Background
Methods
Study population
Ethics statement
Data collection and study variables
Body mass index-based and waist circumference-based obesity
Stress-related eating
Indicators of early-life stress
Food and drink consumption at 16 years
Other health behaviours at 16 years
Family characteristics
Statistical analyses
Results
Girls n = 3598 | Boys n = 3347 |
p(χ2-test) | |||
---|---|---|---|---|---|
% | Mean (95% CI) | % | Mean (95% CI) | ||
Weight (kg)
| 56.9 (56.6, 57.3) | 64.6 (64.2, 65.1) | |||
Height (cm)
| 163.9 (163.7, 164.1) | 174.6 (174.4, 174.9) | |||
Body mass index (kg/m
2
)
| 21.2 (21.1, 21.3) | 21.1 (21.0, 21.3) | |||
Waist circumference (cm)
| 71.9 (71.6, 72.2) | 75.8 (75.4, 76.1) | |||
Overweight
| 10.9 | 12.7 | |||
Obesity
| 2.9 | 4.3 | <0.001 | ||
Abdominal obesity
| 13.2 | 10.4 | 0.001 | ||
Eating in a stressful situation to make oneself feel better
| |||||
Never | 56.8 | 84.8 | |||
To some extent | 39.2 | 14.3 | |||
Fairly often | 3.2 | 0.8 | |||
Very often | 0.8 | 0.2 | <0.001 | ||
Physical activity hours per week
| |||||
<2 | 40.7 | 31.3 | |||
2–3 | 29.9 | 23.3 | |||
>3 | 29.5 | 45.3 | <0.001 | ||
Use of tobacco
| |||||
Never | 33.2 | 36.9 | |||
Experimental or occasional | 39.9 | 38.9 | |||
Regular | 26.9 | 24.3 | 0.002 | ||
Sleeping hours per night
| |||||
<8 | 24.4 | 16.7 | |||
8–9 | 65.2 | 66.3 | |||
>9 | 10.4 | 16.9 | <0.001 | ||
Devouring large amounts of food
| |||||
Never | 46.3 | 42.4 | |||
Hardly ever | 23.1 | 20.9 | |||
Occasionally | 21.6 | 26.3 | |||
Once a month | 3.5 | 3.5 | |||
Once a week | 3.3 | 3.4 | |||
2–3 times a week | 1.7 | 2.0 | |||
Daily | 0.6 | 1.5 | <0.001 | ||
Strict diet to control weight
| |||||
Never | 70.0 | 90.1 | |||
Occasionally | 27.7 | 9.4 | |||
Often | 2.3 | 0.5 | <0.001 | ||
Heavy exercise to control weight
| |||||
Never | 57.4 | 69.8 | |||
Occasionally | 37.5 | 22.5 | |||
Often | 5.1 | 7.6 | <0.001 | ||
Meals with parents or other family members
| |||||
Daily or almost daily | 63.5 | 75.0 | |||
A few times a week | 17.3 | 14.0 | |||
1–2 times a week | 7.6 | 5.2 | |||
Occasionally | 8.8 | 4.6 | |||
Hardly ever | 2.7 | 1.2 | <0.001 | ||
Maternal basic education
| |||||
Comprehensive school | 67.0 | 68.2 | |||
Upper secondary school | 33.0 | 31.8 | 0.309 | ||
Parents interested in their child’s schooling and hobbies
| |||||
Never | 0.8 | 0.5 | |||
Seldom | 13.8 | 14.0 | |||
Almost always | 85.4 | 85.5 | 0.372 |
Measure or degree of obesity | Girls | Boys | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Non-stress-driven eaters n = 2026 | Stress-driven eaters n = 1538 | Non-stress-driven eaters n = 2757 | Stress-driven eaters n = 496 | |||||||
Mean (95% CI) | n (%) | Mean (95% CI) | n (%) |
p(χ2-test) | Mean (95% CI) | n (%) | Mean (95% CI) | n (%) |
p(χ2-test) | |
Body mass index (kg/m
2
)
| 21.0 (20.8, 21.1) | 21.4 (21.3, 21.6) | 21.0 (20.9, 21.1) | 21.8 (21.4, 22.1) | ||||||
Waist circumference (cm)
| 71.4 (71.1, 71.8) | 72.6 72.1, 73.0) | 75.5 (75.1, 75.8) | 77.2 (76.2, 78.2) | ||||||
Normal weight + underweight
| 1757 (87.4) | 1296 (84.7) | 2285 (83.8) | 388 (78.5) | ||||||
Overweight
| 208 (10.3) | 177 (11.6) | 336 (12.3) | 77 (15.6) | ||||||
