1
|
Reuter M, Diehl K, Richter M, Sundmacher L, Hövener C, Spallek J, Dragano N. A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes. Adv Life Course Res 2024; 59:100593. [PMID: 38340523 DOI: 10.1016/j.alcr.2024.100593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants' age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children's educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.
Collapse
Affiliation(s)
- Marvin Reuter
- Junior Professorship for Sociology, esp. Work and Health, Department of Sociology, University of Bamberg, Bamberg, Germany.
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Richter
- Chair for Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Leonie Sundmacher
- Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| |
Collapse
|
2
|
Lowe SA, Hunter S, Patte KA, Leatherdale ST, Pabayo R. Exploring the longitudinal associations between census division income inequality and BMI trajectories among Canadian adolescent: Is gender an effect modifier? SSM Popul Health 2023; 24:101519. [PMID: 37808229 PMCID: PMC10550757 DOI: 10.1016/j.ssmph.2023.101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Background Income inequality is a structural determinant of health linked to increased risk of overweight and obesity, although its links to the health of adolescent populations are not well understood. This study investigated the longitudinal associations between census-division-level (CD) income inequality and BMI trajectories among Canadian adolescents, and determine if these associations vary by gender. Methods Study data are from the Cannabis use, Obesity, Mental health, Physical Activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) cohort of adolescents attending secondary schools in Canada. Our sample included 14,675 adolescents who were followed up across three waves of the COMPASS study (2016-2017, 2017-2018, and 2018-2019) and linked to 30 CDs. Measures of income inequality and other area-level covariates were derived and linked to COMPASS participants using data from the 2016 Canadian Census. We utilized multilevel mixed-effects linear regression modelling to quantify the associations between income inequality and BMI and test for effect modification by gender. Sensitivity analyses were run excluding those with BMI scores in the range considered overweight or obesity at baseline. Results Higher CD income inequality was significantly associated with higher z-transformed BMI scores (β = 0.11, 95% CI = 0.034 to 0.19). The interaction term between income inequality and time was not statistically significant, indicating that this association remained constant over time. Once stratified by gender, the association between inequality and BMI became stronger for males (β = 0.14, 95% CI = 0.060 to 0.022) and attenuated for females (β = 0.063, 95% CI = -0.047 to 0.17). Conclusion Attending schools in CDs with higher income inequality was associated with higher BMI scores among male but not female adolescents. Further work is needed to investigate this discrepancy and identify the structural mechanisms that mediate the relationship between inequality and adolescent health.
Collapse
Affiliation(s)
- Samuel A.J. Lowe
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Stephen Hunter
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Karen A. Patte
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | | | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
3
|
Sitaula D, Dhakal A, Lageju N, Silwal A, Basnet SK, Shrestha N, Anup Bikram BC, Phoju N. Prevalence and Associated Factors of Adolescent Obesity among Rural School Adolescents in Nepal: A Cross-Sectional Study. Glob Health Epidemiol Genom 2023; 2023:2957278. [PMID: 37808524 PMCID: PMC10558264 DOI: 10.1155/2023/2957278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Abstract
Background Overweight and obesity are major risk factors for chronic diseases and are the leading cause of mortality worldwide. Obesity during adolescence is strongly associated with adulthood obesity leading to increased morbidities and mortality. As a developing country undergoing rapid urbanization, Nepal is in a transitional phase where undernutrition coexists with obesity; however, there is a dearth of literature on the status of adolescent obesity in the rural section of Nepal. The aim of this study was to determine the prevalence of adolescent obesity in a rural district of Nepal and find out its associated factors. Methods An institution-based cross-sectional study was conducted among the adolescent students studying in classes 8, 9, and 10 in four secondary schools of Gosaikunda rural municipality of Rasuwa district, Nepal. Total enumerative sampling was used, and Global School-based Health Survey (GSHS) standard questionnaires were used in collecting the information. Height and weight measurements were taken, and the body mass index was classified according to Asia-Pacific criteria. The collected data were analyzed using "SPSS" version 22. Logistic regression analysis was used to evaluate the associated factors, and a p value of ≤0.05 was considered statistically significant. Results Out of 267 adolescents, 14.6% were obese and 14.6% were overweight. Of the female participants, 39.6% were either obese or overweight, while 12.6% of the male adolescents were overweight/obese. Among the total participants, 16.5% were underweight, including 14.0% females and 20.4% males. Female adolescents were about five times (AOR: 5.2, 95% CI (2.5-10.9), p < 0.01) more likely of being overweight/obese than male adolescents. Conclusions More than one-quarter of the adolescents were found to be obese/overweight, and the prevalence was significantly more among female adolescents. It emphasizes the necessity of school-based programs promoting a healthy lifestyle among students to maintain healthy weight status.
Collapse
Affiliation(s)
| | - Aarati Dhakal
- Department of Community Programs, Dhulikhel Hospital, Kathmandu University, Kavre, Nepal
| | - Nimesh Lageju
- Rasuwa Hospital, Dhunche, Rasuwa, Bagmati Province, Nepal
| | - Amisha Silwal
- Department of Medical Oncology, Nepal Cancer Hospital and Research Center, Lalitpur, Nepal
| | | | - Niki Shrestha
- Department of Community Medicine, Chitwan Medical College, Chitwan, Nepal
| | - B. C. Anup Bikram
- NCD and Mental Health Section, Epidemiology and Disease Control Division, Kathmandu, Nepal
| | - Niraj Phoju
- Rasuwa Hospital, Dhunche, Rasuwa, Bagmati Province, Nepal
| |
Collapse
|
4
|
de la Rie S, Washbrook E, Perinetti Casoni V, Waldfogel J, Kwon SJ, Dräger J, Schneider T, Olczyk M, Boinet C, Keizer R. The role of energy balance related behaviors in socioeconomic inequalities in childhood body mass index: A comparative analysis of Germany, the Netherlands, the United Kingdom, and the United States. Soc Sci Med 2023; 317:115575. [PMID: 36470056 DOI: 10.1016/j.socscimed.2022.115575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Socioeconomic inequalities in childhood Body Mass Index (BMI) are becoming increasingly more pronounced across the world. Although countries differ in the direction and strength of these inequalities, cross-national comparative research on this topic is rare. This paper draws on harmonized longitudinal cohort data from four wealthy countries-Germany, the Netherlands, the United Kingdom (UK), and the United States (US)-to 1) map cross-country differences in the magnitude of socioeconomic inequalities in childhood BMI, and 2) to examine cross-country differences in the role of three energy-balance-related behaviors-physical activity, screen time, and breakfast consumption-in explaining these inequalities. Children were aged 5-7 at our first timepoint and were followed up at age 8-11. We used data from the German National Educational Panel Study, the Dutch Generation R study, the UK Millennium Cohort Study and the US Early Childhood Longitudinal-Kindergarten Study. All countries revealed significant inequalities in childhood BMI. The US stood out in having the largest inequalities. Overall, inequalities between children with low versus medium educated parents were smaller than those between children with high versus medium educated parents. The role of energy-balance-related behaviors in explaining inequalities in BMI was surprisingly consistent. Across countries, physical activity did not, while screen time and breakfast consumption did play a role. The only exception was that breakfast consumption did not play a role in the US. Cross-country differences emerged in the relative contribution of each behavior in explaining inequalities in BMI: Breakfast consumption was most important in the UK, screen time explained most in Germany and the US, and breakfast consumption and screen time were equally important in the Netherlands. Our findings suggest that what constitutes the most effective policy intervention differs across countries and that these should target both children from medium as well as low educated families.
Collapse
Affiliation(s)
- Sanneke de la Rie
- Department of Public Administration & Sociology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Netherlands.
| | - Elizabeth Washbrook
- School of Education, University of Bristol, 35 Berkeley Square, Bristol, BS8 1JA, United Kingdom
| | | | - Jane Waldfogel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Sarah Jiyoon Kwon
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Jascha Dräger
- School of Education, University of Strathclyde, 141 St James Road, Glasgow, G4 0LT, United Kingdom
| | | | - Melanie Olczyk
- Martin-Luther-Universität Halle-Wittenberg, Paracelsusstr. 22, 06114, Halle (Saale), Germany
| | - Césarine Boinet
- Department of Economics, University of Strathclyde, 199 Cathedral Street, Glasgow, G4 0QU, United Kingdom; French Institute for Demographic Studies (INED), 9 Cours des Humanités CS 50004, 93322, Aubervilliers Cedex, Aubervilliers, France
| | - Renske Keizer
- Department of Public Administration & Sociology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Netherlands
| |
Collapse
|
5
|
Rahal D, Chiang JJ, Huynh VW, Bower JE, McCreath H, Fuligni AJ. Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods. Appetite 2023; 180:106338. [PMID: 36210016 PMCID: PMC10479967 DOI: 10.1016/j.appet.2022.106338] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)-the feeling of having relatively lower social status-in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults' daily food choices through processes beyond heightened stress.
Collapse
Affiliation(s)
- Danny Rahal
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, State College, PA, USA.
| | - Jessica J Chiang
- Department of Psychology, Georgetown University, Washington, DC, USA
| | - Virginia W Huynh
- Department of Child and Adolescent Development, California State University, Northridge, Northridge, CA, USA
| | - Julienne E Bower
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Heather McCreath
- Division of Geriatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Andrew J Fuligni
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
6
|
Holstein BE, Andersen A, Damsgaard MT, Madsen KR, Pedersen TP. Underweight among adolescents in Denmark: prevalence, trends (1998-2018), and association of underweight with socioeconomic status. Fam Pract 2022; 39:413-419. [PMID: 34718536 DOI: 10.1093/fampra/cmab134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Underweight among adolescents is an important clinical and public health issue. It is associated with adverse health outcomes throughout the life-span and may reflect food poverty, unhealthy eating habits, or some underlying health conditions. OBJECTIVE To study prevalence and trends in underweight among adolescents 1998-2018, to examine social inequality in underweight, and whether social inequality changed over time. METHODS Data were derived from 6 cross-sectional school surveys from The Health Behaviour in School-aged Children study in Denmark. The study included 11-, 13-, and 15-year-old schoolchildren in random samples of schools in 1998, 2002, 2006, 2010, 2014, and 2018 (n = 22,177). Underweight was determined by body mass index-for-age thinness grade 2-3 (the Cole and Lobstein method). Socioeconomic status was determined using occupational social class (the Danish OSC Measurement). RESULTS The overall prevalence of underweight was 3.1% among boys and 5.3% among girls (P < 0.0001) and decreased by age (P < 0.0001) among both boys and girls. The prevalence of underweight was almost stable from 1998 to 2018. There was no observed absolute or relative social inequality in the prevalence of underweight among boys or girls. CONCLUSION The prevalence of underweight in 11- to 15-year-olds was significantly higher among girls than boys. The prevalence remained stable from 1998 to 2018. There was no significant association between SES and prevalence of underweight. It is important to elucidate the underlying causes of underweight such as malnutrition, eating disorders, eating problems, loss of appetite, chronic diseases, insufficient knowledge of nutrients effects on bodily functions, and persistent pain.
