Differences in adiposity trajectories by birth cohort and childhood social class: evidence from cohorts born in the 1930s, 1950s and 1970s in the west of Scotland

BACKGROUND Since the 1930s, the environment has become increasingly obesogenic, leading to rising rates of adiposity and socioeconomic inequalities in adiposity. Building on studies comparing body mass index (BMI) for cohorts born over a period of 20 years, we examine the social patterning of BMI and central adiposity for three cohorts born over a 40-year period. METHODS Using data from the West of Scotland Twenty-07 study (n=4510), we investigate 20-year trajectories of adiposity for three cohorts born in the 1930s, 1950s and 1970s, allowing us to study 60 years of the lifecourse. Stratified by gender, we employed multilevel models to generate trajectories for BMI and waist-to-height ratio (WHtR) and explored how these trajectories varied by childhood social class. RESULTS Adiposity increased most quickly with age in the youngest cohort, and cohort differences were greater than socioeconomic differences. For example, the smallest cohort difference for BMI, a comparison of men in the 1930s and 1950s cohorts at age 55, was 2.66 (95% CI 2.11 to 3.20) kg/m(2), while the largest socioeconomic difference, a comparison of manual and non-manual women at age 64, was 1.18 (95% CI 0.37 to 1.98) kg/m(2). Socioeconomic inequalities in adiposity increased with age and were greater for women than for men. The results for WHtR differed in that increases in WHtR accelerated with age while increases in BMI slowed. CONCLUSIONS Socioeconomic differences in adiposity accumulate slowly across the lifecourse and are approximately only a third of the adiposity differences between cohorts.