Obesity
| 45 (2.2) | 58 (3.8) |
0.010
| 106 (3.9) | 29 (5.9) |
0.012
| ||||
Abdominal obesity
| 215 (12.1) | 198 (14.7) | 236 (9.7) | 58 (13.5) | ||||||
No abdominal obesity
| 1566 (87.9) | 1152 (85.3) |
0.037
| 2194 (90.3) | 371 (86.5) |
0.020
|
Early-life factor | Girls | Boys | |||||
---|---|---|---|---|---|---|---|
Non-stress-driven eaters n (%) | Stress-driven eaters n (%) |
p(χ2-test) | Non-stress-driven eaters n (%) | Stress-driven eaters n (%) |
p(χ2-test) | ||
Maternal smoking at the end of the 2nd month of pregnancy
| No | 1602 (81.2) | 1226 (81.2) | 2176 (80.7) | 412 (84.4) | ||
1-9 cigarettes a day | 173 (8.8) | 139 (9.2) | 255 (9.5) | 36 (7.4) | |||
>9 cigarettes a day | 197 (10.0) | 144 (9.5) |
0.836
| 267 (9.9) | 40 (8.2) |
0.142
| |
Maternal alcohol use during pregnancy
| No | 1738 (87.4) | 1299 (85.9) | 2346 (87.0) | 432 (88.3) | ||
Yes | 251 (12.6) | 214 (14.1) |
0.192
| 352 (13.0) | 57 (11.7) |
0.420
| |
Maternal weight gain during the first 20 weeks of pregnancy
| Lowest quartile | 551 (29.7) | 391 (27.9) | 653 (25.9) | 113 (24.8) | ||
Second quartile | 556 (30.0) | 455 (32.5) | 726 (28.8) | 148 (32.5) | |||
Third quartile | 442 (23.8) | 330 (23.6) | 628 (24.9) | 116 (25.4) | |||
Highest quartile | 306 (16.5) | 224 (16.0) |
0.449
| 511 (20.3) | 79 (17.3) |
0.298
| |
Birth weight
| Low <2500 g | 81 (4.0) | 43 (2.8) | 76 (2.8) | 14 (2.8) | ||
Normal 2500–3999 g | 1613 (79.6) | 1238 (80.5) | 2054 (74.5) | 345 (69.6) | |||
High ≥4000 g | 332 (16.4) | 257 (16.7) |
0.152
| 627 (22.7) | 137 (27.6) |
0.059
| |
Gestational age at birth
| <37 weeks (preterm) | 91 (4.5) | 61 (4.0) | 134 (4.9) | 21 (4.2) | ||
≥37 weeks | 1935 (95.5) | 1477 (96.0) |
0.453
| 2621 (95.1) | 475 (95.8) |
0.647
| |
Birth weight for gestational age
| Small | 185 (9.1) | 127 (8.3) | 237 (8.6) | 44 (8.9) | ||
Appropriate | 1640 (80.9) | 1250 (81.3) | 2262 (82.0) | 396 (79.8) | |||
Large | 201 (9.9) | 161 (10.5) |
0.597
| 258 (9.4) | 56 (11.3) |
0.384
|
Food or beverage | Amount or frequency | Girls | Boys | ||||
---|---|---|---|---|---|---|---|
Non-stress-driven eaters n (%) | Stress-driven eaters n (%) |
p(χ2-test) | Non-stress-driven eaters n (%) | Stress-driven eaters n (%) |
p(χ2-test) | ||
Sausages and frankfurters
| Once a week or less often | 1692 (84.2) | 1278 (83.6) | 1890 (69.3) | 313 (63.7) | ||
Twice a week or more often | 317 (15.8) | 251 (16.4) |
0.611
| 838 (30.7) | 178 (36.3) |
0.018
| |
Hamburgers and pizzas
| Twice a week or less often | 1959 (97.5) | 1480 (96.9) | 2519 (92.4) | 438 (89.0) | ||
3–5 times a week or more often | 50 (2.5) | 48 (3.1) |
0.256
| 208 (7.6) | 54 (11.0) |
0.015
| |
Chocolate
| Twice a week or less often | 1788 (89.0) | 1303 (85.2) | 2482 (91.2) | 433 (88.0) | ||
3–5 times a week or more often | 221 (11.0) | 227 (14.8) |
0.001
| 239 (8.8) | 59 (12.0) |
0.028
| |
Sweets
| Twice a week or less often | 1481 (74.0) | 1019 (67.0) | 2105 (77.6) | 357 (72.7) | ||
3-5 times a week or more often | 520 (26.0) | 503 (33.0) |
<0.001
| 607 (22.4) | 134 (27.3) |
0.020
| |
Ice cream
| Twice a week or less often | 1509 (75.0) | 1115 (73.0) | 2054 (75.2) | 363 (74.2) | ||
