Social and lifestyle influences on age-related changes in body morphology are complex because lifestyle and physiological response to social stress can affect body fat differently.
In this study, we examined the associations of socioeconomic status (SES) and lifestyle factors with BMI and waist circumference (WC) in middle-aged and elderly European men.
Design and setting
A cross-sectional study of 3319 men aged 40–79 years recruited from eight European centres.
We estimated relative risk ratios (RRRs) of overweight/obesity associated with unfavourable SES and lifestyles.
The prevalence of BMI ≥30 kg/m2 or WC ≥102 cm rose linearly with age, except in the eighth decade when high BMI, but not high WC, declined. Among men aged 40–59 years, compared with non-smokers or most active men, centre and BMI-adjusted RRRs for having a WC between 94 and 101.9 cm increased by 1.6-fold in current smokers, 2.7-fold in least active men and maximal at 2.8-fold in least active men who smoked. Similar patterns but greater RRRs were observed for men with WC ≥102 cm, notably 8.4-fold greater in least active men who smoked. Compared with men in employment, those who were not in employment had increased risk of having a high WC by 1.4-fold in the 40–65 years group and by 1.3-fold in the 40–75 years group. These relationships were weaker among elderly men.
Unfavourable SES and lifestyles associate with increased risk of obesity, especially in middle-aged men. The combination of inactivity and smoking was the strongest predictor of high WC, providing a focus for health promotion and prevention at an early age.