Prospective cohort study on the impact of socioeconomic status and healthy lifestyle on the incidence of overweight and obesity
Objective To understand the relationship between socioeconomic status,healthy lifestyle,and the incidence of overweight and obesity,and to provide a scientific basis for the intervention and prevention of overweight and obesity in the population.Methods The method of multi-stage stratified cluster random sampling was adopted to conduct a baseline survey on permanent residents over 18 years of age in 48 towns and townships in 12 counties(cities and districts)of Guizhou Province from November 2010 to December 2012,with a total of 9 280 residents surveyed.From December 2016 to June 2020,all subjects in this cohort were followed up,excluding those who did not meet the inclusion criteria and those who were lost to follow-up.Finally,2 672 residents were included in the analysis.Single-factor analysis was performed using the Chi-square test,and Cox proportional hazards regression models were used to analyze the impact of socioeconomic status and healthy lifestyle on the incidence of overweight and obesity.Results A total of 2 672 individuals were included in the study,among whom 786 were overweight or obese.The median follow-up period was 6.42 years,with an incidence density of 41.68/1 000 person-years.Multivariate Cox regression results showed that compared with low socioeconomic status individuals,the risk of overweight and obesity in high socioeconomic status had a 32％lower risk of overweight and obesity(HR=0.68,95％CI:0.58-0.79).Individuals with seven or more healthy lifestyle factors had a 30％lower risk(HR=0.70,95％CI:0.55-0.89),while those with eight or more healthy lifestyle factors had a 33％lower risk(HR=0.67,95％CI:0.50-0.90)compared to those with≤4 healthy lifestyle factors.Compared to the population with low socioeconomic status and healthy lifestyle ≤ 4 types,the incidence risk for individuals with high socioeconomic status and ≤4,5,6,7,and ≥8 healthy lifestyle factors was 0.69 times(HR=0.69,95％CI:0.49-0.98),0.67 times(HR=0.67,95％CI:0.48-0.92),0.65 times(HR=0.65,95％CI:0.47-0.89),0.40 times(HR=0.40,95％CI:0.28-0.57),and 0.46 times(HR=0.46,95％CI:0.31-0.67)respectively.Conclusions A healthy lifestyle may not significantly influence the risk of overweight and obesity in individuals with low socioeconomic status in Guizhou Province.Promoting healthy lifestyles alone may not reduce the health differences caused by socioeconomic inequality,emphasizing the need to address social injustice factors more effectively.
Socioeconomic statusHealthy lifestyleOverweight and obesityCohort study
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