Collapse
Affiliation(s)
- Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anette Andersen
- Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Katrine Rich Madsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| |
Collapse
|
7
|
Ren X, Jensen BW, Larsen SC, Rohde JF, Specht IO, Nielsen BM, Husby I, Bugge A, Andersen LB, Trolle E, Heitmann BL. Three-Year Intervention Effects on Food and Beverage Intake-Results from the Quasi-Experimental Copenhagen School Child Intervention Study (CoSCIS). Int J Environ Res Public Health 2021; 18:10543. [PMID: 34639843 DOI: 10.3390/ijerph181910543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 11/23/2022]
Abstract
The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status (SES). The study included 307 children (intervention group: 184; comparison group: 123) with information on dietary intake pre- and post-intervention as well as on SES. Linear regression models were conducted to assess the effect of the intervention on changes in dietary factors. Children from the intervention group increased their intake of whole-grain bread during the intervention (group means: 6.1 g/d (95% CI: 2.2 to 10.0) vs. 0.3 g/d (95% CI: −3.1 to 3.7) in the comparison group, p = 0.04). A significant interaction between SES and group allocation was observed to change in fruit intake (p = 0.01). Among children from low SES families, only those from the comparison group decreased their fruit intake (group means: −40.0 g/d (95% CI: −56.0 to −23.9) vs. 9.3 g/d (95% CI: −16.1 to 94) in the intervention group, p = 0.006). The present study found no convincing effect of introducing a multi-component intervention on dietary intake except a small beneficial effect on whole-grain bread consumption. However, beneficial intervention effects in fruit intake were found particularly among children from low SES families.
Collapse
|
8
|
Castellini G, D’anna G, Rossi E, Cassioli E, Voller F, Silvestri C, Lazzeretti M, Berti A, Innocenti F, Ricca V. Body weight trends in adolescents of Central Italy across 13 years: social, behavioural, and psychological correlates. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Aim
The study aimed to determine trends in the prevalence of underweight, overweight, obesity and their putative risk factors in different cohorts from a representative population of adolescents in Central Italy.
Subject and methods
After random sampling, five cohorts of adolescents attending public high schools – aged 14 to 18 years – were evaluated from 2005 to 2018 (n: 25,174). Collected information included self-reported body mass index (BMI), descriptors of family environment, eating behaviour, physical activity, screen use, bullying victimisation, sexual behaviour (age at first intercourse, number of partners) and perceived psychological distress. For these data, between-cohort prevalence differences were used to esteem prevalence variations across time. In the 2018 cohort, the association between these factors and body weight was evaluated through multinomial regressions with sex-specific crude relative risk ratios for different BMI categories.
Results
An increased prevalence of overweight was observed for both boys and girls. The study outlined a transition towards higher parental education and unemployment, reduced soft drinks consumption and higher psychological distress. Sex-specific changes were observed for physical and sexual activity, and a rising percentage of girls reported being bullied and distressing family relationships. Parental education and employment, together with physical activity, confirmed to be protective factors against pathological weight. The latter clustered with reduced soft drinks consumption, bullying victimisation, early sexual activity, worse family relationships and higher distress.
Conclusion
An increased prevalence of both overweight and underweight was observed across time. Economic factors associated with unemployment and changes in behavioural patterns may have contributed to this trend.
Collapse
|
9
|
Ferreira CS, Andrade FBD. [Socioeconomic inequalities in the prevalence of excess weight and sedentary behavior among Brazilian adolescents]. Cien Saude Colet 2021; 26:1095-1104. [PMID: 33729362 DOI: 10.1590/1413-81232021263.09022019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/03/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to estimate the prevalence of excess weight and a sedentary lifestyle among Brazilian students between 13 and 17 years of age and investigate the magnitude of the socioeconomic inequalities related to these outcomes. A cross-sectional study was carried out based on data from the National School Health Survey (PeNSE) conducted in 2015. Inequalities were evaluated using the Absolute and Relative Index of Inequality. The prevalence of excess weight in Brazil was 24.2%, ranging from 20.7% in the Northeast Region to 27.8% in the Southern Region. The prevalence of a sedentary lifestyle in Brazil was 67.8%, ranging from 61.8 % in the North Region to 70.3% in the Southeast Region. The direct and positive association between better socioeconomic conditions and the prevalence of excess weight and a sedentary lifestyle indicate health inequities in Brazil. The results of this study point to the need to restructure and reinforce public policies directed at adolescents, which should have as guidelines the promotion of a healthy lifestyle and the reduction of health inequities.
Collapse
Affiliation(s)
- Carolina Souza Ferreira
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz (Fiocruz). Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Fabíola Bof de Andrade
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz (Fiocruz). Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| |
Collapse
|
10
|
Kliś K, Wronka I. Reducing socioeconomic differences in anthropometric characteristics among young Polish women. J Biosoc Sci 2021;:1-7. [PMID: 33583446 DOI: 10.1017/S0021932021000067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this paper was to evaluate the socioeconomic differences in adult anthropometric parameters of young women in Poland. The study was cross-sectional and conducted in the years 2015 to 2018 among 1257 women aged 19-24 years. The heights, weights, wrist widths and waist, hip and chest circumferences of the subjects were measured. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-chest ratio (WCR) and chest-to-height ratio (CHtR) were calculated. A survey was conducted to collect data on the women's socioeconomic characteristics. The application of the Generalized Linear Model (GLM) including all socioeconomic indicators (urbanization level of place of residence in childhood, parental education, number of siblings, material conditions) revealed no significant association of these with any of the analysed anthropometric traits. The results of the logistic regression showed no significant differences in the risk of underweight, too low abdominal adiposity or too high abdominal adiposity. However, the risk of overweight and obesity was significantly affected by the degree of urbanization of the women's place of residence in childhood and by their number of siblings. The results show that the socioeconomic factors that once had a significant influence on anthropometric traits currently do not play such an important role. This change can be explained by the equalization of living conditions and lifestyles of individual social groups in Poland.
Collapse
|
11
|
Musić Milanović S, Lang Morović M, Križan H, Pezer M, Seferović J, Missoni S. Exploring the effect of socioeconomic development on child growth in posttransitional Croatia: a cross-sectional study. Int J Public Health 2020; 65:1299-1307. [DOI: 10.1007/s00038-020-01424-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/08/2020] [Accepted: 06/26/2020] [Indexed: 11/24/2022] Open
|
12
|
Mbogori T, Kimmel K, Zhang M, Kandiah J, Wang Y. Nutrition transition and double burden of malnutrition in Africa: A case study of four selected countries with different social economic development. AIMS Public Health 2020; 7:425-439. [PMID: 32968668 PMCID: PMC7505783 DOI: 10.3934/publichealth.2020035] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/22/2020] [Indexed: 01/12/2023] Open
Abstract
Background Disease and lifestyle patterns have been changing rapidly especially in Africa due to transformation in economic development and urbanization. Research on the magnitude and consequences of these transformations in Africa is limited. This study investigates the shifts in nutritional status in children and adults in four selected low-, middle- and high-income countries in Africa, identifies factors associated with the shifts, and provides recommendations for future studies. Methods Malawi, Kenya, Ghana, and South Africa were selected based on their Gross Domestic Product (GDP). Nationally representative data were obtained from the 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), and the World Health Organization (WHO) database. Prevalence of underweight, overweight, and obesity were assessed and compared across the countries, gender, residence, and over time. Results: South Africa had the highest GDP and largest prevalence of overweight and obesity rates in children < 5 years old and adults > 18 (13.3% and 51.9%, respectively). Malawi, with the lowest GDP, had the highest stunting rate (37.0%). In all 4 countries, but most notably in South Africa, trends indicated that the increasing prevalence of overweight and obesity was much greater than the declining rate of underweight. Malawi, Kenya, and Ghana had a slight decline in overweight prevalence in children under 5 years. Conclusions Nutritional shifts are occurring in Africa and seem to be heavily influenced by economic development. The double-burden of malnutrition presents prioritization challenges for policymakers. Attention needs to be shifted towards prevention of obesity, at least in the higher income countries in Africa.
Collapse
Affiliation(s)
- Teresia Mbogori
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Kilee Kimmel
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Mengxi Zhang
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Jay Kandiah
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Youfa Wang
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA.,Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, Ball State University, 2000 W University Avenue, Muncie Indiana 47306, USA
| |
Collapse
|
13
|
Gao L, Bhurtyal A, Wei J, Akhtar P, Wang L, Wang Y. Double Burden of Malnutrition and Nutrition Transition in Asia: A Case Study of 4 Selected Countries with Different Socioeconomic Development. Adv Nutr 2020; 11:1663-1670. [PMID: 32529215 PMCID: PMC7666889 DOI: 10.1093/advances/nmaa064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/29/2020] [Accepted: 05/13/2020] [Indexed: 12/24/2022] Open
Abstract
Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.
Collapse
Affiliation(s)
- Liwang Gao
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Ashok Bhurtyal
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China,Nepal Public Health Foundation, Kathmandu, Nepal,Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Junxiang Wei
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Parveen Akhtar
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | | |
Collapse
|
14
|
Barreira TV, Broyles ST, Tudor-Locke C, Chaput JP, Fogelholm M, Hu G, Kuriyan R, Lambert EV, Maher CA, Maia JA, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Katzmarzyk PT; ISCOLE Research Group. Epidemiological Transition in Physical Activity and Sedentary Time in Children. J Phys Act Health 2019; 16:518-24. [PMID: 31104544 DOI: 10.1123/jpah.2018-0546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/19/2019] [Accepted: 02/22/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND To determine if children's moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. METHODS Data from 6548 children (55% girls) aged 9-11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. RESULTS For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. CONCLUSIONS Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.
