Age, Period and Cohort Effects on Adult Body Mass Index and Overweight from 1991 to 2009 in China: the China Health and Nutrition Survey
Open Access
- 14 June 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in International Journal of Epidemiology
- Vol. 42 (3), 828-837
- https://doi.org/10.1093/ije/dyt052
Abstract
Background Contributions of age-period-cohort effects to increases in BMI and overweight among Chinese adults must be resolved in order to design appropriate interventions. The objectives were to (i) describe the period effect on BMI and overweight among Chinese adults from 1991 to 2009 and assess modification of this effect by age (e.g. cohort effect) and gender, and (ii) quantify the influence of household income and community urbanicity on these effects. Methods Data are from the China Health and Nutrition Survey, a prospective sample across nine provinces in China; 53 298 observations from 18 059 participants were collected over a 19-year period. A series of mixed effects models was used to explicitly assess differences in BMI within individuals over time (age effect) and population-wide differences in BMI over time (period effect), and implicitly assess differences in the experienced period effect across individuals of varying ages (cohort effect). Results Stronger period effects on BMI and overweight were observed among males compared with females; and younger cohorts had higher BMIs compared with older cohorts. Simulations predicted that increases in income and urbanicity in the order of magnitude of that observed from 1991 to 2009 would correspond to shifts in the BMIs of average individuals of 0.07 and 0.23 kg/m2, respectively. Conclusions Although period effects had a stronger influence on the BMI of males, interventions should not overlook younger female cohorts who are at increased risk compared with their older counterparts.Keywords
This publication has 57 references indexed in Scilit:
- The expanding burden of cardiometabolic risk in China: the China Health and Nutrition SurveyObesity Reviews, 2012
- Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993–2009Obesity Reviews, 2011
- Unravelling the effects of age, period and cohort on metabolic syndrome components in a Taiwanese population using partial least squares regressionBMC Medical Research Methodology, 2011
- Understanding community context and adult health changes in China: Development of an urbanicity scaleSocial Science & Medicine (1982), 2010
- What is a cohort effect? Comparison of three statistical methods for modeling cohort effects in obesity prevalence in the United States, 1971–2006Social Science & Medicine (1982), 2010
- Dynamics and Heterogeneity in the Process of Human Frailty and Aging: Evidence From the U.S. Older Adult PopulationThe Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 2009
- Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United StatesSocial Science & Medicine (1982), 2009
- Cohort Profile: The China Health and Nutrition Survey--monitoring and understanding socio-economic and health change in China, 1989-2011International Journal of Epidemiology, 2009
- Why have physical activity levels declined among Chinese adults? Findings from the 1991–2006 China health and nutrition surveysSocial Science & Medicine (1982), 2009
- China's transition: The effect of rapid urbanization on adult occupational physical activitySocial Science & Medicine (1982), 2007