Body Mass Index and Subjective Social Status: The Coronary Artery Risk Development in Young Adults Study

Associations Between Subjective Social Status and Health Behaviors Among College Students

OBJECTIVE

Examine the associations between subjective social status (SSS), diet, and health outcomes in college students.

METHODS

Cross-sectional study of 841 students enrolled at a large Midwestern university. Subjective social status within the US, as well as within the university, was measured using the MacArthur Scale of SSS. Outcomes included dietary intake (assessed using the Dietary Screening Questionnaire), body mass index, sleep, physical activity, alcohol use, and vaping behavior. Generalized linear models adjusting for students' sociodemographic characteristics were used to assess associations between SSS and outcomes of interest.

RESULTS

Higher SSS-US was associated with 4%, 3%, and 1% higher intake of fruits, whole grains, and fiber, respectively (P < 0.05). Higher SSS-US and SSS-university rankings were both significantly associated with lower body mass index and better sleep duration (P < 0.05). Higher SSS-university rankings were also associated with more days of physical activity and alcohol consumption (P < 0.05).

CONCLUSIONS AND IMPLICATIONS

In this exploratory study, higher SSS, apart from alcohol intake, was associated with more favorable health outcomes. More research is needed to consider additional psychological and biological mediators and dynamic aspects of SSS, examine potential interactions between SSS and racial and ethnic identities, and explore potential mechanisms underlying the observed associations.

Independent and Interactive Associations of Subjective and Objective Socioeconomic Status With Body Composition and Parent-Reported Hyperphagia Among Children

Background: Subjective socioeconomic status (SSES) and objective socioeconomic status (OSES) have been independently associated with body composition and eating behavior in children. While low OSES may constrain access to healthier foods, low SSES has been associated with increased preference for and motivation to consume higher energy foods and portions independent of OSES. Despite these distinct ways that OSES and SSES may affect children's eating behavior and adiposity, their joint contributions remain unclear. We investigated the independent and interactive associations of SSES and OSES with children's BMI, fat mass index (FMI), and caregiver-reported hyperphagia. Methods: Data were derived from the Children's Growth and Behavior Study, an ongoing observational study. Multiple linear regressions used child's SSES and OSES of the family as independent factors and modeled the statistical interaction of SSES and OSES with BMI (n = 128), FMI (n = 122), and hyperphagia and its subscales (n = 76) as dependent variables. Results: SSES was independently and negatively associated with hyperphagia severity and OSES was independently and negatively associated with both FMI and hyperphagia severity. There was a statistical interaction effect of SSES and OSES on hyperphagia severity-lower SSES was associated with greater hyperphagia severity only at lower levels of OSES. Conclusions: These findings demonstrate a relationship between low OSES and child adiposity and that the relationship between child SSES and hyperphagia severity may be most relevant for children from households with lower family OSES. Future research on socioeconomic disparities in children's body composition and eating behaviors should examine the interaction of SSES and OSES. Clinical Trial Registration: NCT02390765.

Subjective social status and nocturnal blood pressure dipping

OBJECTIVE

Low social status has been linked to cardiovascular disease. Subjective social status (SSS), which represents one's perceived position in a social hierarchy, has been suggested to predict health outcomes beyond objective measures of socioeconomic status. The present study examined if lower SSS is related to reduced nocturnal blood pressure (BP) dipping, a risk factor for cardiovascular disease.

METHODS

In this cross-sectional study, a community sample of 53 healthy adults underwent 24-h ambulatory BP monitoring. All participants provided information on SSS and objective measures of socioeconomic status (i.e., education, occupation, and income). SSS was measured in comparison to others in the country (national SSS) as well as in comparison to one's social environment (local SSS) using the German versions of the MacArthur Scales.

RESULTS

Analyses found that participants with low local SSS exhibited attenuated nocturnal diastolic blood pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .043) and mean arterial pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .041). These associations remained significant after adjusting for objective socioeconomic status. No significant associations between national SSS and cardiovascular measures were observed.

CONCLUSION

In conclusion, one's perceived social position in the social environment (i.e., local SSS) is associated with nocturnal BP dipping. Therefore, local SSS may be an important psychosocial factor linking social inequality and cardiovascular health.

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

BACKGROUND

Subjective social status (SSS, perception of social position relative to a frame of reference) has been associated with physical, mental and socio-emotional wellbeing. However, these associations may be susceptible to unmeasured confounding by life course objective socio-economic position (SEP; such as wealth, education and employment) and life satisfaction.

PURPOSE

To estimate the association of position on ladders of perceived community respect and perceived economic status with weight, distress and wellbeing, independent of objective SEP in cohorts from three low and middle-income countries.

