Research ArticleEating, Activity, and Weight-related Problems From Adolescence to Adulthood
Introduction
The high prevalence of eating, activity, and weight-related problems during adolescence is of great public health concern, given that adolescence is a period of rapid growth and development,1, 2, 3, 4, 5, 6 and behavioral patterns established during this time may set the stage for adulthood.7 If eating, activity, and other weight-related problems persist from adolescence into early adulthood, then young adults, and the future generations they influence as parents, will be at increased risk for developing chronic health outcomes. To inform the content and timing of interventions, it is important to understand the scope and stability of eating, activity, and weight-related problems throughout the critical period from adolescence to adulthood.
The current study examines the prevalence and stability of a broad spectrum of eating, activity, and weight-related factors that have been linked to adverse health consequences. Examining a broad spectrum of eating, activity, and weight-related problems concurrently is valuable for learning about the scope of various problems that may be interrelated and have cumulative impacts on health. The current study thus includes indicator variables from within the domains of eating, physical activity, weight control practices, body image, and weight status that have been found to be associated with adverse health outcomes: high fast-food intake,8, 9 low levels of moderate to vigorous physical activity (MVPA),10, 11, 12 unhealthy weight control practices,13 body dissatisfaction,14, 15, 16, 17 and obesity.18 For example, eating fast food more than twice a week is associated with excess weight gain and increased insulin resistance 15 years later.9 Low MVPA predicts elevated all-cause mortality and cardiovascular risk 20 years later.19 Unhealthy weight control behaviors (e.g., skipping meals, taking diet pills) predict greater weight gain over time13 and low body satisfaction is linked to higher rates of binge eating, smoking,16 depression, and poor self-esteem.20
Research questions to be addressed include: (1) How does the prevalence of eating, activity, and weight-related problems change over time among females and males during the transition from adolescence to early adulthood? And (2) what are the individual trajectories over time for having at least one eating, activity, or weight-related problem in females and males? Examining prevalence over time provides information about the scope of the problems, whereas examining individual trajectories provides information about the stability or consistency of having at least one problematic outcome. Findings will inform the field’s understanding of the scope, timing, and patterns of eating, activity, and weight-related problems across key developmental periods of the life cycle and thus provide important information to guide policies, community- and school-based interventions, and clinical practices.
Section snippets
Study Population and Measures
Project EAT (Eating and Activity in Teens and Young Adults) is a longitudinal study of eating, activity, and weight-related measures in young people. In 1998–1999 (Project EAT-I/Wave 1), middle school and high school students (n=4,746, mean age=14.8 [SD=1.6] years) from 31 public schools in the Minneapolis and St. Paul metropolitan area completed surveys and anthropometric measures.21, 22 Follow-up mailed assessments were conducted at 5-year intervals: EAT-II/Wave 2 (n=2,516, mean age=19.4
Results
Prevalences of most eating, activity, and weight-related problems were high in adolescence and either remained high or increased during the transition to adulthood (Figure 1). For example, among females, the prevalence of low MVPA increased from 26.7% (Wave 1, adolescence) to 42.1% (Wave 4, adulthood). Among males, the prevalence of low MVPA increased from 16.5% to 28.7% during the study period. The prevalence of obesity tripled in females and nearly doubled in males from adolescence to young
Discussion
There is both theoretical and empirical support for addressing a broad spectrum of eating, activity, and weight-related outcomes.13, 16, 23, 39, 40, 41, 42, 43 Current study findings show that the majority of adolescents and young adults have problematic eating, activity, or weight-related outcomes and demonstrate the stability of these problems across critical developmental stages. Both the scope and the stability of having at least one eating, activity, or weight-related problem were
Conclusions
Study findings indicate that eating, activity, and weight-related problems are prevalent and have high stability over critical stages of physical and psychosocial development. Addressing eating, activity, and weight-related concerns in a comprehensive manner, both early on and throughout adolescence and young adulthood, is warranted. An example of an intervention that addresses a broad spectrum of eating, activity, and weight-related problems in adolescent girls is New Moves68 (//www.newmovesonline.com
Acknowledgments
This study was supported by the National Heart, Lung, and Blood Institute through grant number R01HL116892.
DNS is principal investigator of the study and wrote the manuscript. MMW is a co-investigator on the study and contributed to data analysis and interpretation. CC conducted data analysis for this study. NL is the study project director, managed acquisition of data, and contributed to writing. MJC and NES contributed to writing this manuscript. All authors critically reviewed and approved
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