Collapse
|
15
|
Lutz A. Internalising dietary norms and transforming food practices: social inequalities in the management of childhood obesity. Health Sociol Rev 2020; 29:16-30. [PMID: 33411660 DOI: 10.1080/14461242.2019.1691933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 11/08/2019] [Indexed: 06/12/2023]
Abstract
Over the last two decades, childhood obesity has emerged as a major public health issue in Switzerland. Health professionals and public health organisations now frame this condition as a disease that requires medical intervention. In this article, I report the findings of an ethnographic study conducted in a Swiss hospital program for the management of childhood obesity. The study explored the impact of the medical treatment of childhood obesity on children's lives. Using a Bourdieusian approach to guide my analysis, I found that the experience of the therapy varies substantially according to children's socioeconomic position. Children with a high SES seem to encounter less difficulties in adapting their lifestyle to professionals' recommendations than low SES children, because their habitus facilitates the internalisation of health norms and they have greater access to economic, social and cultural capitals. Therefore, childhood obesity management tends to reproduce health inequalities between children.
Collapse
Affiliation(s)
- Andrea Lutz
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
16
|
Rasmussen M, Damsgaard MT, Morgen CS, Kierkegaard L, Toftager M, Rosenwein SV, Krølner RF, Due P, Holstein BE. Trends in social inequality in overweight and obesity among adolescents in Denmark 1998-2018. Int J Public Health 2020; 65:607-616. [PMID: 32076738 DOI: 10.1007/s00038-020-01342-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The aim was to analyze trends in overweight and obesity in relation to socioeconomic position among Danish adolescents in the 20-year period 1998-2018. METHODS The study used data on self-reported height and weight and parents' occupational social class (OSC) from 11-, 13- and 15-year-old schoolchildren in 1998, 2002, 2006, 2010, 2014 and 2018, n = 22,177. The analyses included absolute social inequality in overweight/obesity (prevalence difference between low and high OSC) and relative social inequality (OR for overweight/obesity). RESULTS In the total sample, the prevalence of overweight and obesity was 9.7% and 1.4%, respectively, with significantly higher prevalence in low than high OSC. There were significantly increasing trends in both overweight and obesity 1998-2018 in low OSC and no significant increase in high OSC. The OR for overweight was 1.59 (1.42-1.74) in middle and 2.16 (1.89-2.46) in low OSC, OR for obesity 1.74 (1.29-2.34) in middle and 2.97 (2.15-4.11) in low OSC. Associations were not modified by survey year. CONCLUSIONS There was a persistent absolute and relative social inequality in overweight and obesity 1998-2018 among Danish adolescents.
Collapse
Affiliation(s)
- Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Camilla Schmidt Morgen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Mette Toftager
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Stine Vork Rosenwein
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Rikke Fredenslund Krølner
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Bjørn Evald Holstein
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.
| |
Collapse
|
17
|
Affiliation(s)
- Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Korea.,Research Institute of Medical Nutrition, Kyung Hee University, Seoul, Korea
| | - Youfa Wang
- Fisher Institute of Health and Well-being, Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA.,Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an 710000, China
| |
Collapse
|
18
|
Weldearegay HG, Gebrehiwot TG, Abrha MW, Mulugeta A. Overweight and obesity among children under five in Ethiopia: further analysis of 2016 national demographic health survey: a case control study. BMC Res Notes 2019; 12:716. [PMID: 31672167 PMCID: PMC6822342 DOI: 10.1186/s13104-019-4752-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the determinants of overweight and obesity among children under 5 years in Ethiopia. RESULTS Data from a total of 672 (224 cases and 448 controls) under 5 years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI 1.29, 5.34), boys (AOR = 1.56, 95% CI 1.10, 2.22) and age of the child less than 6 months (AOR = 3.40, 95% CI 2.05, 5.64) were the determinants for being childhood overweight and obesity.
Collapse
Affiliation(s)
| | | | | | - Afework Mulugeta
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| |
Collapse
|
19
|
Pereira S, Katzmarzyk PT, Hedeker D, Maia J. Change and Stability in Sibling Resemblance in Obesity Markers: The Portuguese Sibling Study on Growth, Fitness, Lifestyle, and Health. J Obes 2019; 2019:2432131. [PMID: 31827922 PMCID: PMC6886354 DOI: 10.1155/2019/2432131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/19/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVES Obesity markers evolve over time and these changes are shared within the family orbit and governed by individual and environmental characteristics. Available reports often lack an integrated approach, in contrast to a multilevel framework that considers their concurrent influence. Hence, this study aims to (1) describe mean changes in obesity markers (body fat (%BF), body mass index (BMI), and waist circumference (WC)) across sib-ships; (2) analyze tracking of individuals within their sib-ship in these markers during 2 years of follow-up; (3) probe consistency in sibling resemblance in these markers; and (4) analyze the joint influence of individual and familial characteristics in these markers. SUBJECTS/METHODS The sample comprises 168 biological Portuguese siblings (brother-brother (BB), sister-sister (SS), and brother-sister (BS)) aged 9-17 years. %BF, BMI, and WC were measured using standardized protocols, and biological maturation was assessed. Physical activity, diet, screen time, and familial characteristics were obtained by questionnaires. Multilevel models were used to analyze the clustered longitudinal data. Sibling resemblance was estimated with the intraclass correlation. RESULTS On average, all sib types increased in BMI and WC over 2 years of follow-up, and SS pairs increased in %BF. Individuals within sib-ships track high in all obesity markers across time. Consistency in siblings' resemblance was also noted, except for BB pairs in %BF which decreased at follow-up. More maturing siblings tend to have higher values in all markers. Greater screen time was associated with higher %BF, whereas those consuming more sugary drinks had lower %BF and BMI values. Siblings whose mothers had less qualified occupations tended to have lower BMI values. CONCLUSIONS Longitudinal individual tracking and sibling resemblance for obesity markers were found. Yet, different trajectories were also identified depending on the marker and sib type. Individual and familial characteristics exert different influences on each obesity marker.
Collapse
Affiliation(s)
- Sara Pereira
- CIFI2D, Faculty of Sport, University of Porto, Porto 4200-450, Portugal
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL 60637, USA
| | - José Maia
- CIFI2D, Faculty of Sport, University of Porto, Porto 4200-450, Portugal
| |
Collapse
|
20
|
Kwok MK, Schooling CM, Subramanian SV, Leung GM, Kawachi I. Opposite associations of household income with adolescent body mass index according to migrant status: Hong Kong's "Children of 1997" birth cohort. Int J Obes (Lond) 2018; 42:1221-9. [PMID: 29899522 DOI: 10.1038/s41366-018-0118-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 01/24/2018] [Accepted: 02/25/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES In economically developed settings, household income is usually inversely associated with child and adolescent adiposity, but this association may not extend to migrants. Hong Kong is a unique developed setting to study how household income and adolescent adiposity vary by migrant status given many Hong Kong-born Chinese children were born to parents who migrated from neighboring provinces of Mainland China. SUBJECTS/METHODS We examined differences between the associations of absolute household income vs. relative household income on adolescent body mass index (BMI) z-score or overweight (including obesity) status using a linear or logistic model in a Chinese birth cohort (n = 5613, 68% follow-up). We focused on whether the associations differed by mother's or father's migrant status (birthplace). RESULTS No association was found between absolute household income and BMI z-score among adolescents with either native or migrant mothers. However, the association of relative household income with BMI z-score varied by mother's migrant status (P-values for interaction <0.0005). In adolescents of native born mothers, greater relative household income deprivation was associated with higher BMI z-score (0.03 z-score per USD 128 difference in Yitzhaki index, 95% confidence interval (CI) 0.01 to 0.05). However, in adolescents of migrant mothers, greater relative household income deprivation was associated with lower BMI z-score (-0.05, 95% CI -0.09 to -0.01). Similar association of relative household income with overweight (including obesity) status was found in adolescents of native born mothers but not in adolescents of migrant mothers. CONCLUSIONS Relative income (mediated by social comparisons with others in society) appears to be relevant to adolescent adiposity, but the association depends on the interplay between individual characteristics (migrant background) and societal context.
Collapse
|
21
|
Murphy R, Stewart AW, Hancox RJ, Wall CR, Braithwaite I, Beasley R, Mitchell EA. Obesity, underweight and BMI distribution characteristics of children by gross national income and income inequality: results from an international survey. Obes Sci Pract 2018; 4:216-228. [PMID: 29951212 PMCID: PMC6009988 DOI: 10.1002/osp4.169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Economic wealth and income inequality may impact on childhood BMI distribution by affecting overconsumption of food and sedentary forms of transportation and entertainment across the whole or some of the population. OBJECTIVES To determine whether BMI distribution of children differs by gross national income (GNI) per capita and Gini index derived from World Bank data. METHODS Secondary analysis of largely self-reported height and weight data from a multi-country, cross-sectional study (ISAAC), of 77,963 children aged 6-7 (from 19 countries) and 205,388 adolescents aged 13-14 (from 36 countries), were used to examine underweight vs obesity prevalence and BMI distribution skewness, median and dispersion. RESULTS Children and adolescents from 'lower' GNI countries had higher prevalence of underweight than those from 'higher' GNI countries (6% vs 3%, p = 0.03; 2% vs 1%, p = 0.05 respectively), but the prevalence of obesity was not different (2% vs 5%, p = 0.29; 2% vs 2%, p = 0.66). BMI distribution of participants from 'higher' GNI countries had higher median, without significant difference in skewness or dispersion compared to 'lower' GNI countries (higher medians +1.1 kg/m2 for 6-7 year olds, and + 0.7 kg/m2, +1.2 kg/m2 for 13-14 year old girls and boys respectively). Gini index was not associated with underweight or obesity prevalence in either children or adolescents, nor with any BMI distribution characteristics with one exception. Adolescent girls from higher income inequality countries had a greater median BMI (+0.7 kg/m2) and a less skewed BMI distribution. CONCLUSIONS It appears that the obesogenic impact of economic prosperity affects all children similarly. Income inequality may have a gender specific effect affecting BMI distribution in adolescent girls.
