Do the associations of body mass index and waist circumference with back pain change as people age? 32 years of follow-up in a British birth cohort

OBJECTIVES: To investigate whether cross-sectional and longitudinal associations of body mass index (BMI) and waist circumference (WC) with back pain change with age and extend into later life. DESIGN: British birth cohort study. SETTING: England, Scotland and Wales. PARTICIPANTS: Up to 3426 men and women from the MRC National Survey of Health and Development. PRIMARY OUTCOME MEASURES: Back pain (sciatica, lumbago or recurring/severe backache all or most of the time) was self-reported during nurse interviews at ages 36, 43, 53 and 60–64 years and in a postal questionnaire using a body manikin at age 68. RESULTS: Findings from mixed-effects logistic regression models indicated that higher BMI was consistently associated with increased odds of back pain across adulthood. Sex-adjusted ORs of back pain per 1 SD increase in BMI were: 1.13 (95% CI: 1.01 to 1.26), 1.11 (95% CI: 1.00 to 1.23), 1.17 (95% CI: 1.05 to 1.30), 1.31 (95% CI: 1.15 to 1.48) and 1.08 (95% CI: 0.95 to 1.24) at ages 36, 43, 53, 60–64 and 68–69, respectively. Similar patterns of associations were observed for WC. These associations were maintained when potential confounders, including education, occupational class, height, cigarette smoking status, physical activity and symptoms of anxiety and depression were accounted for. BMI showed stronger associations than WC in models including both measures. CONCLUSIONS: These findings demonstrate that higher BMI is a persistent risk factor for back pain across adulthood. This highlights the potential lifelong consequences on back pain of the rising prevalence of obesity within the population.