Abstract
BackgroundAn emerging body of research suggests the trajectory of a family’s income affects children’s health and development more profoundly than the often-measured income at a single time point. The purpose of this study was to examine the associations between changes in family income status, early-life risk factors, and body mass index (BMI) z-score trajectory from age 2 to 15 years.MethodsThis longitudinal study employed a birth cohort (n = 595) located in a rural region of New York State. Data were collected through an audit of medical records and mailed questionnaires. Family low-income and BMI z-score trajectories were identified using latent-class modeling techniques that group children based on similar trends across time. We examined five early-life risk factors in relation to income and BMI z-score trajectories: maternal overweight/obesity, maternal gestational weight gain, maternal smoking during pregnancy, breastfeeding duration, and early-life weight gain trajectory. We used multinomial logistic regression models to estimate the odds of being in a BMI z-score trajectory group based on income trajectory and early-life risk factors.ResultsChildren who remain low-income throughout childhood were more likely to maintain overweight (AOR = 2.55, 95% CI = 1.03, 5.42) and children who moved into low-income during childhood were more likely to be obese (AOR = 2.36, 95% CI = 1.12, 5.93) compared to children who were never low-income. Maternal overweight/obesity was significantly associated with a child become obese (AOR = 8.31, 95% CI = 3.80, 18.20), become overweight (AOR = 2.37, 95% CI = 1.34, 4.22), and stay overweight (AOR = 1.79, 95% CI = 1.02, 3.14). Excessive gestational weight gain was associated with increased likelihood of a child becoming overweight trajectory (AOR = 2.01, 95% CI = 1.01, 4.00).ConclusionsOur findings further supports the growing evidence that there are several preventable early-life risk factors that could be targeted for intervention. This study provides new evidence that remaining in low-income and moving into low-income increases risk for adolescent overweight and obesity.
Highlights
An emerging body of research suggests the trajectory of a family’s income affects children’s health and development more profoundly than the often-measured income at a single time point
body mass index (BMI) z-score trajectory classification based on family income trajectory and early-life risk factors We examined all bivariate relationships between BMI zscore trajectory, family income trajectory, and potential early-life risk factors using Chi-squared analysis (Additional file 4: Table S3)
We developed multivariate multinomial logistic regression models to estimate the odds of being in a certain BMI z-score trajectory based on family income trajectory and early-life risk factors
Summary
An emerging body of research suggests the trajectory of a family’s income affects children’s health and development more profoundly than the often-measured income at a single time point. The purpose of this study was to examine the associations between changes in family income status, early-life risk factors, and body mass index (BMI) z-score trajectory from age 2 to 15 years. While ample evidence suggests that poorer children do not perform as well as higher income children on a wide variety of health, occupational, and educational measures, the evidence is inconclusive on the association between family income and childhood body mass index (BMI). An emerging body of research suggests that it is the persistence and trajectory of the family’s low-income, rather than the often-measured overall level of deprivation at a single point in time, that affects children’s health and development [4,5,6]. A change in one trajectory, such as family low-income, may lead to changes in other trajectories, such as body weight
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