Collapse
Affiliation(s)
- R. Murphy
- Department of Medicine, Faculty of Medical and Health SciencesThe University of AucklandNew Zealand
| | - A. W. Stewart
- School of Population Health, Faculty of Medical and Health SciencesThe University of AucklandNew Zealand
| | - R. J. Hancox
- Department of Preventive & Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - C. R. Wall
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health SciencesThe University of AucklandNew Zealand
| | - I. Braithwaite
- Medical Research Institute of New ZealandWellingtonNew Zealand
| | - R. Beasley
- Medical Research Institute of New ZealandWellingtonNew Zealand
| | - E. A. Mitchell
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health SciencesThe University of AucklandNew Zealand
| | | |
Collapse
|
22
|
Erdogdu UE, Cayci HM, Demirci H. Laparoscopic Sleeve Gastrectomy Is More Effective in Patients with Puberty-Onset Obesity. Bariatr Surg Pract Patient Care 2018. [DOI: 10.1089/bari.2017.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Umut Eren Erdogdu
- Department of General Surgery, Bursa Yuksek Ihtisas Teaching and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Haci Murat Cayci
- Department of General Surgery, Bursa Yuksek Ihtisas Teaching and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Hakan Demirci
- Department of Family Medicine Section, Bursa Yuksek Ihtisas Teaching and Research Hospital, University of Health Sciences, Bursa, Turkey
| |
Collapse
|
23
|
Markowska M, Przychodni AM, Nowak-Starz G, Cieśla E. The frequency of overweight and obesity occurrence among Polish children (age 6–7 years) in relation to the place of residence, the education level of parents and the number children in the family. Anthropological Review 2017. [DOI: 10.1515/anre-2017-0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
This study sought to evaluate the number of those overweight and the rate of obesity among 6- and 7-year-olds living in Poland with regard to their place of residence, the parental level of education and the number of children in the family. The analysis was based on a survey of 64 544 children (33 051 boys and 31 493 girls) living in Poland. Overweight and obesity were defined based on body mass index (BMI) using the IOTF cut-off points. To evaluate the rates of overweight and obesity occurrence in children with regard to family socio-economic status, parental level of education, the number of children in the family, and the place of residence (divided into city and village) was used. ‘Only children’ were the most likely group to be overweight or obese. These children were twice as likely to be obese as their peers living in families with four or more children. Overweight and obesity occurred more often amongst children living in cities rather than those living in rural areas. Moreover, these conditions were more frequent among children whose parents had higher levels of education. The most significant predictors of childhood overweight and obesity were the number of children in the family and the educational level of the mother
Collapse
Affiliation(s)
| | | | | | - Elżbieta Cieśla
- Faculty of Health Sciences, Jan Kochanowski University in Kielce , Poland
| |
Collapse
|
24
|
Maras D, Obeid N, Flament M, Buchholz A, Henderson KA, Gick M, Goldfield GS. Attachment Style and Obesity: Disordered Eating Behaviors as a Mediator in a Community Sample of Canadian Youth. J Dev Behav Pediatr 2016; 37:762-70. [PMID: 27801724 DOI: 10.1097/DBP.0000000000000361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Obesity and overweight are associated with many negative health outcomes. Attachment style has been implicated in the development of obesity in youth. The present study examined if disordered eating behaviors mediate the relationship between attachment style and body mass index (BMI) in a large community sample of Canadian youth. METHOD A total of 3,043 participants (1,254 males and 1,789 females, Mage = 14.20 years) completed self-report questionnaires including the Relationship Questionnaire and the Dutch Eating Behavior Questionnaire, and BMI was objectively measured. Disordered eating behaviors (restrained, emotional, and external) were examined as possible mediating mechanisms in the relationship between attachment style and BMI z-score, using a multiple mediation model using bootstrapping while controlling for socio-demographic covariates. RESULTS Insecure attachment was significantly associated with higher BMI, and disordered eating mediated this relationship. Restrained eating was the strongest mediator of this pathway. CONCLUSION Results suggest that it may be important to take attachment history and restrained eating into account when designing treatment and prevention strategies for obesity in youth.
Collapse
|
25
|
Castro R, Fajnzylber E. Income inequality and adolescent fertility in low-income countries. CAD SAUDE PUBLICA 2017; 33:e00203615. [PMID: 28977284 DOI: 10.1590/0102-311x00203615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 11/28/2016] [Indexed: 11/22/2022] Open
Abstract
: The well-known socioeconomic gradient in health does not imply that income inequality by itself has any effect on well-being. However, there is evidence of a positive association between income inequality and adolescent fertility across countries. Nevertheless, this key finding is not focused on low-income countries. This study applies a multilevel logistic regression of country-level adolescent fertility on country-level income inequality plus individual-level income and controls to the Demographic and Health Surveys data. A negative association between income inequality and adolescent fertility was found among low-income countries, controlling for income (OR = 0.981; 95%CI: 0.963-0.999). Different measures and different subsamples of countries show the same results. Therefore, the international association between income inequality and adolescent fertility seems more complex than previously thought.
Collapse
Affiliation(s)
- Ruben Castro
- Instituto de Políticas Públicas, Universidad Diego Portales, Santiago, Chile
| | | |
Collapse
|
26
|
Ulijaszek SJ, Pentecost M, Marcus C, Karpe F, Frühbeck G, Nowicka P. Inequality and childhood overweight and obesity: a commentary. Pediatr Obes 2017; 12:195-202. [PMID: 26990034 DOI: 10.1111/ijpo.12128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/17/2016] [Indexed: 02/02/2023]
Abstract
Statements on childhood overweight and obesity (COO) have focused on different avenues for prevention and treatment, critical stages of the life cycle, including pregnancy and lactation, individual, family, school and community-based interventions, multidisciplinary family programmes and multicomponent interventions. This commentary is concerned with the less-addressed relationship between COO and inequality. It describes current global patterns of inequality and COO and the ways in which those inequalities are linked to COO at micro-level, meso-level and macro-level. It then describes current programmatic approaches for COO inequality, preventive and medical, and considers important pitfalls in the framing of the problem of COO and inequality. It ends with describing how childhood and adolescent overweight and obesity prevention and treatment programmes might be formulated within broader socio-political frameworks to influence outcomes.
Collapse
Affiliation(s)
- S J Ulijaszek
- School of Anthropology, University of Oxford, Oxford, UK
| | - M Pentecost
- School of Anthropology, University of Oxford, Oxford, UK
| | - C Marcus
- Karolinska Institutet, Stockholm, Sweden
| | - F Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - G Frühbeck
- Department of Endocrinology and Nutrition, Clinica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | - P Nowicka
- Karolinska Institutet, Stockholm, Sweden.,Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| |
Collapse
|
27
|
Kornet-van der Aa DA, Altenburg TM, van Randeraad-van der Zee CH, Chinapaw MJM. The effectiveness and promising strategies of obesity prevention and treatment programmes among adolescents from disadvantaged backgrounds: a systematic review. Obes Rev 2017; 18:581-593. [PMID: 28273680 DOI: 10.1111/obr.12519] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 02/06/2023]
Abstract
This review aimed to summarize the evidence on the effectiveness of obesity prevention and treatment programmes for adolescents from socioeconomically disadvantaged backgrounds. A secondary aim was to identify potential successful intervention strategies for this target group. PubMed, EMBASE, PsycINFO and Cochrane Library were searched from January 2000 up to February 2016. Intervention studies targeting adolescents from disadvantaged backgrounds were included, with body mass index as outcome. Secondary outcomes were other adiposity measures, physical activity, diet, sedentary behaviour and screen time. Two independent reviewers extracted data, coded intervention strategies and conducted quality assessments. Fourteen studies were included: nine obesity prevention and five obesity treatment studies. Two preventive and four treatment studies showed significant beneficial effects on body mass index. Five of six studies (four preventive, one treatment studies) measuring dietary behaviour reported significant intervention effects. Evidence on other secondary outcomes was inconclusive. We found no conclusive evidence for which specific intervention strategies were particularly successful in preventing or treating obesity among disadvantaged adolescents. However, the current evidence suggests that involving adolescents in the development and delivering of interventions, the use of experiential activities and involvement of parents seem to be promising strategies. More high quality studies are needed. PROSPERO registration number: CRD42016041612.
Collapse
Affiliation(s)
- D A Kornet-van der Aa
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - C H van Randeraad-van der Zee
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
28
|
Hernández-Cordero S, Cuevas-Nasu L, Morán-Ruán MC, Méndez-Gómez Humarán I, Ávila-Arcos MA, Rivera-Dommarco JA. Overweight and obesity in Mexican children and adolescents during the last 25 years. Nutr Diabetes 2017; 7:e247. [PMID: 28287630 PMCID: PMC5380891 DOI: 10.1038/nutd.2016.52] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/11/2016] [Accepted: 11/01/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/OBJECTIVE The objective of the study was to provide current estimates of the prevalence and trends of overweight and obesity (OW+OB) in Mexican children and adolescents. SUBJECTS/METHODS Body mass index objectively measured was analyzed for 37 147 children and adolescents aged 0-19 years obtained in 2012 as part of the National Health and Nutrition Survey (ENSANUT-2012), a nationally representative sample of the Mexican population. In addition, data from previous National Nutrition Surveys obtained in 1988, 1999 and 2006 were compared with analyze trends over a 24-year period (1988-2012) for children <5 years of age and adolescents and over a 13-year period (1999-2012) for school-age children. World Health Organization Child Growth Standard was used to define OW+OB. RESULTS In 2012, 33.5% of children <5 years of age (both sexes) were at risk of overweight or were overweight (OW); 32% and 36.9% of girls and boys 5-11 years of age were OW+OB, respectively, and 35.8% and 34.1% of female and male adolescents were OW+OB, respectively. Statistically significant trends were documented for all age groups during the study period. Overall change in the combined prevalence in preschool children was 6.3±1.0 percentage points (pp; P<0.001; 0.26 pp per year) in the last 24 years, showing the highest increase between 1988 and 1999, whereas for school-age girls (from 1999 to 2012) and adolescent females (from 1988 to 2012), OW+OB increased across all periods at a declining trend, with an overall change of 0.5 and 1.0 pp per year, respectively. Changes in the prevalence of OW+OB were highest among children and adolescents in the lowest quintile of the household living condition index. CONCLUSIONS Prevalence of OW+OB among children and adolescents increased significantly during the last 13-24 years. The rate of increase has declined in the last 6 years in all age groups. Changes in prevalence of OW+OB presented here suggest that, in Mexico, the burden of obesity is shifting toward the groups with lower socioeconomic level.
