Projected Trends of Obesity throughout the Life Course According to Sex, Race, and Birth Cohorts in the United States
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Background
Most research on obesity trends and projections has focused on changes across calendar years. However, as the risk of disease increases with cumulative exposure to obesity, it is crucial to characterize the obesity landscape through a life-course perspective and across birth cohorts.
Objective
To enhance the accuracy of obesity epidemic projections throughout life course and across birth cohorts in the US.
Design
Cross-sectional and cohort study.
Setting
United States
Participants
Individuals participated in three National Health Examination Surveys (NHES) from 1959 to 1970 and 18 National Health and Nutrition Examination Surveys (NHANES) from 1971 to 2020.
Measurements
Body mass index (BMI) distributions by sex, race, and birth cohort.
Results
By leveraging over 40 years of cross-sectional and longitudinal data from nationally representative surveys, we developed models to estimate historical and future BMI distributions in the US for both children and adults throughout their life course. We also calculated life-years of exposure to overweight and obesity, according to sex, race, and birth cohort. Our findings reveal significant increases in these metrics among birth cohorts since 1965 and highlight differential trends by sex and race for the 1965, 1985, and 2005 cohorts.
Limitations
Assumption that model parameters will hold in the future.
Conclusion
Our approach significantly expands upon previous models by projecting life course with continuous BMI distributions informed by longitudinal trajectories, explicitly accounting for variations in birth cohorts.
Primary Funding Source
National Institutes of Health.