3–5 times a week or more often | 503 (25.0) | 413 (27.0) |
0.175
| 676 (24.8) | 126 (25.8) |
0.650
| |
Sugar-free soft drinks (light sodas)
| Twice a week or less often | 1805 (90.2) | 1336 (88.0) | 2456 (90.5) | 435 (88.6) | ||
3–5 times a week or more often | 197 (9.8) | 182 (12.0) |
0.042
| 259 (9.5) | 56 (11.4) |
0.216
| |
Sugar-sweetened soft drinks
| Twice a week or less often | 1552 (77.2) | 1173 (76.8) | 1799 (66.0) | 302 (61.5) | ||
3–5 times a week or more often | 459 (22.8) | 354 (23.2) |
0.809
| 925 (34.0) | 189 (38.5) |
0.057
| |
Alcoholic beverages
| Never | 1047 (51.9) | 615 (40.2) | 1565 (57.1) | 267 (54.0) | ||
Randomly | 544 (26.9) | 439 (28.7) | 666 (24.3) | 115 (23.3) | |||
Once a month or more often | 428 (21.2) | 475 (31.1) |
<0.001
| 511 (18.6) | 112 (22.7) |
0.111
| |
Physical activity
| <2 hours a week | 796 (39.7) | 637 (41.9) | 852 (31.3) | 152 (31.0) | ||
2–3 hours a week | 613 (30.6) | 440 (28.9) | 627 (23.0) | 116 (23.6) | |||
>3 hours a week | 596 (29.7) | 444 (29.2) |
0.391
| 1246 (45.7) | 223 (45.4) |
0.956
| |
Tobacco use
| Never smoked or taken snuff | 758 (37.5) | 417 (27.2) | 1015 (37.2) | 166 (33.6) | ||
Experimental or occasional use of cigarettes or snuff | 763 (37.8) | 657 (42.9) | 1058 (38.7) | 198 (40.1) | |||
Smoking or taking snuff regularly | 499 (24.7) | 458 (29.9) |
<0.001
| 658 (24.1) | 130 (26.3) |
0.288
| |
Sleeping
| <8 hours per night | 450 (22.4) | 410 (26.8) | 446 (16.4) | 92 (18.9) | ||
8–9 hours per night | 1344 (66.9) | 966 (63.1) | 1813 (66.8) | 312 (63.9) | |||
>9 hours per night | 215 (10.7) | 154 (10.1) |
0.010
| 457 (16.8) | 84 (17.2) |
0.370
| |
Binge eating
| Never - occasionally | 1914 (94.8) | 1316 (85.8) | 2513 (91.3) | 395 (79.6) | ||
Once a month - daily | 104 (5.2) | 218 (14.2) |
<0.001
| 239 (8.7) | 101 (20.4) |
<0.001
| |
Strict diet to control weight
| Never | 1544 (76.7) | 928 (61.0) | 2487 (91.3) | 399 (83.1) | ||
Occasionally or often | 469 (23.3) | 594 (39.0) |
<0.001
| 237 (8.7) | 81 (16.9) |
<0.001
| |
Heavy exercise to control weight
| Never | 1284 (64.0) | 738 (48.6) | 1963 (71.8) | 286 (58.5) | ||
Occasionally or often | 723 (36.0) | 781 (51.4) |
<0.001
| 770 (28.2) | 203 (41.5) |
<0.001
| |
Eating meals with family
| Daily or almost daily | 1342 (66.6) | 918 (59.8) | 2059 (75.4) | 361 (73.2) | ||
A few times a week or less often | 674 (33.4) | 616 (40.2) |
<0.001
| 672 (24.6) | 132 (26.8) |
0.309
|
Number of classes in model | Statistical indices | ||||
---|---|---|---|---|---|
Girls | |||||
AIC | BIC | SSABIC | Entropy | LMR p-value | |
One class
| 40869.835 | 40937.363 | 40902.411 | N/A | N/A |
Two classes
| 39696.616 | 39737.810 | 39764.728 | 0.829 | <0.0001 |
Three classes
| 39192.423 | 39407.283 | 39296.071 | 0.731 | <0.0001 |
Four classes
| 39128.532 | 39417.059 | 39267.718 | 0.701 | 0.0585 |
Five classes
| 39094.938 | 39457.130 | 39269.659 | 0.704 | 0.0152 |
Boys
| |||||
AIC
|
BIC
|
SSABIC
|
Entropy
|
LMR
p
-value
| |
One class
| 32361.412 | 32427.747 | 32392.795 | N/A | N/A |
Two classes
| 31878.669 | 32017.368 | 31944.288 | 0.978 | <0.0001 |
Three classes
| 31756.911 | 31967.976 | 31856.766 | 0.570 | 0.0007 |