Collapse
Affiliation(s)
- S Hernández-Cordero
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - L Cuevas-Nasu
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - M C Morán-Ruán
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - I Méndez-Gómez Humarán
- Centro de Investigación en Matemáticas A.C., Unidad Aguascalientes, Aguascalientes, México
| | - M A Ávila-Arcos
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - J A Rivera-Dommarco
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| |
Collapse
|
29
|
Vitus K, Tørslev MK, Ditlevsen K, Nielsen AL. Body weight management and dilemmas of health responsibility for vulnerable groups in the changing Danish welfare state: a comparative case analysis. Critical Public Health 2017. [DOI: 10.1080/09581596.2017.1286294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Kathrine Vitus
- Department of Sociology and Social Work, Aalborg University, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Kia Ditlevsen
- Department of Food and Resource Economics, Section for Consumption, Bioethics and Governance, University of Copenhagen, Frederiksberg, Denmark
| | - Annemette Ljungdalh Nielsen
- Department of Food and Resource Economics, Section for Consumption, Bioethics and Governance, University of Copenhagen, Frederiksberg, Denmark
| |
Collapse
|
30
|
Morgen CS, Andersen PK, Mortensen LH, Howe LD, Rasmussen M, Due P, Sørensen TIA, Andersen AMN. Socioeconomic disparities in birth weight and body mass index during infancy through age 7 years: a study within the Danish National Birth Cohort. BMJ Open 2017; 7:e011781. [PMID: 28110282 PMCID: PMC5253532 DOI: 10.1136/bmjopen-2016-011781] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 11/07/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in birth weight and in body mass index (BMI) later in childhood are in opposite directions, which raises questions about when during childhood the change in direction happens. We examined how maternal and paternal education and household income were associated with birthweight z-scores and with BMI z-scores at age 5 and 12 months and 7 years, and we examined the socioeconomic differences in the tracking of these z-scores across infancy and childhood. METHODS The associations were studied in a cohort of children in the Danish National Birth Cohort, single born between 1997 and 2003, for whom information on body size from at least 1 of 4 time points (n=85 062) was recorded. We examined the associations using linear mixed-effects modelling. RESULTS Children from families with a low maternal and paternal educational level changed their body size z-scores upwards between birth and age 7 years. At age 5 and 12 months, there were no educational gradient. A low maternal educational level was associated with lower birth weight for gestational age z-scores at birth for boys (-0.199; 95% CI -0.230 to -0.169) and girls (-0.198; 95% CI -0.229 to -0.167) and higher BMI z-scores at age 7 for boys (0.198; 95% CI 0.154 to 0.242) and girls (0.218; 95% CI 0.173 to 0.264). There was not a similarly clear pattern in the tracking between different household income groups. However, a low household income level was associated with higher z-scores of both birth weight and BMI at age 7 years, but with a much weaker gradient at 5 and 12 months. CONCLUSIONS The educational gradient shifts from positive with birth weight, to none during infancy to inverse with BMI at age 7 years. In contrast, the income gradient was positive at birth and at 7 years and much weaker during infancy.
Collapse
Affiliation(s)
- Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust Hvas Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
31
|
Ip P, Ho FKW, So HK, Chan DFY, Ho M, Tso W, Nelson EAS. Socioeconomic Gradient in Childhood Obesity and Hypertension: A Multilevel Population-Based Study in a Chinese Community. PLoS One 2016; 11:e0156945. [PMID: 27258094 PMCID: PMC4892679 DOI: 10.1371/journal.pone.0156945] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/23/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aims to assess evidence for any socioeconomic gradients in childhood obesity and hypertension in a population-representative sample in Hong Kong, China. METHODS The data of a stratified random sampled growth survey collected in 2005-2006 was matched with a population by-census. Obesity was defined using the International Obesity Task Force standard and hypertension was defined using the Hong Kong norm table. Family socioeconomic status (SES) was measured by maternal education level. Neighbourhood SES was measured by median household income of the neighbourhood. Multilevel Poisson regression models with robust standard error were used to test the association. Body mass indices of children's parents were included as potential confounders. Intra-school/neighbourhood correlations were adjusted using random factors. RESULTS Totally 14842 children (age 6-19 years) included in the analysis, in which 16.6% of them were overweight or obese. Children whose mother only completed secondary school or below had higher risk of childhood obesity (RR 1.41, 95% CI 1.13-1.76, p = 0.003) and hypertension (RR 1.18, 95% CI 1.01-1.36, p = 0.03). Meanwhile, children in the lowest neighbourhood SES group had higher risk of childhood underweight (RR 1.61, 95% CI 1.04-2.49, p = 0.03), overweight (RR 1.35, 95% CI 1.05-1.72, p = 0.02), and obesity (RR 2.07, 95% CI 1.11-3.88, p = 0.02). CONCLUSIONS Socioeconomic gradient in childhood obesity and hypertension existed in Hong Kong, one of the most developed cities in China. These results have implications for policymakers and public health experts and highlight the need to monitor trends in other parts of China.
Collapse
Affiliation(s)
- Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Frederick Ka Wing Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Hung-Kwan So
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Matthew Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Winnie Tso
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - E. Anthony S. Nelson
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
32
|
Kim S, Macaskill P, Baur LA, Hodson EM, Daylight J, Williams R, Kearns R, Vukasin N, Lyle DM, Craig JC. The differential effect of socio-economic status, birth weight and gender on body mass index in Australian Aboriginal Children. Int J Obes (Lond) 2016; 40:1089-95. [PMID: 27121249 DOI: 10.1038/ijo.2016.71] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 04/04/2016] [Accepted: 04/18/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adult Aboriginal Australians have 1.5-fold higher risk of obesity, but the trajectory of body mass index (BMI) through childhood and adolescence and the contribution of socio-economic factors remain unclear. Our objective was to determine the changes in BMI in Australian Aboriginal children relative to non-Aboriginal children as they move through adolescence into young adulthood, and to identify risk factors for higher BMI. METHODS A prospective cohort study of Aboriginal and non-Aboriginal school children commenced in 2002 across 15 different screening areas across urban, regional and remote New South Wales, Australia. Socio-economic status was recorded at study enrolment and participants' BMI was measured every 2 years. We fitted a series of mixed linear regression models adjusting for age, birth weight and socio-economic status for boys and girls. RESULTS In all, 3418 (1949 Aboriginal) participants were screened over a total of 11 387 participant years of follow-up. The prevalence of obesity was higher among Aboriginal children from mean age 11 years at baseline (11.6 vs 7.6%) to 16 years at 8 years follow-up (18.6 vs 12.3%). The mean BMI increased with age and was significantly higher among Aboriginal girls compared with non-Aboriginal girls (P<0.01). Girls born of low birth weight had a lower BMI than girls born of normal birth weight (P<0.001). Socio-economic status and low birth weight had a differential effect on BMI for Aboriginal boys compared with non-Aboriginal boys (P for interaction=0.01). Aboriginal boys of highest socio-economic status, unlike those of lower socio-economic status, had a higher BMI compared with non-Aboriginal boys. Non-Aboriginal boys of low birth weight were heavier than Aboriginal boys. CONCLUSIONS Socio-economic status and birth weight have differential effects on BMI among Aboriginal boys, and Aboriginal girls had a higher mean BMI than non-Aboriginal girls through childhood and adolescence. Intervention programs need to recognise the differential risk for obesity for Aboriginal and non-Aboriginal boys and girls to maximise their impact.
Collapse
Affiliation(s)
- S Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - P Macaskill
- Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - L A Baur
- Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - E M Hodson
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - J Daylight
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - R Williams
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - R Kearns
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - N Vukasin
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - D M Lyle
- Department of Rural Health, University of Sydney, Camperdown, New South Wales, Australia
| | - J C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
33
|
Abstract
Food insecurity is paradoxically associated with obesity in the United States. Current hypotheses to explain this phenomenon are descriptive regarding the low food security population's dietary and physical activity habits, but are not mechanistic. Herein it is proposed that a resource scarcity hypothesis may explain this paradox, such that fattening is a physiologically regulated response to threatened food supply that occurs specifically in low social status individuals. Evidence that this may be occurring, the implications for addressing the food insecurity-obesity paradox, and future areas of research, are reviewed and discussed.
Collapse
Affiliation(s)
- Emily J Dhurandhar
- Department of Kinesiology and Sport Management, Texas Tech University, United States
| |
Collapse
|
34
|
Malczyk E. Nutritional status of children and youth in Poland on basis of literature from last ten years (2005–2015). ACTA ACUST UNITED AC 2016; 70:56-65. [DOI: 10.18794/aams/58971] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
W pracy dokonano przeglądu badań dotyczących stanu odżywienia dzieci i młodzieży w Polsce z uwzględnieniem podziału według płci, wieku oraz miejsca zamieszkania, a także zastosowanych metod, przyjętych kryteriów i punktów odcięcia. Analiza wyników badań wykazała znaczne nieprawidłowości w stanie odżywienia dzieci i młodzieży, a także brak systematyczności i spójności celującej w sposób, zakres i szczegółowość prowadzonych badań.
Collapse
|
35
|
Hui LL, Leung GM, Schooling CM. Social Patterning in Adiposity in Adolescence: Prospective Observations from the Chinese Birth Cohort ''Children of 1997''. PLoS One 2016; 11:e0146198. [PMID: 26735134 PMCID: PMC4703380 DOI: 10.1371/journal.pone.0146198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 12/13/2015] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Low early life socio-economic position is more strongly associated with adiposity among women than men. We examined whether the sex difference of social patterning in general and central adiposity exists before adulthood. METHODS In Hong Kong's "Children of 1997" birth cohort, we used multivariable regression to examine the association of parental education, a marker of early life socio-economic position, with body mass index (BMI) (n = 7252, 88% follow-up) and waist-height ratio (n = 5636, 68% follow-up), at 14 years. RESULTS Parental education of Grade 9 or below, compared to Grade 12 or above, was associated with higher waist-height ratio z-score particularly in girls (0.30, 95% confidence interval (CI) 0.19, 0.41) compared to boys (0.12, 95% CI 0.02, 0.22) (p for sex interaction = 0.02). Lower parental education was associated with greater BMI z-score in adolescents of locally born mothers, but not adolescents of migrant mothers, with no difference by sex. CONCLUSIONS Different social patterning in different markers of adiposity may imply different sociological and biological mediating pathways. A stronger association between low early life socio-economic position and waist-height ratio in adolescent girls may indicate sex-specific influences of SEP related early life exposures on central adiposity.
