title: Combined early and adult life risk factor associations for mid-life obesity in a prospective birth cohort: assessing potential public health impact.
abstract: OBJECTIVE
  The combined effect of life-course influences on obesity development and thus their potential public health impact is unclear. We evaluated combined associations and predicted probabilities for early and adult life risk factors with central and general obesity in mid-adulthood.
  
  
  METHODS
  1958 British birth cohort.
  
  
  METHODS
  4629 males and 4670 females with data on waist circumference.
  
  
  METHODS
  45 year obesity measured via waist circumference, waist-hip ratio (WHR) and BMI.
  
  
  RESULTS
  At 45 years, approximately a third of the population were centrally obese and a quarter were generally obese. Three factors (parental overweight, maternal smoking during pregnancy and adult inactivity) were consistently associated with central and general obesity. Predicted probabilities for waist obesity increased from those with none to all three risk factors (0.15-0.33 in men; 0.19-0.39 in women (ptrend<0.001)), with a similar trend for general obesity. Additional factors (adult smoking, low fibre and heavy alcohol consumption) were associated with WHR obesity, although varying by gender. Prevalence of risk factors was higher in manual than non-manual groups: for example, in men 38% versus 25%, respectively, had ≥2 risk factors for waist and general obesity.
  
  
  CONCLUSIONS
  Early-life and adult factors that are amenable to change are highly prevalent and accumulate in association with central and general obesity in mid-adulthood. The increase in probabilities for mid-adult obesity associated with cumulative levels of risk factors suggests the potential for public health impact.
authors.affiliation: Department of Population, Policy and Practice, Institute of Child Health, University College London, London, UK.
authors.forename: Snehal M
authors.initials: SM
authors.lastname: Pinto Pereira
authors.affiliation: Department of Population, Policy and Practice, Institute of Child Health, University College London, London, UK.
authors.forename: Karin
authors.initials: K
authors.lastname: van Veldhoven
authors.affiliation: Department of Population, Policy and Practice, Institute of Child Health, University College London, London, UK.
authors.forename: Leah
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Population, Policy and Practice, Institute of Child Health, University College London, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Power
mesh_terms: D000328:Adult; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology*; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000209:etiology; D010290:Parents; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D011446:Prospective Studies; D011634:Public Health; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
keywords: BMI; adulthood; central and general obesity; early life; waist circumference; waist-hip-ratio