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Abstract

Purpose :This prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood.Methods :Participants aged 7–15 years in 1985 (n = 8498) were followed up in 2004–2006 (n = 3999, aged 26–36 years) and 2009–2011 (n = 3049, aged 31–41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009–2011). We tested which of three life-course models (“accumulation,” “sensitive period,” “mobility”) best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework.Results :Accumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m2 per time in a rural area, P = .005) and were more likely obese (relative risk = 1.13 per time in a rural area, P = .002). Living in rural areas at ages 26–30 years was also associated with a higher BMI and obesity in mid-adulthood.Conclusions :Greater cumulative exposure to rurality and exposure during the “sensitive period” of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.

Item Type:	Article
Authors/Creators:	Patterson, KAE and Gall, SL and Venn, AJ and Otahal, P and Blizzard, CL and Dwyer, T and Cleland, V
Keywords:	obesity, rural health, longitudinal studies, life course, body mass index, body weight
Journal or Publication Title:	Annals of Epidemiology
Publisher:	Elsevier Science Inc
ISSN:	1047-2797
DOI / ID Number:	https://doi.org/10.1016/j.annepidem.2017.01.007
Copyright Information:	Copyright 2017 Elsevier Inc.
Related URLs:	UTAS Profile: Patterson, KAE Google Scholar: Gall, SL UTAS Profile: Gall, SL Google Scholar: Venn, AJ UTAS Profile: Venn, AJ Google Scholar: Otahal, P UTAS Profile: Otahal, P UTAS Profile: Blizzard, CL Google Scholar: Cleland, V
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