by subtracting age from period.

Results:

Recent birth cohorts are becoming obese in greater proportions for a given age, and are experiencing a greater duration of obesity over their lifetime. For example, although the 1966–1975 and 1976–1985 birth cohorts had reached an estimated obesity prevalence of at least 20% by 20–29 years of age, this level was only reached by 30–39 years for the 1946–1955 and 1956–1965 birth cohorts, by 40–49 years for the 1936–1945 birth cohort and by 50–59 years of age for the 1926–1935 birth cohort. Trends are particularly pronounced for female compared with male, and black compared with white cohorts.

Conclusions:

The increasing cumulative exposure to excess weight over the lifetime of recent birth cohorts will likely have profound implications for future rates of type 2 diabetes, and mortality within the US population.

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Acknowledgements

This study was considered exempt from the IRB. Dr Lee was supported by NIDDK K08DK082386 and the Clinical Sciences Scholars Program at the University of Michigan. The funding sources had no role in the study design; collection, analysis and interpretation of data; writing of the report; or the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Division of Pediatric Endocrinology, University of Michigan, Ann Arbor, MI, USA

    J M Lee

  2. Division of General Pediatrics, Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, MI, USA

    J M Lee, S Pilli, A Gebremariam, M M Davis, G L Freed & J G Gurney

  3. Department of Preventive Medicine, Stony Brook University, Stony Brook, NY, USA

    C C Keirns

  4. Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA

    M M Davis

  5. Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA

    M M Davis

  6. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    M M Davis, S Vijan & W H Herman

  7. Veterans Affairs Health Services Research and Development, University of Michigan, Ann Arbor, MI, USA

    S Vijan

  8. Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA

    W H Herman

Authors
  1. J M Lee
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  2. S Pilli
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  4. C C Keirns
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  5. M M Davis
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  6. S Vijan
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  7. G L Freed
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  8. W H Herman
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  9. J G Gurney
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Corresponding author

Correspondence to J M Lee.

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Competing interests

The authors declare no conflict of interest.

Additional information

Authors’ Contributions

Joyce Lee (JL) accepts full responsibility for the work and/or the conduct of the study, had access to the data and controlled the decision to publish. JL was involved with conception and design, acquisition of data, analysis and interpretation of data, drafting of the paper, critical revision of the paper for important intellectual content, statistical analysis, obtaining funding and supervision. JG was involved with conception and design, acquisition of data, analysis and interpretation of data, drafting of the paper and critical revision of the paper for important intellectual content. SP and AG were involved with acquisition of data, analysis and interpretation of data, drafting of the paper, critical revision of the paper for important intellectual content and statistical analysis. MD, CK, GF, WH and SV were involved with analysis and interpretation of data, drafting of the paper and critical revision of the paper for important intellectual content. All authors read and approved the final paper.

Appendix

Appendix

Table A1, Table A2, Table A3, Table A4, Table A5, Table A6, Table A7

Table a1 Period trends in obesity prevalence by age group (1971–2006) (% (standard error))
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Table a2 Period trends in obesity prevalence by birth cohort (1971–2006) (% (standard error))
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Table a3 Age trends in obesity prevalence by birth cohort (1971–2006) (% (standard error))
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Table a4 Age trends in obesity prevalence by birth cohort for males (1971–2006) (% (standard error))
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Table a5 Age trends in obesity prevalence by birth cohort for females (1971–2006) (% (standard error))
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Table a6 Age trends in obesity prevalence by birth cohort for whites (1971–2006) (% (standard error))
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Table a7 Age trends in obesity prevalence by birth cohort for blacks (1971–2006) (% (standard error))
Full size table

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Lee, J., Pilli, S., Gebremariam, A. et al. Getting heavier, younger: trajectories of obesity over the life course. Int J Obes 34, 614–623 (2010). https://doi.org/10.1038/ijo.2009.235

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