Life-course trajectories of body mass index from adolescence to old age: Racial and educational disparities


Yang, Yang Claire; Walsh, Christine E.; Johnson, Moira P.; Belsky, Daniel W.; Reason, Max; Curran, Patrick; Aiello, Allison E.; Chanti-Ketterl, Marianne; & Harris, Kathleen Mullan (2021). Life-course trajectories of body mass index from adolescence to old age: Racial and educational disparities. Proceedings of the National Academy of Sciences. vol. 118 (17) , PMCID: PMC8092468


This comprehensive life-course longitudinal study of body mass index (BMI) contributes knowledge about the temporal dynamics of BMI as individuals age and how social status defines disparities in lifetime obesity risk. Results show that adolescence and young adulthood are critical life stages when excess weight can rapidly accumulate and racial/ethnic or educational disparities emerge, most significantly among recent cohorts of young people. These cohort increases in the prevalence and rate of increase in obesity have alarming consequences for contemporary epidemiologic conditions such as the COVID-19 pandemic and US population health and life expectancy in years to come. Our study further contributes data analytic tools by linking and integrating multiple existing studies to advance science on social determinants of health. No research exists on how body mass index (BMI) changes with age over the full life span and social disparities therein. This study aims to fill the gap using an innovative life-course research design and analytic methods to model BMI trajectories from early adolescence to old age across 20th-century birth cohorts and test sociodemographic variation in such trajectories. We conducted the pooled integrative data analysis (IDA) to combine data from four national population-based NIH longitudinal cohort studies that collectively cover multiple stages of the life course (Add Health, MIDUS, ACL, and HRS) and estimate mixed-effects models of age trajectories of BMI for men and women. We examined associations of BMI trajectories with birth cohort, race/ethnicity, parental education, and adult educational attainment. We found higher mean levels of and larger increases in BMI with age across more recent birth cohorts as compared with earlier-born cohorts. Black and Hispanic excesses in BMI compared with Whites were present early in life and persisted at all ages, and, in the case of Black–White disparities, were of larger magnitude for more recent cohorts. Higher parental and adulthood educational attainment were associated with lower levels of BMI at all ages. Women with college-educated parents also experienced less cohort increase in mean BMI. Both race and education disparities in BMI trajectories were larger for women compared with men.All study data are included in the article and/or SI Appendix.



Body Mass Index

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Journal Article

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Proceedings of the National Academy of Sciences


Yang, Yang Claire
Walsh, Christine E.
Johnson, Moira P.
Belsky, Daniel W.
Reason, Max
Curran, Patrick
Aiello, Allison E.
Chanti-Ketterl, Marianne
Harris, Kathleen Mullan

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