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Findings From a Prospective Cohort Study

Adina R. Lemeshow, SM; Laurie Fisher, SM; Elizabeth Goodman, MD; Ichiro Kawachi, MD, PhD; Catherine S. Berkey, ScD; Graham A. Colditz, MD, DrPH

Arch Pediatr Adolesc Med. 2008;162(1):23-28.

Objective  To determine whether subjective social standing in school predicts a change in body mass index (BMI) in adolescent girls during a 2-year period.

Design  Prospective cohort study.

Setting  Self-report questionnaires from a community-based population of adolescent girls living across the United States from 1999 to 2001.

Participants  Of 5723 girls aged 12 to 18 years participating in the Growing Up Today Study (GUTS), adequate information was available for 4446 (78%), who provided the analytic sample.

Main Exposure  Low subjective social status in the school.

Main Outcome Measures  Change in BMI between 1999 and 2001 and multivariable odds ratio for a 2-U increase in BMI in girls with low subjective social status in the school compared with girls with higher subjective social status in the school.

Results  After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother's BMI, and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69% increased odds of having a 2-unit increase in BMI (odds ratio, 1.69; 95% confidence interval, 1.10-2.60) during the next 2 years compared with other girls.

Conclusion  Higher subjective social standing in school may protect against gains in adiposity in adolescent girls.

Author Affiliations: Departments of Society, Human Development, and Health (Ms Lemeshow and Dr Kawachi) and Epidemiology (Dr Colditz), Harvard School of Public Health; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School (Ms Fisher and Drs Berkey and Colditz); and Department of Pediatrics, Tufts-New England Medical Center and the Floating Hospital for Children (Dr Goodman), Boston, Massachusetts; New York City Department of Health and Mental Hygiene, Bureau of Tobacco Control, New York (Ms Lemeshow); and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri (Dr Colditz).

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