Socioeconomic differences in overweight and weight-related behaviors across adolescence and young adulthood: 10-year longitudinal findings from Project EAT

Abstract

Reducing socioeconomic disparities in weight-related health is a public health priority. The purpose of this paper was to examine 10-year longitudinal patterns in overweight and weight-related behaviors from adolescence to young adulthood as a function of family-level socioeconomic status (SES) and educational attainment. Project EAT (Eating and Activity in Teens and Young Adults) followed a diverse sample of 2,287 adolescents from 1999 to 2009. Mixed-effects regression tested longitudinal trends in overweight, fast food, breakfast skipping, physical inactivity, and screen use by family-level SES. The influence of subsequent educational attainment in young adulthood was examined. Results revealed that the prevalence of overweight increased significantly from adolescence to young adulthood with the greatest change seen in those from low SES (mean change = 30.7%, 95% CI = 25.6%-35.9%) as compared to high SES families (mean change = 21.7%, 95% CI = 18.2% to 25.1%). Behavioral changes from adolescence to young adulthood also differed by SES background; the prevalence of frequent fast food intake (≥ 3 times/wk) increased most dramatically in those from low SES (mean change = 6%, 95% CI = 0.5%-11%) as compared to high SES families (mean change = -1.2%, 95% CI = -5.2%-2.9%). Overall trends suggest that a higher educational attainment mitigates the negative impacts of a low SES background. These findings suggest that continued effort is needed to ensure that public health strategies addressing obesity and related behaviors reach adolescents and young adults from low SES backgrounds and do not contribute to widening socioeconomic gaps in weight-related health.

30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015

“…The increasing SES disparities in obesity and abdominal obesity are especially concerning and suggest that urgent intervention is needed in low SES populations. Australia is not alone in identifying SES disparities in children and adolescents with studies in the US 35 and Europe 36 recently reporting similar findings of social inequality in child overweight and obesity.…”

Multicontextual correlates of adolescent sugar-sweetened beverage intake

“…Adolescents reported their age, gender and race/ethnicity; Socioeconomic status was determined primarily using the higher education level of either parent. [26]…”

Diet quality in Canada: policy solutions for equity

“…9,10 Rather, it is factors such as their childhood environments, gender, Indigenous status, income, education and occupation that shape their opportunities to do so. 1,2,[11][12][13][14] Collectively referred to as the social determinants of health, these factors largely explain why the diets of Canadians with a higher social position are healthier than the diets of those with a lower social position, and are ultimately responsible for much of the diet-related disability and death in Canada.…”