METHODS

We used data from birth cohorts in Guatemala (n = 1258), Philippines (n = 1323) and South Africa (n = 1393). We estimated the association of perceived community respect and perceived economic status with body mass index (kg/m²), the World Health Organization's Self-Reported Questionnaire-20 (SRQ-20) for psychological distress, and Lyubomirsky's Subjective Happiness Scale. We estimated these associations using robust linear regression models adjusting for indicators of life course objective SEP, early life characteristics, adult covariates, and life satisfaction.

RESULTS

Participants in South Africa (age 27-28y) rated themselves higher on average for both the respect (7 vs 5 in Guatemala and 6 in Philippines) and economic (5 vs 3 in Guatemala and 4 in Philippines) ladder measures. Position on neither community respect nor economic ladders were associated with BMI or psychological distress. Higher position on community respect (Guatemala: 0.03, 95%CI: 0.01, 0.04; Philippines: 0.03, 95% CI: 0.02, 0.05; South Africa: 0.07, 95%CI: 0.04, 0.09) and economic (Guatemala: 0.02, 95%CI: 0, 0.04; Philippines: 0.04, 95%CI: 0.02, 0.07; South Africa: 0.07, 95%CI: 0.04, 0.10) ladders were associated with greater happiness.

CONCLUSIONS

Subjective social status showed small but consistent associations with happiness in birth cohorts independent of life-course SEP.

Genetic propensity for obesity, socioeconomic position, and trajectories of body mass index in older adults

Identifying how socioeconomic positioning and genetic factors interact in the development of obesity is imperative for population-level obesity prevention strategies. The current study investigated whether social positioning, either independently or through interaction with a polygenic score for Body Mass Index (BMI-PGS), influences BMI trajectories across older adulthood. Data were analysed from 7,183 individuals from the English Longitudinal Study of Aging (ELSA). Interactions between the BMI-PGS and; lower educational attainment, self-perceived social status (SSS), and income, on BMI trajectories over 12 years across older adulthood were investigated through linear mixed effects models. Lower educational attainment, SSS and income were each associated with a higher baseline BMI for women, but not for men. There were interaction effects between BMI-PGS and social positioning such that men aged > 65 with a lower educational attainment (β = 0.62; 95%CI 0.00 – 1.24, p < 0.05), men aged ≤ 65 of a lower income (β = − 0.72, 95%CI − 1.21 - − 0.23, p < 0.01) and women aged ≤ 65 of lower SSS (β = − 1.41; 95%CI − 2.46 – 0.36, p < 0.01) showed stronger associations between the BMI-PGS and baseline BMI. There were few associations between markers of socioeconomic position and rate of change in BMI over the follow-up period. In sum, lower socioeconomic positioning showed adverse associations with women’s BMI in older adulthood. Moreover, the expression of the BMI-PGS, or extent to which it translates to a higher BMI, was subtly influenced by socioeconomic standing in both women and in men.

Subjective Social Status and Cardiometabolic Risk Markers by Intersectionality of Race/Ethnicity and Sex Among U.S. Young Adults

BACKGROUND

Subjective social status (SSS) has shown inverse relationships with cardiometabolic risk, but intersectionalities of race/ethnicity and sex may indicate more nuanced relationships.

PURPOSE

To investigate associations of SSS with cardiometabolic risk markers by race/ethnicity and sex.

METHODS

Data were from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health (n = 4,847; 24-32 years), which collected biological cardiometabolic risk markers. A 10-step ladder captured SSS; respondents indicated on which step they perceived they stood in relation to other people in the U.S. higher values indicated higher SSS (range: 1-10). We tested the relationship between SSS and individual markers using generalized least square means linear regression models, testing three-way interactions between SSS, race/ethnicity, and sex (p < .10) before stratification.

RESULTS

SSS-race/ethnicity-sex interactions were significantly associated with waist circumference (p ≤ .0001), body mass index (BMI; p ≤ .0001), systolic blood pressure (SBP; p ≤ .0001), diastolic blood pressure (DBP; p = .0004), and high-density lipoprotein cholesterol (HDL-C; p = .07). SSS was associated with waist circumference (β [SE]: -1.2 (0.4), p < .05) and BMI (-0.6 [0.2], p < .01) for non-Hispanic White females, compared with males; with HDL-C among non-Hispanic White (0.2 [0.1]; p < .05) and Hispanic (0.3 (0.1); p < .05) females, compared with males; with SBP for non-Hispanic Asian (1.7 [0.8]; p < .05) and Multiracial (1.8 [0.8]; p < .05), versus White, females; and with DBP for non-Hispanic Black (0.8 [0.3]; p < .01), versus White, males.

