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Changes in physical activity, diet, and body weight across the education and employment transitions of early adulthood: A systematic review and meta-analysis.

ABSTRACT: Early adulthood is a time when individuals go through important life transitions, such as moving from high school into higher education or employment, but the impact of these life transitions on changes in body weight, diet, and physical activity is not known. We searched six electronic databases to July 2019 for longitudinal observational studies providing data on adiposity, diet, and/or physical activity across education or employment transitions in young people aged between 15 and 35 years. We found 19 studies, of which 17 assessed changes in physical activity, three body weight, and five diet or eating behaviours. Meta-analysis (n=9) found that leaving high school was associated with a decrease of -7.04 (95% CI, -11.26, -2.82) min/day of moderate-to-vigorous physical activity. Three studies reported increases in body weight on leaving high school. A small number of studies suggested decreases in diet quality on leaving high school (n=2/4 papers) and leaving university (n=1) but not on starting employment (n=1). Studies suggested no change in physical activity on leaving university (n=4) but decreases in physical activity on starting employment (n=2/3). The transition of leaving high school is an important time to support individuals to prevent decreases in physical activity and gains in body weight.

SUBMITTER: Winpenny EM

PROVIDER: S-EPMC7079102 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Changes in physical activity, diet, and body weight across the education and employment transitions of early adulthood: A systematic review and meta-analysis.

Winpenny Eleanor M EM Smith Miranda M Penney Tarra T Foubister Campbell C Guagliano Justin M JM Love Rebecca R Clifford Astbury Chloe C van Sluijs Esther M F EMF Corder Kirsten K

Obesity reviews : an official journal of the International Association for the Study of Obesity 20200119 4

Early adulthood is a time when individuals go through important life transitions, such as moving from high school into higher education or employment, but the impact of these life transitions on changes in body weight, diet, and physical activity is not known. We searched six electronic databases to July 2019 for longitudinal observational studies providing data on adiposity, diet, and/or physical activity across education or employment transitions in young people aged between 15 and 35 years. W ...[more]

PMID: 31955496

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Project description:BackgroundEarly adulthood is a period associated with poor diet and rapid weight gain. This is also an age of transition, including environmental, social and lifestyle changes which may be associated with changes in diet. We assess longitudinal associations between four early adulthood life transitions (leaving home, leaving education, entering employment, and cohabitation) and changes in consumption of fruit, vegetables, confectionery and sugar-sweetened beverages (SSBs).MethodsParticipants (n?=?1100) from the Norwegian Longitudinal Health Behaviour Study, reported data on diet and life transitions on up to eight occasions from age 14 to age 30. Diet data were self-reported in response to questions on intake of fruit, vegetables, confectionery and sugar-sweetened beverages. Growth models were developed to describe changing intake of each of the four diet indicators with age. Fixed-effects regression models assessed associations between the four life transitions and within-individual changes in diet indicators, with adjustment for the remaining transitions and parenthood.ResultsDiet indicators showed quadratic trajectories with age: fruit and vegetable intakes declined from age 14 to ages 23 and 21 respectively, before increasing to age 30. SSB and confectionery intakes increased to age 18, before subsequently decreasing. Leaving the parental home was associated with a decrease in fruit intake of -?0.54 times/week (95% confidence interval (95%CI): -0.87;-0.22) and vegetable intake of -?0.43 times/week (95%CI: -0.70;-0.15). Leaving education was associated with increases in confectionery (0.33 times/week (95%CI: 0.04;0.62)) and SSB intakes (0.49 times/week (95%CI: 0.10;0.87).ConclusionsLeaving home and leaving education are associated with negative changes in diet and may present opportunities for effective diet and obesity intervention. Further study of these transitions is needed to understand the mechanisms mediating associations between life transitions and changes in diet.