Collapse
Affiliation(s)
- L. L. Hui
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M. Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C. Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- CUNY School of Public Health and Hunter College, New York City, New York, United States of America
- * E-mail:
| |
Collapse
|
36
|
Broyles ST, Denstel KD, Church TS, Chaput JP, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Zhao P, Katzmarzyk PT; ISCOLE Research Group. The epidemiological transition and the global childhood obesity epidemic. Int J Obes Suppl 2015; 5:S3-8. [PMID: 27152182 DOI: 10.1038/ijosup.2015.12] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Childhood obesity is now recognized as a global public health issue. Social patterning of obesity, consistent with the theory of epidemiologic transition, has not been well described in children, and the limited research has focused on developed settings. The aim of this study was to describe the relationship between childhood obesity and household income using objective measures of adiposity and to explore how this relationship differs across levels of country human development. METHODS The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was a multi-national cross-sectional study conducted in 12 urban/suburban study sites that represented all inhabited continents and wide ranges of development. ISCOLE collected objectively measured height, body mass and percentage body fat in 7341 10-year-old children. Multi-level random-effects models were used to examine income gradients in several obesity measures. RESULTS The mean age of the children was 10.4 years, and 12.6% were obese, ranging from 5.4% (Finland) to 23.8% (China). For both boys and girls, obesity prevalence, body fat percentage and body mass index (BMI) z-score increased linearly with higher income at lower levels of development (all P for trend ⩽0.0012), but decreased linearly with higher income at higher levels of development (all P for trend ⩽0.0003). Country human development explained 75% of the variation in the country-specific income-obesity relationships (r=-0.87, P=0.0003). CONCLUSIONS Results are consistent with the theory of epidemiologic transition. Global efforts to control obesity must account for socioeconomic factors within a country's context. Future research should seek to understand global socioeconomic patterns in obesity-related lifestyle behaviors.
Collapse
|
37
|
Sudharsanan N, Ali MK, Mehta NK, Narayan KMV. Population aging, macroeconomic changes, and global diabetes prevalence, 1990-2008. Popul Health Metr 2015; 13:33. [PMID: 26640415 PMCID: PMC4670493 DOI: 10.1186/s12963-015-0065-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 11/24/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Diabetes is an important contributor to global morbidity and mortality. The contributions of population aging and macroeconomic changes to the growth in diabetes prevalence over the past 20 years are unclear. METHODS We used cross-sectional data on age- and sex-specific counts of people with diabetes by country, national population estimates, and country-specific macroeconomic variables for the years 1990, 2000, and 2008. Decomposition analysis was performed to quantify the contribution of population aging to the change in global diabetes prevalence between 1990 and 2008. Next, age-standardization was used to estimate the contribution of age composition to differences in diabetes prevalence between high-income (HIC) and low-to-middle-income countries (LMICs). Finally, we used non-parametric correlation and multivariate first-difference regression estimates to examine the relationship between macroeconomic changes and the change in diabetes prevalence between 1990 and 2008. RESULTS Globally, diabetes prevalence grew by two percentage points between 1990 (7.4 %) and 2008 (9.4 %). Population aging was responsible for 19 % of the growth, with 81 % attributable to increases in the age-specific prevalences. In both LMICs and HICs, about half the growth in age-specific prevalences was from increasing levels of diabetes between ages 45-65 (51 % in HICs and 46 % in LMICs). After age-standardization, the difference in the prevalence of diabetes between LMICs and HICs was larger (1.9 % point difference in 1990; 1.5 % point difference in 2008). We found no evidence that macroeconomic changes were associated with the growth in diabetes prevalence. CONCLUSIONS Population aging explains a minority of the recent growth in global diabetes prevalence. The increase in global diabetes between 1990 and 2008 was primarily due to an increase in the prevalence of diabetes at ages 45-65. We do not find evidence that basic indicators of economic growth, development, globalization, or urbanization were related to rising levels of diabetes between 1990 and 2008.
Collapse
Affiliation(s)
- Nikkil Sudharsanan
- />Population Studies Center, University of Pennsylvania, 239 McNeil Building, 3718 Locust Walk, Philadelphia, PA 19104 USA
| | - Mohammed K. Ali
- />Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322 USA
| | - Neil K. Mehta
- />Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322 USA
| | - K M Venkat Narayan
- />Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322 USA
| |
Collapse
|
38
|
San Sebastian M, Hammarström A, Gustafsson PE. Socioeconomic inequalities in functional somatic symptoms by social and material conditions at four life course periods in Sweden: a decomposition analysis. BMJ Open 2015; 5:e006581. [PMID: 26319773 PMCID: PMC4554899 DOI: 10.1136/bmjopen-2014-006581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Socioeconomic inequalities in health are deemed a worldwide public health problem, but current research is lacking on key points including determinants of socioeconomic differences in health, and not the least variations of these determinants over the life course. Using a 26-year prospective Swedish community-based cohort, we aim at decomposing socioeconomic inequalities in functional somatic symptoms by social and material life circumstances, at 4 periods of the life course. DESIGN Repeated cross-sectional study. SETTING Participants came from the Northern Swedish Cohort (n=1001), who completed questionnaires about occupational class, social and material living conditions, and symptoms at ages 16, 21, 30 and 42. Socioeconomic inequalities were estimated and decomposed using the Blinder-Oaxaca decomposition analysis. RESULTS Inequalities in symptoms between blue-collar and white-collar socioeconomic groups increased along the life course in the sample. In the decomposition analysis, a high proportion of the gap between socioeconomic groups could be explained by social and material living conditions at ages 16 (84% explained), 30 (45%) and 42 (68%), but not at age 21. Specific social (parental illness at age 16 and violence at ages 30 and 42) and material (parental unemployment at age 16, and own unemployment and financial strain at ages 30 and 42) factors contributed jointly to the health gaps. CONCLUSIONS Socioeconomic inequalities in functional somatic symptoms increased along the life course in this Swedish cohort. A considerable portion of the social gaps in health was explained by concurrent social and material conditions, and the importance of specific adversities was dependent on the life course stage. Our findings suggest that socioeconomic inequalities in functional somatic symptoms may be reduced by addressing both social and material living conditions of disadvantaged families, and also that the life course stage needs to be taken into consideration.
Collapse
Affiliation(s)
- Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Anne Hammarström
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Per E Gustafsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| |
Collapse
|
39
|
van Vliet JS, Gustafsson PA, Duchen K, Nelson N. Social inequality and age-specific gender differences in overweight and perception of overweight among Swedish children and adolescents: a cross-sectional study. BMC Public Health 2015; 15:628. [PMID: 26156095 PMCID: PMC4496810 DOI: 10.1186/s12889-015-1985-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 06/29/2015] [Indexed: 11/20/2022] Open
Abstract
Background Overweight among children and adolescents related to social inequality, as well as age and gender differences, may contribute to poor self-image, thereby raising important public health concerns. This study explores social inequality in relation to overweight and perception of overweight among 263 boys and girls, age 7 to 17, in Växjö, Sweden. Methods Data were obtained through a questionnaire and from physical measurements of height, weight and waist circumference [WC]. To assess social, age and gender differences in relation to overweight, the independent sample t- and chi-square tests were used, while logistic regression modeling was used to study determinants for perception of overweight. Results Social inequality and gender differences as they relate to high ISO-BMI [Body Mass Index for children] and WC were associated with low maternal socioeconomic status [SES] among boys < 13 years [mean age = 10.4; n = 65] and with low paternal education level among boys ≥ 13 years [mean age = 15.0; n = 39] [p < 0.05]. One suggested explanation for this finding is maternal impact on boys during childhood and the influence of the father as a role model for adolescent boys. The only association found among girls was between high ISO-BMI in girls ≥ 13 years [mean age = 15.0; n = 74] and low paternal occupational status. Concerning perception of overweight, age and gender differences were found, but social inequality was not the case. Among boys and girls < 13 years, perception of overweight increased only when overweight was actually present according to BMI or WC [p < 0.01]. Girls ≥ 13 years [mean age = 15.0] were more likely to unrealistically perceive themselves as overweight or “too fat,” despite factual measurements to the contrary, than boys [p < 0.05] and girls < 13 years [mean age = 10.4; n = 83] [p < 0.001]. Conclusions The association between social inequality and overweight in adolescence in this study is age- and gender-specific. Gender differences, especially in perception of overweight, tend to increase with age, indicating that adolescence is a crucial period. When planning interventions to prevent overweight and obesity among children and adolescents, parental SES as well as age and gender-specific differences in social norms and perception of body weight status should be taken into account.
Collapse
Affiliation(s)
- J S van Vliet
- Department of Clinical and Experimental Medicine, Division of Pediatrics, Faculty of Health Sciences, Linköping University, Linköping, SE-58185, Sweden.
| | - P A Gustafsson
- Department of Clinical and Experimental Medicine, Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, Linköping University, Sweden and County Council of Östergötland, Linköping, SE-58185, Sweden. .,Department of Pediatrics, University Hospital, County Council of Östergötland, Linköping, SE-58185, Sweden.
| | - K Duchen
- Department of Clinical and Experimental Medicine, Division of Pediatrics, Faculty of Health Sciences, Linköping University, Linköping, SE-58185, Sweden. .,Department of Pediatrics, University Hospital, County Council of Östergötland, Linköping, SE-58185, Sweden.
| | - N Nelson
- Department of Clinical and Experimental Medicine, Division of Pediatrics, Faculty of Health Sciences, Linköping University, Linköping, SE-58185, Sweden. .,Quality and Patient Safety, Karolinska University Hospital, Stockholm, SE-17176, Sweden.
| |
Collapse
|
40
|
Nielsen L, Koushede V, Vinther-Larsen M, Bendtsen P, Ersbøll AK, Due P, Holstein BE. Does school social capital modify socioeconomic inequality in mental health? A multi-level analysis in Danish schools. Soc Sci Med 2015; 140:35-43. [PMID: 26189012 DOI: 10.1016/j.socscimed.2015.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 06/18/2015] [Accepted: 07/02/2015] [Indexed: 10/23/2022]
Abstract
It seems that social capital in the neighbourhood has the potential to reduce socioeconomic differences in mental health among adolescents. Whether school social capital is a buffer in the association between socioeconomic position and mental health among adolescents remains uncertain. The aim of this study is therefore to examine if the association between socioeconomic position and emotional symptoms among adolescents is modified by school social capital. The Health Behaviour in School-aged Children Methodology Development Study 2012 provided data on 3549 adolescents aged 11-15 in two municipalities in Denmark. Trust in the school class was used as an indicator of school social capital. Prevalence of daily emotional symptoms in each socioeconomic group measured by parents' occupational class was calculated for each of the three categories of school classes: school classes with high trust, moderate trust and low trust. Multilevel logistic regression analyses with parents' occupational class as the independent variable and daily emotional symptoms as the dependent variable were conducted stratified by level of trust in the school class. The prevalence of emotional symptoms was higher among students in school classes with low trust (12.9%) compared to school classes with high trust (7.2%) (p < 0.01). In school classes with low level of trust, the odds ratio for daily emotional symptoms was 1.89 (95% CI 1.25-2.86) in the low socioeconomic group compared to the high socioeconomic group. In school classes characterised by high and moderate trust, there were no statistically significant differences in emotional symptoms between high and low socioeconomic groups. Although further studies are needed, this cross-sectional study suggests that school social capital may reduce mental health problems and diminish socioeconomic inequality in mental health among adolescents.
