Subjective social status in the school and change in adiposity in female adolescents: findings from a prospective cohort study.

OBJECTIVE To determine whether subjective social standing in school predicts a change in body mass index (BMI) in adolescent girls during a 2-year period. DESIGN Prospective cohort study. SETTING Self-report questionnaires from a community-based population of adolescent girls living across the United States from 1999 to 2001. PARTICIPANTS Of 5723 girls aged 12 to 18 years participating in the Growing Up Today Study (GUTS), adequate information was available for 4446 (78%), who provided the analytic sample. MAIN EXPOSURE Low subjective social status in the school. MAIN OUTCOME MEASURES Change in BMI between 1999 and 2001 and multivariable odds ratio for a 2-U increase in BMI in girls with low subjective social status in the school compared with girls with higher subjective social status in the school. RESULTS After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother's BMI, and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69% increased odds of having a 2-unit increase in BMI (odds ratio, 1.69; 95% confidence interval, 1.10-2.60) during the next 2 years compared with other girls. CONCLUSION Higher subjective social standing in school may protect against gains in adiposity in adolescent girls.