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      Socioeconomic Patterning of Childhood Overweight Status in Europe

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          Abstract

          There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country comparisons of household inequality and child overweight prevalence in Europe and review within-country variations over time of childhood overweight by social grouping, drawn from a review of the literature. Data from 22 European countries suggest that greater inequality in household income is positively associated with both self-reported and measured child overweight prevalence. Moreover, seven studies from four countries reported on the influence of socioeconomic factors on the distribution of child overweight over time. Four out of seven reported widening social disparities in childhood overweight, a fifth found statistically significant disparities only in a small sub-group, one found non-statistically significant disparities, and a lack of social gradient was reported in the last study. Where there is evidence of a widening social gradient in child overweight, it is likely that the changes in lifestyles and dietary habits involved in the increase in the prevalence of overweight have had a less favourable impact in low socio-economic status groups than in the rest of the population. More profound structural changes, based on population-wide social and environmental interventions are needed to halt the increasing social gradient in child overweight in current and future generations.

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          Socioeconomic status and obesity: a review of the literature.

          A review of 144 published studies of the relationship between socioeconomic status (SES) and obesity reveals a strong inverse relationship among women in developed societies. The relationship is inconsistent for men and children in developed societies. In developing societies, however, a strong direct relationship exists between SES and obesity among men, women, and children. A review of social attitudes toward obesity and thinness reveals values congruent with the distribution of obesity by SES in different societies. Several variables may mediate the influence of attitudes toward obesity and thinness among women in developed societies that result in the inverse relationship between SES and obesity. They include dietary restraint, physical activity, social mobility, and inheritance.
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            Early-life determinants of overweight and obesity: a review of systematic reviews.

            The aim of this paper was to review the evidence for early-life (from conception to 5 years of age) determinants of obesity. The design is review of published systematic reviews. Data sources included Medline, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO. Identification of 22 eligible reviews from a database of 12,021 independent publications. Quality of selected reviews assessed using the Assessment of Multiple Systematic Reviews score. Articles published after the reviews were used to confirm results. No review was classified as high quality, 11 as moderate and 11 as low. Factors associated with later overweight and obesity: maternal diabetes, maternal smoking, rapid infant growth, no or short breastfeeding, obesity in infancy, short sleep duration, <30 min of daily physical activity, consumption of sugar-sweetened beverages. Other factors were identified as potentially relevant, although the size of their effect is difficult to estimate. Maternal smoking, breastfeeding, infant size and growth, short sleep duration and television viewing are supported by better-quality reviews. It is difficult to establish a causal association between possible determinants and obesity, and the relative importance of each determinant. Future research should focus on early-life interventions to confirm the role of protective and risk factors and to tackle the high burden obesity represents for present and future generations. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.
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              Socioeconomic status and health. The challenge of the gradient.

              Socioeconomic status (SES) is consistently associated with health outcomes, yet little is known about the psychosocial and behavioral mechanisms that might explain this association. Researchers usually control for SES rather than examine it. When it is studied, only effects of lower, poverty-level SES are generally examined. However, there is evidence of a graded association with health at all levels of SES, an observation that requires new thought about domains through which SES may exert its health effects. Variables are highlighted that show a graded relationship with both SES and health to provide examples of possible pathways between SES and health end points. Examples are also given of new analytic approaches that can better illuminate the complexities of the SES-health gradient.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                16 April 2012
                April 2012
                : 9
                : 4
                : 1472-1489
                Affiliations
                [1 ]London School of Hygiene & Tropical Medicine, 15–17 Tavistock Place, London WC1H 9SH, UK; Email: harry.rutter@ 123456lshtm.ac.uk (H.R.); martin.mckee@ 123456lshtm.ac.uk (M.M.)
                [2 ]International Association for the Study of Obesity, Charles Darwin House, 12 Roger Street, London WCIN 2JU, UK; Email: tlobstein@ 123456iaso.org
                [3 ]INRA, UMR1260, INSERM, UMR1062, Nutrition, Obesity and Risk of Thrombosis, Faculté de Médecine, Aix-Marseille University, F-13385, Marseille, France; Email: nicole.darmon@ 123456univ-amu.fr
                Author notes
                [* ] Author to whom correspondence should be addressed; Email: cecile.knai@ 123456lshtm.ac.uk ; Tel.: +44-207-958-8155; Fax: +44-207-927-2701.
                Article
                ijerph-09-01472
                10.3390/ijerph9041472
                3366624
                22690206
                7a51937c-ec22-428a-a2c9-651815641176
                © 2012 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 17 February 2012
                : 08 March 2012
                : 16 March 2012
                Categories
                Article

                Public health
                social gradient,overweight,child,europe
                Public health
                social gradient, overweight, child, europe

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