Elsevier

Preventive Medicine

Volume 39, Issue 4, October 2004, Pages 722-730
Preventive Medicine

Changes in health-related behaviours and cardiovascular risk factors in young adults: associations with living with a partner

https://doi.org/10.1016/j.ypmed.2004.02.038Get rights and content

Abstract

Objective. To examine changes in cardiovascular risk factors and health-related behaviours in young Australian adults at a stage of transition from the family environment.

Study design. Repeated surveys between 9 and 25 years of age in a community-based group that included 569 eighteen-year-olds and 600 twenty-five-year-olds.

Results. There were significant increases (P < 0.001 for all variables) in body mass index (BMI) [men 2.5 kg/m2 (2.0); women 1.7 kg/m2 (2.9)], waist girth [men 7.6 cm (6.5); women 4.3 cm (7.2)], BP (systolic/diastolic) [men 5(12)/7(8) mm Hg; women 3(10)/6(7) mm Hg] and in total cholesterol [men 15% increase; women 9%]. The proportion of sedentary behaviour increased from 19% to 39% in men (P < 0.001) and from 40% to 41% (P = 0.801) in women. Cohabitation was associated with significantly greater increases in BMI, waist circumference, and total cholesterol, associated with dietary change in women and decreased physical activity in men. In mothers, waist girth increased by 8.0 cm (0.1) compared with 3.5 cm (0.6) in women without children (P = 0.003), and physical fitness decreased [−0.5 W/kg (0.4) vs. 1.2 W/kg (0.2), respectively; P = 0.001].

Conclusion. Encouragement of a healthy lifestyle, particularly physical activity, should be a priority in this age group, particularly among newly cohabiting couples and in young mothers.

Introduction

There is worldwide concern about the increasing prevalence of overweight and obesity, both in adults and children [1], [2], [3], [4], [5], [6]. Recently, the AusDiab study [7] reported that 60% of Australian men and women between the ages of 25 and 64 years were overweight or obese. Among 25- to 34-year-olds, the youngest age group reported in that study, 61% of men and 45% of women were overweight or obese, defined by the cutpoints for body mass index (BMI) of 25.0 kg/m2 for overweight and 30.0 kg/m2 for obesity. Relative to previous cross-sectional Australian surveys, this represents a 2.5-fold increase in prevalence of obesity over a period of 20 years. However, these reported rates are not based on longitudinal data and do not allow documentation of changes in early adult life.

Periods of transition in the life course may be associated with changes in health-related behaviours [8]. Transition includes events that are common in young adults such as leaving the family home, changing marital status or becoming a parent [9]. Changes in patterns of physical activity [8], food habits [10] and changes in weight [11] have been linked to change in marital status, whereas leaving home has been associated with changes in patterns of leisure-time activity [12]. Women report altered dietary patterns associated with adopting the role of a parent, tending to provide and eat more fruit and vegetables to promote optimal nutrition in their children [13]. King et al. [8] suggest that periods of transition may be important in health promotion by identifying stages in the life course when individuals or groups may be more receptive to interventions that aim to promote a healthy lifestyle.

Several reports suggest that, consistent with popular belief [14], becoming married is associated with weight gain, although change from married to unmarried status leads to weight loss [11]. However, not all data have been longitudinal and, in those that have, intervals of up to 10 years between observations have not allowed recognition of changes in the early stages of living with a partner [8], [11]. Australian studies that examined weight, diets and physical activity within the first 2–3 years of marriage, however, showed that men, but not women, gained weight in that interval [15], [16], [17], [18]. In contrast, data from the United States showed that women, but not men gained weight early in marriage [19]. Such reports are confounded by differences in socioeconomic status [20], failure to account for associations with parenthood, a factor that may interact with the marital state [21] and lack of information about young adults moving out of the family home.

In the present study, we report data from surveys of a Perth cohort of young adults examined at the ages of 18 and 25 years. We aimed to document changes in risk factors over that period and examine associations between changes in social circumstances and changes in risk factors and health-related behaviours with a focus on the effects of leaving the family environment, living with a partner and having children.

Section snippets

Participants and methods

In 2000, a cohort of 25-year-olds who had been participating from the age of 9 years in a longitudinal study of cardiovascular risk factors were re-surveyed. Surveys had been carried out at 3-yearly intervals between 1985 and 1994 beginning with 1066 nine-year-old children recruited from schools chosen randomly after stratification by socioeconomic group. Further recruiting in 1988 increased the sample size to 1565 students. In 1994 when participants were 18 years old, 583 individuals attended

Results

There were 569 eighteen-year-olds (301 men, 282 women) and 600 twenty-five-year-olds (266 men, 334 women) who attended the surveys; 405 individuals (194 men, 211 women) attended both surveys. At the age of 25 years, occupational status was: professional in 36% of men and 38% of women; blue collar in 27% of men and 31% of women; manual in 10% of men and 4% of women; 27% of both men and women were students.

Discussion

Overall, these young adults have shown substantial increases in weight, central obesity and the prevalence of overweight or obesity between the ages of 18 and 25 years, with accompanying deterioration in cardiovascular risk factors. We have also shown, for the first time, in a study that accounted for leaving home and for parenthood, that living with a partner is associated with weight gain, increased waist girth, higher cholesterol and, in men, less physical activity and lower physical fitness.

Acknowledgements

This study was supported by Healthway.

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