Collapse
Affiliation(s)
- Line Nielsen
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| | - Vibeke Koushede
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| | - Mathilde Vinther-Larsen
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| | - Pernille Bendtsen
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| | - Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1353 Copenhagen K, Denmark.
| |
Collapse
|
41
|
Pabayo R, Kawachi I, Gilman SE. US State-level income inequality and risks of heart attack and coronary risk behaviors: longitudinal findings. Int J Public Health 2015; 60:573-88. [PMID: 25981210 PMCID: PMC4517572 DOI: 10.1007/s00038-015-0678-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To examine prospectively the association between US state income inequality and incidence of heart attack. METHODS We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,445). Respondents completed interviews at baseline (2001-2002) and follow-up (2004-2005). Weighted multilevel modeling was used to determine if US state-level income inequality (measured by the Gini coefficient) at baseline was a predictor of heart attack during follow-up, controlling for individual-level and state-level covariates. RESULTS In comparison to residents of US states in the lowest quartile of income inequality, those living in the second [Adjusted Odds Ratio (AOR) = 1.71, 95 % CI 1.16-2.53)], third (AOR = 1.81, 95 % CI 1.28-2.57), and fourth (AOR = 2.04, 95 % CI 1.26-3.29) quartiles were more likely to have a heart attack. Similar findings were obtained when we excluded those who had a heart attack prior to baseline. CONCLUSIONS This study is one of the first to empirically show the longitudinal relationship between income inequality and coronary heart disease. Living in a state with higher income inequality increases the risk for heart attack among US adults.
Collapse
Affiliation(s)
- Roman Pabayo
- Department of Community Health Sciences, University of Nevada, Reno, Lombardi Building, 203, MS 0274, 1664 North Virginia Street, Reno, NV, 89557, USA,
| | | | | |
Collapse
|
42
|
Bodzsar EB, Zsakai A, Utczas K, Mascie-taylor CGN. THE BIOLOGICAL STATUS OF CHILDREN LIVING IN DISADVANTAGED REGIONS OF HUNGARY. J Biosoc Sci 2016; 48:306-21. [DOI: 10.1017/s0021932015000097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
SummaryThe aim of this study was to find out whether differences exist in the physical development, nutritional status and psychosomatic status of children living in deprived regions of Hungary compared with the Hungarian national reference values. The Hungarian government’s decree No. 24/2003 created a complex indicator of social and economic conditions by which the country’s regions were graded into deprived and non-deprived regions. This study examined 3128 children (aged 3–18 years) living in the deprived regions and their biological status was compared with the national reference values (2nd Hungarian National Growth Study). Children’s body development was assessed via some absolute body dimensions. Nutritional status was estimated by BMI with children being divided into ‘underweight’, ‘normal’, ‘overweight’ and ‘obese’ categories. For children aged 7–18 years a standard symptoms list was used to characterize psychosomatic status. The subjects were asked to rate their health status as excellent, good, fair or poor. The body development of children living in these deprived regions was significantly retarded compared with the national references in the age groups 7–9 years and 14–17 years for boys and in the age groups 4–6 and 14–17 for girls. The prevalence of underweight was significantly higher in children and adolescents living in deprived regions (boys: 4.8%; girls: 5.9%) than the national references (boys: 2.9%; girls: 4.0%), while the prevalence of overweight and obese children did not differ between deprived regions (boys: 20.2%; girls: 19.8%) and the national references (boys: 21.5%; girls: 19.1%). Children and adolescents living in the deprived regions rated their health status worse, and experienced more psychosomatic complaints (abdominal discomfort and fear), than the national references. Although the majority of body dimensions of children in deprived regions were close to the 50th centile of the Hungarian national references, a sizeable minority (31%) were 0.20SD or more away from the median value, which has implications as to how social, medical and public welfare policy can be shaped.
Collapse
|
43
|
Boylan SM, Gill TP, Hare-Bruun H, Andersen LB, Heitmann BL. Associations between adolescent and adult socioeconomic status and risk of obesity and overweight in Danish adults. Obes Res Clin Pract 2015; 8:e163-71. [PMID: 24743012 DOI: 10.1016/j.orcp.2013.03.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/21/2013] [Accepted: 03/24/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND It has been suggested that socioeconomic status (SES) may influence the risk of obesity; however it is important to consider individual changes in SES over the life-course in addition to SES at specific time-points to better understand the complex associations with obesity. We explored the relationship between lifetime-specific and life-course SES and risk of obesity and overweight in Danish adults. METHODS Data were used from the Danish Youth and Sports Study (DYSS) – a 20–22 year follow-up study of Danish teenagers born between 1964 and 1969. Baseline data gathered in 1983 and 1985 included self-reported BMI, SES and physical activity. The follow-up survey (2005) repeated these assessments in addition to an assessment of diet. Complete data on adolescent and adult SES and BMI were available for 623 participants. RESULTS Following adjustments, adolescent SES had no significant association with overweight/obesity in this sample, however females of low or medium adult SES were significantly more likely to be overweight/obese compared to those of high SES (low SES: OR: 2.7; 95% CI: (1.3–5.8); p = 0.008; medium SES: OR: 4.0, 95% CI (1.6–10.2); p = 0.003). Females who decreased in SES during adulthood were significantly more likely to be overweight/obese compared to those who remained of high SES (OR: 3.1; 95% CI (1.1–9.2); p = 0.04). CONCLUSION Effects of early life-factors may be conditional upon the environment in adulthood, particularly for the women. Further research should consider the timing of SES exposure and the mechanisms which may be responsible for the socioeconomic gradients in prevalence of obesity and overweight.
Collapse
Affiliation(s)
- Sinead M Boylan
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Timothy P Gill
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Helle Hare-Bruun
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Lars B Andersen
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Berit L Heitmann
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| |
Collapse
|
44
|
Ramcharitar-Bourne A, Nichols S, Badrie N. Correlates of adiposity in a Caribbean pre-school population. Public Health Nutr 2014; 17:1796-804. [PMID: 23866843 PMCID: PMC10282291 DOI: 10.1017/s1368980013001900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 05/01/2013] [Accepted: 06/13/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate ethnic and anthropometric correlates of adiposity among a nationally representative, multi-ethnic, Trinidadian pre-school population. DESIGN Cross-sectional study conducted between June 2008 and July 2009. SETTING Government and privately owned Early Childhood Care and Education Centres in Trinidad. SUBJECTS A total of 596 pre-school children (aged 31-73 months) from thirty-four schools had their weight, height, mid-upper arm circumference, waist circumference, biceps and triceps skinfold thicknesses measured by a registered dietitian using standard procedures. Percentage body fat was estimated using a foot-to-foot bioelectric impedance analyser (Tanita 531, Tokyo, Japan). Date of birth, religion and ethnicity were extracted from school records and pre-schoolers' ethnicity was categorized as East Indian, African, Mixed (a combination of two or more ethnicities), Chinese or Caucasian. RESULTS Anthropometric variables explained significantly more of the variance in adiposity among girls (67·4-88·1 %) than boys (24·4-39·2 %; P < 0·0 0 1). Pre-schoolers of African descent were significantly taller, heavier and had higher abdominal fat and mid-upper arm circumference than their East Indian and Mixed counterparts (all P < 0·001). The overall prevalence of excess adiposity (≥25 % body fat) as determined by bioelectrical impedance was 14·6 %, while 2·9 % of the children were undernourished according to WHO weight-for-age criteria. Differences in anthropometry were non-existent between children attending government and private pre-schools. CONCLUSIONS Gender, ethnicity and anthropometry all explained excess adiposity in these pre-schoolers. These findings highlight the need to elucidate the mechanisms that may be involved in explaining these differences, particularly those of ethnic origin.
Collapse
Affiliation(s)
- Anisa Ramcharitar-Bourne
- Department of Agricultural Economics and Extension, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Selby Nichols
- Department of Agricultural Economics and Extension, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Neela Badrie
- Department of Food Production, The University of the West Indies, St. Augustine, Trinidad and Tobago
| |
Collapse
|
45
|
KOWALKOWSKA J, WADOLOWSKA L, WERONIKA WUENSTEL J, SŁOWIŃSKA MA, NIEDŹWIEDZKA E. Socioeconomic status and overweight prevalence in polish adolescents: the impact of single factors and a complex index of socioeconomic status in respect to age and sex. Iran J Public Health 2014; 43:913-25. [PMID: 25909059 PMCID: PMC4401056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 04/11/2014] [Indexed: 12/03/2022]
Abstract
BACKGROUND The aim of this study was to analyze the association between overweight prevalence and socioeconomic status (SES) measured by complex SES index and single SES factors in Polish adolescents in respect to age and sex. METHODS This cross-sectional study was conducted in 2010-2011. A total of 1,176 adolescents aged 13.0-18.9 years were included. The respondents were students of junior-high and high schools from northern, eastern and central Poland. Quota sampling by sex and age was used. The SES was determined by: place of residence, self-declared economic situation, and parental education level. Respondents with low, average or high SES index (SESI) were identified. The level of overweight was assessed using Polish and international standards. RESULTS The odds ratio (OR) for overweight prevalence in the oldest girls (aged 17.0-18.9 years) with high SESI was 0.34 (95%CI:0.13-0.92; P < 0.05) by Polish standards and 0.22 (95%CI:0.05-0.95; P < 0.05) by international standards, in comparison to the reference group (low SESI). In total girls who had mothers with higher education level, the OR adjusted for age was 0.44 (95%CI:0.21-0.90; P <0.05) by Polish standards and 0.35 (95%CI:0.15-0.81; P < 0.05) by international standards, in comparison to the reference group (maternal elementary education). The other single SES factors were not significant for overweight prevalence. CONCLUSIONS The relationship between socioeconomic status and prevalence of overweight was related to sex and age. The high socioeconomic status strongly lowered the risk of overweight prevalence in the oldest girls, but not in boys, irrespective of age. Maternal education level lowered risk of overweight prevalence in girls.
