Employment transitions and weight change : a longitudinal study of retirement and work stoppage in middle- and older-aged adults in Canada using the CLSA

The objectives of this thesis were to: (1) examine the sex/gender-specific impacts that employment status change (employment transitions, ETs) have on body weight and waist circumference (WC) changes in middle- and older-age adults and (2) assess the contribution of changes in health behaviours (HBs: sleep duration and quality, smoking status, alcohol consumption, and physical activity) in the association between ETs and anthropometric changes. Chapter 1: Eight bibliometric databases were systematically searched, with citations followed up. Twelve studies were included. All studies examined retirement but reported mixed results. Retirement either led to weight gain or did not alter weight compared to non-retirement. Occupation type modified the association: weight gain was more commonly reported among retirees from physically demanding occupations. Two included studies also examined job-loss and results were also mixed. Key confounders and commonly studied HBs were identified. Chapter 2 & 3: Two waves of data from the Canadian Longitudinal Study on Aging were used to classify 10,117 working women and men into three ET groups: stayed working, entered retirement, and stopped working. The outcomes were change in weight and WC on continuous scales, and change as categories (≥5% gain, ≥5% loss, no change). Multivariable linear and multinomial logistic regressions were adjusted for confounders and HBs. Multivariable linear regression models showed that weight changes did not differ across ETs in women, although changes in WC showed different directions across ET. By contrast, men who entered retirement lost more weight and had greater reductions in WC relative to men who stayed working (-0.59 kg, [95% CI: -1.11, -0.08] and -0.83 cm, [95% CI: -1.46, -0.20]). Final multinomial logistic regression models did not show significant associations; however, the direction of the effects remained. In models that included HB change variables, estimates were not attenuated. Retirement may result in small amounts of weight loss in middle-aged and older Canadian men. Work stoppage appears to lead to more WC increases in women, but the evidence is uncertain. Contrary to hypotheses that place HBs along the pathway between ETs and anthropometric change, the findings from the empirical study suggest that they are independent risk factors instead.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat