American Journal of Epidemiology Advance Access originally published online on May 8, 2007
American Journal of Epidemiology 2007 166(1):14-16; doi:10.1093/aje/kwm101
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Invited Commentary: Antecedents of Obesity—Analysis, Interpretation, and Use of Longitudinal Data
1 Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
2 Department of Nutrition, Harvard School of Public Health, Boston, MA
Correspondence to Dr. Matthew W. Gillman, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, 133 Brookline Ave., 6th floor, Boston, MA 02215 (e-mail: matthew_gillman{at}hms.harvard.edu).
Received for publication December 18, 2006. Accepted for publication January 11, 2007.
The obesity epidemic causes misery and death. Most epidemiologists accept the hypothesis that characteristics of the early stages of human development have lifelong influences on obesity-related health outcomes. Unfortunately, there is a dearth of data of sufficient scope and individual history to help unravel the associations of prenatal, postnatal, and childhood factors with adult obesity and health outcomes. Here the authors discuss analytic methods, the interpretation of models, and the use to which such rare and valuable data may be put in developing interventions to combat the epidemic. For example, analytic methods such as quantile and multinomial logistic regression can describe the effects on body mass index range rather than just its mean; structural equation models may allow comparison of the contributions of different factors at different periods in the life course. Interpretation of the data and model construction is complex, and it requires careful consideration of the biologic plausibility and statistical interpretation of putative causal factors. The goals of discovering modifiable determinants of obesity during the prenatal, postnatal, and childhood periods must be kept in sight, and analyses should be built to facilitate them. Ultimately, interventions in these factors may help prevent obesity-related adverse health outcomes for future generations.
birth weight; body mass index; body size; growth; obesity; overweight
Abbreviations: BMI, body mass index; NCPP, National Collaborative Perinatal Project
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