Collapse
|
46
|
Elinder LS, Heinemans N, Zeebari Z, Patterson E. Longitudinal changes in health behaviours and body weight among Swedish school children--associations with age, gender and parental education--the SCIP school cohort. BMC Public Health 2014; 14:640. [PMID: 24958251 PMCID: PMC4079619 DOI: 10.1186/1471-2458-14-640] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 05/26/2014] [Indexed: 12/05/2022] Open
Abstract
Background In order to develop health promotion initiatives it is important to identify at what age gender and socioeconomic inequalities in health-related behaviours emerge. The aim of this longitudinal study was to analyse how health-related behaviours and weight status differed by age-group, gender, family socio-economic status and over time in three cohorts of school children. Methods All children in grades 2, 4 and 7 in a Swedish semi-urban municipality were invited to participate (n = 1,359) of which 813 (60%) consented. At baseline and after 2 years a health questionnaire was answered by all children. Height and weight was measured. Fourteen outcomes were analysed. The main and interaction effects of time, gender and parental educational level on the health-related behaviours, weight status and body mass index standard deviation score (BMIsds) were analysed by the Weighted Least Squares method for categorical repeated measures and Analysis of Variance. Results Nine of 12 health behaviours deteriorated over the two years: consumption of breakfast and lunch, vegetables and fruit, intake of sweetened drinks, TV viewing, club membership, being outdoors, and school recess activity; two behaviours were unchanged: intake of sweets, and active transport. Only sports participation increased with time. Girls consumed more vegetables, less sweetened drinks, performed less sports, were less physically active during recess, and had lower BMIsds, compared to boys. Those with more highly educated parents had more favourable or similar behaviours compared to those with less educated parents in 10 out of 12 health behaviours, the only exception being intake of sweets and being outdoors, and had lower BMIsds. Conclusions This study adds to our knowledge regarding the temporal development of health behaviours and weight status in school children. Differences with regard to gender and socioeconomic status were seen already at a young age. These results contribute to our understanding of several important determinants of obesity and chronic diseases and may inform future interventions regarding how to decrease gender and social inequalities in health.
Collapse
Affiliation(s)
- Liselotte Schäfer Elinder
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Stockholm 171 77, Sweden.
| | | | | | | |
Collapse
|
47
|
Miqueleiz E, Lostao L, Ortega P, Santos JM, Astasio P, Regidor E. [Socioeconomic pattern in unhealthy diet in children and adolescents in Spain]. Aten Primaria 2014; 46:433-9. [PMID: 24656757 DOI: 10.1016/j.aprim.2013.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 04/30/2013] [Accepted: 05/05/2013] [Indexed: 12/03/2022] Open
Abstract
Objetivo Investigar la posible asociación de patrones alimentarios relacionados con la obesidad y la posición socioeconómica en la población infantil y adolescente española. Diseño Estudio descriptivo transversal. Participantes Los datos proceden de la Encuesta Nacional de Salud de 2007, realizada a una muestra representativa española de 0 a 15 años. En este estudio se han analizado 6.143 sujetos de 5 a 15 años. Mediciones principales Se ha estimado la prevalencia de omisión de desayuno, la prevalencia de bajo consumo de fruta y verdura y la prevalencia de alto consumo de comida rápida, snacks y bebidas azucaradas. Los indicadores de posición socioeconómica han sido el nivel de estudios y la clase social de la persona que aportaba más ingresos económicos al hogar. En cada consumo de alimentos se han estimado las diferencias socioeconómicas mediante la razón de prevalencia, tomando como referencia la categoría socioeconómica más alta. Resultados Tanto en la infancia como en la adolescencia la magnitud de la razón de prevalencia muestra un gradiente socioeconómico inverso en todos los consumos de alimentos investigados: la menor y la mayor razón de prevalencia se observa en los sujetos de familias de posición socioeconómica más alta y más baja, respectivamente. Conclusión En la población infantil y adolescente española la alimentación no saludable relacionada con la obesidad muestra un patrón socioeconómico claro.
Collapse
|
48
|
Matthiessen J, Stockmarr A, Biltoft-Jensen A, Fagt S, Zhang H, Groth MV. Trends in overweight and obesity in Danish children and adolescents: 2000-2008--exploring changes according to parental education. Scand J Public Health 2014; 42:385-92. [PMID: 24516062 DOI: 10.1177/1403494813520356] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS To examine the hypotheses that an overall levelling off in the prevalence of overweight and obesity during the period 2000-2008 has occurred, and that increasing social inequality in overweight and obesity exists in a nationally representative sample of Danish children and adolescents. METHODS The population comprised a random sample of 1849 children aged 4-14 years who participated in the Danish National Survey of Diet and Physical Activity in 2000-2002, 2003-2004 and 2005-2008. Parental education was chosen as an indicator of children's socioeconomic status. Body mass index (BMI) was calculated from parent-reported weight and height. Subjects were classified as overweight and obese according to the International Obesity Task Force age- and gender-specific BMI cut-off values. Crude prevalence estimates and logistic regression models were used to analyse trends in overweight and obesity as the main outcome measures. RESULTS An increase was found in the crude prevalence of overweight (including obesity) in boys (12.8-21.7%, p = 0.0006), but not in girls (17.6-15.9%, p = 0.56), between 2000-2002 and 2005-2008. The prevalence of overweight increased significantly in boys of parents with low educational level only. A strong inverse social gradient in overweight and obesity was documented for boys and girls during the whole survey period. CONCLUSIONS The present study showed an increase in the prevalence of overweight in Danish boys, but not in girls. This increase was due to increasing social inequality in overweight among boys. Public health initiatives aimed at preventing and reducing overweight and obesity should consider gender difference and especially target boys with parents of low educational level.
Collapse
Affiliation(s)
- Jeppe Matthiessen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Anders Stockmarr
- Department of Applied Mathematics and Computer Science, Technical University of Denmark,. Lyngby, Denmark
| | - Anja Biltoft-Jensen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Sisse Fagt
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Hao Zhang
- Department of Applied Mathematics and Computer Science, Technical University of Denmark,. Lyngby, Denmark
| | - Margit Velsing Groth
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| |
Collapse
|
49
|
Wohlfahrt-Veje C, Tinggaard J, Winther K, Mouritsen A, Hagen CP, Mieritz MG, de Renzy-Martin KT, Boas M, Petersen JH, Main KM. Body fat throughout childhood in 2647 healthy Danish children: agreement of BMI, waist circumference, skinfolds with dual X-ray absorptiometry. Eur J Clin Nutr 2014; 68:664-70. [PMID: 24473457 DOI: 10.1038/ejcn.2013.282] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND/OBJECTIVES Total body fat percentage (%BF) evaluated by dual energy X-ray absorptiometry (DXA) scans (DXA %BF) is widely recognized as a precise measure of fatness. We aimed to establish national reference curves for DXA %BF, %BF calculated from skinfolds (SF %BF) and waist circumference (WC) in healthy children, and to compare agreement between the different methods. SUBJECTS/METHODS Based on 11 481 physical examinations (anthropometry) and 1200 DXA scans from a longitudinal cohort of Danish children (n=2647), we established reference curves (LMS-method) for SF %BF, WC (birth to 14 years) and DXA %BF (8-14 years). Age- and sex-specific Z-scores for body mass index (BMI), WC and SF %BF were compared. Sensitivity and specificity were calculated for agreement of WC, SF %BF and BMI with DXA %BF to identify obese children (>+1 s.d.). RESULTS %BF differed with age, sex, pubertal stage and social class. SF %BF correlated strongly with DXA %BF (r=0.86). BMI and WC also correlated positively with DXA %BF (Z-scores; r= 0.78 and 0.69). Sensitivity and specificity were 79.5 and 93.8 for SF %BF, 75.9 and 90.3 for BMI and 59.2 and 95.4 for WC. CONCLUSIONS SF %BF showed the highest correlation and best agreement with DXA %BF in identifying children with excess fat (+1 s.d.).
Collapse
|
50
|
Frederiksen P, Jensen KE, Kjaer SK. Sociodemographic factors and risk-taking behaviour during adolescence and obesity among more than 40 000 Danes. Public Health Nutr 2014; 17:162-9. [PMID: 23072877 PMCID: PMC10282392 DOI: 10.1017/s1368980012004545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 07/20/2012] [Accepted: 08/24/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The prevalence of obesity has increased in the last decades in the Western world. The aim of the present study was to examine the association between risk-taking behaviour in adolescence and adult obesity in men and women. Furthermore, we wished to describe social differences in obesity in Denmark. DESIGN Two population-based questionnaire studies (2004-2005 and 2006-2007) were used to collect information on weight and height, sociodemographic factors and factors regarding risk-taking behaviour during adolescence. Data were analysed using multivariate logistic regression. SETTING Denmark. SUBJECTS Individuals aged 18-45 years (men: n 22 827, participation rate 71·0%; women: n 20 870, participation rate 81·4%). RESULTS The prevalence of overweight and obesity was respectively 37·8% and 10·6% in men and 20·1% and 9·7% in women. In both sexes, obesity was found to be associated with older age, low level of schooling and living outside the capital centre. In relation to risk-taking behaviour, young age (≤13 years) at first intercourse significantly increased the odds of being obese in adulthood (men: OR = 1·34, 95% CI 1·04, 1·71; women: OR = 1·66, 95% CI 1·27, 1·99). In women specifically, young age at start drinking alcohol (≤12 years) was associated with obesity. CONCLUSIONS Sociodemographic factors, in particular age, level of schooling and area of residence, are associated with obesity in both men and women. Risk-taking behaviour during adolescence seems to cluster in both obese men and obese women, however most convincingly in women.
Collapse
Affiliation(s)
- Pernille Frederiksen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Kirsten E Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|