Project description:BackgroundAdolescence to early adulthood is a period of multiple education-, employment- and family-related life transitions. Changing resources and food environments within the context of these transitions could contribute to significant changes in diet, which persist into later adulthood. This study investigated diet quality trajectories from age 15 to 31 years and changes in diet quality associated with life transitions, by sex.MethodsData from the Project EAT (Eating and Activity in Teens and Young Adults) study were used to examine diet quality among a longitudinal cohort (n=2,524) across four waves (mean ages of 15, 19, 25 and 31 years). Diet quality was evaluated using the DASH (Dietary Approaches to Stop Hypertension) index. Life transitions were assessed by changes in life circumstances between pairs of waves, including leaving the parental home, leaving full-time education, beginning full-time employment, cohabitating with a partner, and becoming a parent. Average within-person changes in DASH scores were analysed by sex-specific latent growth models, incorporating underlying growth trajectories, five life transitions and baseline socio-demographic characteristics.ResultsBoth sexes followed a quadratic trajectory of DASH scores, showing decreases in diet quality from waves 1 to 2 followed by increases until wave 4. Compared to females, males had worse diet quality at wave 1, and this sex difference widened at wave 4. Leaving the parental home between waves 1 and 2 was associated with transient decreases in diet quality at wave 2 only for males. For females, cohabitating with a partner and becoming a parent between waves 3 and 4 were respectively related to decreases and increases in diet quality at wave 4. Leaving full-time education and starting full-time employment respectively had long-term negative and positive associations with diet quality for both sexes.ConclusionsDiet quality remained suboptimal throughout adolescence but to some extent improved across early adulthood. A sex-sensitive approach in public health policy is welcome for addressing sex differences in diet quality and dietary changes associated with family-related life transitions. Targeted dietary interventions are beneficial for young people who leave their parental home early or who do not enter into a structured school or workplace environment.

Project description:BackgroundIncreased physical activity (PA), reduced time spent sedentary (SED), healthier diet and reduced body weight may all have a positive impact on cardiometabolic risk. The relative importance of change in each of these variables on cardiometabolic risk, however, is unclear. We therefore sought to investigate the relative contributions of changes in PA, SED, diet and body weight on cardiometabolic risk.MethodsThis is a secondary analysis of data collected from the EuroFIT randomised controlled trial, which was a 12-week group-based lifestyle intervention for overweight middle-aged men delivered by coaches in football club stadia aiming to improve PA, SED, diet, and body weight. PA and SED were assessed by accelerometry, diet using the Dietary Instrument for Nutrition Education (DINE). An overall cardiometabolic risk score was derived from combining z-scores for glucose, HbA1c, insulin, lipids and blood pressure. In total, 707 men (from the overall cohort of 1113) with complete data for these variables at baseline and 12-month follow-up were included in the multivariable linear regression analyses.ResultsIn multivariable analyses, change in number of steps (explaining 5.1% of R2) and dietary factors (less alcohol, fatty and sugary food, and more fruit and vegetables) (together explaining 4.5% of R2), but not changes in standing time or SED, were significantly associated with change in body weight. Changes in number of steps (R2 = 1.7%), fatty food score (R2 = 2.4%), and sugary food score (R2 = 0.4%) were significantly associated with change in cardiometabolic risk score in univariable models. However, in multivariable models which included changes in weight as well as changes in steps and dietary variables, change in weight explained a substantially larger proportion of the change in cardiometabolic risk score, explaining 14.1% of R2 (out of an overall model R2 of 19.0%). When baseline (as well as change) values were also included in the model, 38.8% of R2 for change in cardiometabolic risk score was explained overall, with 14.1% of R2 still explained by change in weight.ConclusionChange in body weight, together with baseline cardiometabolic risk explained most of the change in cardiometabolic risk. Thus, the benefits of increasing physical activity and improving diet on cardiometabolic risk appear to act largely via an effect on changes in body weight.Trial registrationInternational Standard Randomised Controlled Trials, ISRCTN-81935608. Registered 06052015. https://www.isrctn.com/ISRCTN81935608?q=&filters=recruitmentCountry:Portugal&sort=&offset=7&totalResults=92&page=1&pageSize=10&searchType=basic-search.

