Open Access Highly Accessed Research article

Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study

Andrea Gonzalez1*, Michael H Boyle1, Katholiki Georgiades1, Laura Duncan1, Leslie R Atkinson2 and Harriet L MacMillan1

Author Affiliations

1 McMaster University, Department of Psychiatry and Behavioral Neuroscience, Offord Centre for Child Studies, 1280 Main Street West, Chedoke Site, Patterson Building, Hamilton, ON L8S 3K1, Canada

2 Ryerson University, Department of Psychology, 350 Victoria Street, Toronto, ON, M5B 2 K3, Canada

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BMC Public Health 2012, 12:755  doi:10.1186/1471-2458-12-755

Published: 9 September 2012



Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood.


We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4–16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21–35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood.


At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood.


Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.

Family and child level risk factors; Body mass index