CONCLUSIONS

SSS was differentially related to cardiometabolic risk markers by race/ethnicity and sex, suggesting intersectional aspects. Clinical and research applications of SSS should consider race/ethnicity- and sex-specific pathways influencing cardiometabolic risk.

Psychological mechanisms associated with food security status and BMI in adults: a mixed methods study

OBJECTIVE

This study examined psychological constructs (delay discounting, grit, future time perspective and subjective social status) in relation to food security status and body weight.

DESIGN

A simultaneous triangulation mixed methods design was used to collect quantitative and qualitative data. Quantitative data were collected in fifty-six adults. Independent variables included food security status (food secure or food insecure) and BMI category (normal weight or overweight/obese). Participants, matched on race (African American and White), were categorised into four food security status by BMI category groups. Psychological constructs were measured via validated questionnaires. Qualitative data were collected in a subsample of twelve participants via in-depth interviews.

SETTING

This study was conducted in Baton Rouge, Louisiana.

PARTICIPANTS

The sample was 66 % female and 48 % African American with a mean age of 32·3 (sd 9·2) years and BMI of 28·8 (sd 7·7) kg/m2.

RESULTS

Quantitative results showed that food-insecure participants with overweight/obesity had greater delay discounting (-3·78 v. -6·16, P = 0·01; -3·78 v. -5·75, P = 0·02) and poorer grit (3·37 v. 3·99, P = 0·02; 3·37 v. 4·02, P = 0·02 ) than their food-secure counterparts and food-insecure participants with normal weight. Food-insecure participants with overweight/obesity also had a shorter time period for financial planning (0·72 v. 4·14, P = 0·02) than food-secure participants with normal weight. Qualitative data largely supported quantitative findings with participants discussing varied perceptions of psychological constructs.

CONCLUSIONS

This study found differences in delaying gratification, grit and financial planning between food security status and body weight groups.

Subjective social status and health during high school and young adulthood

Although many facets of social status (i.e., socioeconomic status, gender, race) are fairly stable, limited work has assessed how youths' identification with their status changes over time. Subjective social status (SSS) refers to one's perception of standing or rank relative to others, and for youth status is generally in the context of society or school. The current study assessed how adolescents' SSS in American society and in their school changes and predicts health and well-being during and after high school. A total of 336 adolescents (M_age = 16.40 at Wave 1) reported their SSS at up to three time points, each 2 years apart, such that youth provided data between the 10th grade and 3 years following the transition from high school. Piecewise multilevel modeling was used, including discontinuities to assess the importance of the transition from high school. Society SSS decreased across the period, especially among youth with lower family income, youth whose parents reported lower SSS, and youth who did not attend college. School SSS was stable during high school, declined after 12th grade, and remained stable thereafter. Moderation analyses revealed that school SSS declines more consistently among female adolescents than male adolescents and Latinos relative to other ethnic groups. Lower society and school SSS were associated with more depressive symptoms and greater likelihood of obesity, highlighting the relevance of SSS for health during this important developmental transition. Results suggest declines in SSS are especially common among disadvantaged groups as they age, and that lower SSS may indicate risk for poorer health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Subjective social status is associated with compensation for large meals - A prospective pilot study

OBJECTIVES

Subjective social status (SSS) is known to be inversely associated with obesity. Our objective was to determine if SSS is associated with eating behaviors that would predispose to weight gain, specifically, with inadequate compensation for excess energy consumed during a single large meal. Therefore, we conducted a pilot study to determine the association of SSS with 24-h energy balance, 24-h and post-lunch energy intake, changes in body composition and changes in adjusted resting energy expenditure on days when a high-energy lunch was consumed in free-living human subjects.

METHOD

Female participants (7 normal weight and 10 overweight) consumed 60% of' estimated 24-h energy requirements as a lunchtime meal in the laboratory for 14 days. Subjective social status was measured at baseline using the MacArthur Scale. Remote Food Photography Method was used to record food intake outside of the lab on days 1-2, 7-8, and 12-13. Associations of 24-h energy balance, 24-h and post-lunch energy intake, changes in adjusted resting energy expenditure and changes in percent body fat (measured by dual x-ray absorptiometry) with SSS were studied.

RESULTS

Mean (standard deviation) age and BMI were 36.29 (8.25) years and 26.43 (2.32) kg/m², respectively. Lower SSS was significantly associated with positive energy balance (p for trend 0.002), and higher post-lunch energy intake (p = 0.02) when controlled for age and initial body mass index.

CONCLUSIONS

Our pilot data show that lower SSS is associated with higher post-lunch energy intake, which is indicative of poor energy compensation following a large meal. Over a longer time period, this could result in fat mass gain. Studies that are of longer duration and well-powered are warranted to confirm our findings.