• Heikki Frilander, Svetlana Solovieva, Pertti Mutanen, Harri Pihlajamäki, Markku Heliövaara, and Eira Viikari-Juntura.
• Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
• BMJ Open. 2015 Jan 1; 5 (8): e007805.

ObjectivesTo assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course.DesignA longitudinal and cross-sectional study.SettingA nationwide health survey supplemented with data from records of prior compulsory military service.ParticipantsPremilitary health records (baseline) were searched for men aged 30-50 years (n=1385) who participated in a national health examination survey (follow-up).Methods And Outcome MeasuresHeight and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica.ResultsBaseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m(2)) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m(2)). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP.ConclusionsOur findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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