Four classes
| 31724.121 | 32007.550 | 31858.212 | 0.488 | 0.0144 |
Five classes
| 31711.079 | 32066.873 | 31879.406 | 0.536 | 0.7043 |
Health behaviour | Amount or frequency | Girls | Boys | ||||
---|---|---|---|---|---|---|---|
Latent class I n = 1256 | Latent class II n = 1071 | Latent class III n = 1098 | Latent class I n = 862 | Latent class II n = 628 | Latent class III n = 1583 | ||
Stress-related eating
| At least to some extent |
732 (58.3%)
| 527 (49.2%) | 218 (19.9%) | 188 (21.8%) |
142 (22.6%)
| 136 (8.6%) |
Physical activity
| <2 hours a week | 310 (24.7%) |
694 (64.8%)
| 384 (35.0%) | 126 (14.6%) |
361 (57.5%)
| 471 (29.8%) |
2–3 hours a week | 407 (32.4%) | 252 (23.5%) |
369 (33.6%)
|
229 (26.6%)
| 124 (19.7%) | 361 (22.8%) | |
>3 hours a week |
539 (42.9%)
| 125 (11.7%) | 345 (31.4%) |
507 (58.8%)
| 143 (22.8%) | 751 (47.4%) | |
Tobacco use
| Never smoked or taken snuff | 304 (24.2%) | 97 (9.1%) |
735 (66.9%)
| 291 (33.8%) | 70 (11.1%) |
765 (48.3%)
|
Experimental or occasional use of cigarettes or snuff |
557 (44.3%)
| 455 (42.5%) | 363 (33.1%) | 351 (40.7%) | 146 (23.2%) |
704 (44.5%)
| |
Smoking or taking snuff regularly | 395 (31.4%) |
519 (48.5%)
| 0 (0%) | 220 (25.5%) |
412 (65.6%)
| 114 (7.2%) | |
Sleeping
| <8 hours per night | 388 (30.9%) |
378 (35.3%)
| 72 (6.6%) | 167 (19.4%) |
252 (40.1%)
| 100 (6.3%) |
8–9 hours per night | 735 (58.5%) | 549 (51.3%) |
951 (86.6%)
| 564 (65.4%) | 253 (40.3%) |
1224 (77.3%)
| |
≥9 hours per night | 133 (10.6%) |
144 (13.4%)
| 75 (6.8%) | 131 (15.2%) |
123 (19.6%)
| 259 (16.4%) | |
Binge eating
| Once a month - daily |
167 (13.3%)
| 139 (13.0%) | 2 (0.2%) | 111 (12.9%) |
145 (23.1%)
| 64 (4.0%) |
Strict diet to control weight
| Occasionally or often |
792 (63.1%)
| 213 (19.9%) | 17 (1.5%) |
241 (28.0%)
| 35 (5.6%) | 27 (1.7%) |
Heavy exercise to control weight
| Occasionally or often |
1256 (100.0%)
| 0 (0%) | 207 (18.9%) |
862 (100.0%)
| 0 (0%) | 46 (2.9%) |
Eating meals with one’s family
| A few times a week or less often | 574 (45.7%) |
572 (53.4%)
| 103 (9.4%) | 250 (29.0%) |
300 (47.8%)
| 220 (13.9%) |
Degree of obesity and latent cluster | Girls | Boys | ||||||
---|---|---|---|---|---|---|---|---|
Unadjusted | Adjusteda
| Unadjusted | Adjusteda
| |||||
n | OR (95% CI) | n | OR (95% CI) | n | OR (95% CI) | n | OR (95% CI) | |
Normal weight/underweight
|
2939
| Ref. |
2922
| Ref. |
2533
| Ref. |
2513
| Ref. |
Overweight
| ||||||||
Unbalanced weight control | 179 | 2.24 (1.70, 2.97) | 177 | 2.22 (1.67, 2.94) | 181 | 3.00 (2.35, 3.82) | 178 | 2.98 (2.34, 3.81) |
Adverse habits | 111 | 1.54 (1.14, 2.08) | 111 | 1.54 (1.14, 2.09) | 73 | 1.43 (1.06, 1.93) | 72 | 1.42 (1.05, 1.93) |
Healthy lifestyle | 78 | Ref. | 78 | Ref. | 136 | Ref. | 134 | Ref. |
368
|
366
|
390
|
384
| |||||
Obesity
| ||||||||
Unbalanced weight control | 48 | 2.47 (1.44, 4.23) | 47 | 2.49 (1.43, 4.33) | 56 | 3.08 (2.03, 4.65) | 55 | 3.01 (1.98, 4.56) |
Adverse habits | 31 | 1.76 (0.99, 3.15) | 31 | 1.79 (0.99, 3.23) | 26 | 1.69 (1.02, 2.79) | 24 | 1.54 (0.92, 2.58) |
Healthy lifestyle | 19 | Ref. | 18 | Ref. | 41 | Ref. | 41 | Ref. |
98
|
96
|
123
|
120
|