Trajectories of Childhood Weight Gain: The Relative Importance of Local Environment versus Individual Social and Early Life Factors

Objective: To determine the association between local environmental factors with child weight status in a longitudinal study, using a semi-parametric, group-based method, while also considering social and early life factors. Methods: Standardized, directly measured BMI from 4-10 y of age, and group-based trajectory modeling (PROC TRAJ) were used to estimate developmental trajectories of weight change in a Quebec birth cohort (n = 1,566). Associations between the weight trajectories and living location, social cohesion, disorder, and material and social deprivation were estimated after controlling for social and early life factors. Results: Four weight trajectory groups were estimated: low-increasing (9.7%); low-medium, accelerating (36.2%); medium-high, increasing (43.0%); and high-stable (11.1%). In the low-increasing and medium-high trajectory groups, living in a semi-urban area was inversely related to weight, while living in a rural area was positively related to weight in the high-stable group. Disorder was inversely related to weight in the low-increasing group only. Other important risk factors for high-stable weight included obesity status of the mother, smoking during pregnancy, and overeating behaviors. Conclusions: In this study, associations between local environment factors and weight differed by trajectory group. Early life factors appear to play a more consistent role in weight status. Further work is needed to determine the influence of place on child weight.