Project description:BACKGROUND:Early adulthood is a period of rapid personal development when individuals experience major life transitions (e.g. leaving the parental home, leaving education, beginning employment, cohabitation and parenthood). Changes in social and physical environments associated with these transitions may influence development of health-related behaviours. Consumption of fast food is one behaviour associated with poor diet and long-term health outcomes. In this study we assess how frequency of fast food consumption changes across early adulthood, and how major life transitions are associated with changes in fast food intake. METHODS:Data were collected across four waves of the Project EAT study, from mean age 14.9 (SD?=?1.6) to mean age 31.1 (SD?=?1.6) years. Participants reporting data at two or more waves were included (n?=?2902). Participants reported past week frequency of eating food from a fast food restaurant and responded to questions on living arrangements, education and employment participation, and having children. To assess changes in fast food we developed a latent growth model incorporating an underlying trajectory of fast food intake, five life transitions, and time-invariant covariates. RESULTS:Mean fast food intake followed an underlying quadratic trajectory, increasing through adolescence to a maximum of 1.88 (SE 0.94) times/week and then decreasing again through early adulthood to 0.76 (SE 2.06) times/week at wave 4. Beginning full-time employment and becoming a parent both contributed to increases in fast food intake, each resulting in an average increase in weekly fast food intake of 0.16 (p?<?0.01) times/week. Analysis of changes between pairs of waves revealed stronger associations for these two transitions between waves 1-2 (mean age 14.9-19.4?years) than seen in later waves. Leaving the parental home and beginning cohabitation were associated with decreases in fast food intake of -?0.17 (p?=?0.004) and?-?0.16 (p?=?0.007) times/week respectively, while leaving full-time education was not associated with any change. CONCLUSIONS:The transitions of beginning full-time employment and becoming a parent were associated with increases in fast food intake. Public health policy or interventions designed to reduce fast food intake in young adults may benefit from particular focus on populations experiencing these transitions, to ameliorate their impact.

Project description:Importance: The association of weight gain from early to middle adulthood with disease risk has not been adequately studied.Objective: To investigate the association of adult weight gain with major health outcomes in a Chinese population with low body weight in early adulthood.Design, setting, and participants: This population-based cohort study assessed data from 48?377 women and 35?989 men aged 40 to 59 years at recruitment in 2 prospective cohort studies in China. The Shanghai Women's Health Study recruited 74?941 women, aged 40 to 70 years, from January 1, 1996, to December 31, 2000, and the Shanghai Men's Health Study recruited 61?482 men, aged 40 to 74 years, from January 1, 2002, to December 31, 2006. This analysis was conducted from September 1, 2017, to April 30, 2018.Exposures: Weight gain from 20 years of age to 40 to 59 years of age.Main outcomes and measures: Mortality and incidence of cancers and other chronic diseases.Results: This analysis included 48?377 women (mean [SD] age, 47.8 [5.3] years) and 35?989 men (mean [SD] age, 49.6 [5.1] years). Per 5-kg weight gain from early to middle adulthood was associated with an approximately 10% (hazard ratio [HR], 1.09; 95% CI, 1.04-1.14 for men; HR, 1.14; 95% CI, 1.11-1.19 for women) elevated all-cause mortality and a greater than 20% (HR, 1.26; 95% CI, 1.16-1.38 for men; HR, 1.23; 95% CI, 1.14-1.33 for women) cardiovascular disease-related mortality in later life among individuals who reached a body mass index (BMI) of 23 or higher at middle adulthood. Body mass index at middle adulthood also modified the association of weight gain with risk of obesity-related cancers, with weight gain of 20 kg or more associated with increased risks both for men (HR, 1.34; 95% CI, 1.07-1.67) and for women (HR 1.45; 95% CI, 1.24-1.68). No similar associations were found for individuals with a BMI of 18.5 to 22.9. Regardless of BMI, weight gain was associated with elevated risks of type 2 diabetes, hypertension, fatty liver disease, stroke, gout, and gallstones, particularly for type 2 diabetes (HR, 7.87; 95% CI, 6.91-8.97 for women; HR, 4.95; 95% CI, 4.23-5.79 for men) and fatty liver disease (HR, 3.68; 95% CI, 3.42-3.95 for women; HR, 2.83, 95% CI, 2.56-3.13 for men) in individuals with weight gain of 20 kg or more compared with those with a healthy weight.Conclusions and relevance: This study found that weight gain from early to middle adulthood was associated with disease incidence and mortality in later life. The BMI at middle adulthood modified the association of weight gain with mortality and cancer incidence but not risk of other major chronic diseases.

Dataset Information

Changes in physical activity, diet, and body weight across the education and employment transitions of early adulthood: A systematic review and meta-analysis.

Publications

Changes in physical activity, diet, and body weight across the education and employment transitions of early adulthood: A systematic review and meta-analysis.

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