A Review of the Relationship Between Socioeconomic Position and the Early-Life Predictors of Obesity

Abstract

A range of important early-life predictors of later obesity have been identified. Children of lower socioeconomic position (SEP) have a steeper weight gain trajectory from birth with a strong socioeconomic gradient in child and adult obesity prevalence. An assessment of the association between SEP and the early-life predictors of obesity has been lacking. The review involved a two-stage process: Part 1, using previously published systematic reviews, we developed a list of the potentially modifiable determinants of obesity observable in the pre-natal, peri-natal or post-natal (pre-school) periods; and part 2, conducting a literature review of evidence for socioeconomic patterning in the determinants identified in part 1. Strong evidence was found for an inverse relationship between SEP and (1) pre-natal risk factors (pre-pregnancy maternal body mass index (BMI), diabetes and pre-pregnancy diet), (2) antenatal/peri natal risk factors (smoking during pregnancy and low birth weight) and (3) early-life nutrition (including breastfeeding initiation and duration, early introduction of solids, maternal and infant diet quality, and some aspects of the home food environment), and television viewing in young children. Less strong evidence (because of a lack of studies for some factors) was found for paternal BMI, maternal weight gain during pregnancy, child sleep duration, high birth weight and lack of physical activity in young children. A strong socioeconomic gradient exists for the majority of the early-life predictors of obesity suggesting that the die is cast very early in life (even pre-conception). Lifestyle interventions targeting disadvantaged women at or before child-bearing age may therefore be particularly important in reducing inequality. Given the likely challenges of reaching this target population, it may be that during pregnancy and their child's early years are more feasible windows for engagement.

Parental socioeconomic status and risk of cerebral palsy in the child: evidence from two Nordic population-based cohorts

“…The association between parental SES and CP may operate through mediating lifestyle factors, such as poor diet, obesity, type 2 diabetes, cigarette smoking and psychosocial factors. All of these have been associated with SES, 19 , 27 and obesity and smoking increased the risk of CP in large prospective studies conducted in Denmark, Norway and Sweden, 28–31 whereas the role of dietary factors, type-2 diabetes and psychosocial factors in CP have been less explored. Other potential mediating factors include genitourinary infections and use of paracetamol during pregnancy; both differed by socioeconomic status and were associated with risk of CP in three large prospective Danish studies 28 , 32 , 33 .…”

Socioeconomic inequality of overweight and obesity of the elderly in Iran: Bushehr Elderly Health (BEH) Program

“…Previous studies in children also showed that, in developed countries, obesity was more prevalent in lower-income people, but in developing countries it was more common in higher-income people [22]. On the other hand, as SES changes during life, risk of obesity changes accordingly [23].…”

Gender and social mobility modify the effect of birth weight on total and central obesity

“…Unfortunately, we do not have information about maternal BMI in order to explore its impact on offspring BMI and WC. Moreover, there are many environmental determinants and psychological factors involved to the predictors of obesity which mediate the association with LBW, such as maternal cigarette smoking, maternal education and inadequate maternal nutrition [46]. Regarding gender differences in social patterning, social childhood exposure seems to influence later life outcomes, including biological programming during critical periods of growth and the early acquisition an unhealthy lifestyle [47].…”