title: Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study.
abstract: BACKGROUND
  Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood.
  
  
  METHODS
  We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4-16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21-35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood.
  
  
  RESULTS
  At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood.
  
  
  CONCLUSIONS
  Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.
authors.affiliation: McMaster University, Department of Psychiatry and Behavioral Neuroscience, Offord Centre for Child Studies, 1280 Main Street West, Chedoke Site, Patterson Building, Hamilton, ON L8S 3K1, Canada. gonzal@mcmaster.ca
authors.forename: Andrea
authors.initials: A
authors.lastname: Gonzalez
authors.forename: Michael H
authors.initials: MH
authors.lastname: Boyle
authors.forename: Katholiki
authors.initials: K
authors.lastname: Georgiades
authors.forename: Laura
authors.initials: L
authors.lastname: Duncan
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Atkinson
authors.forename: Harriet L
authors.initials: HL
authors.lastname: MacMillan
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D009864:Ontario; D050177:Overweight / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D012923:Social Class; D055815:Young Adult