Abstract
SummaryBackgroundIn many high‐income countries, body mass index (BMI)/obesity levels are inversely associated with socio‐economic position (SEP). Little is known whether socio‐economic patterns in BMI trajectories throughout childhood differ by ethnicity, especially in the United Kingdom.ObjectivesTo investigate socio‐economic disparities in child‐to‐adolescent BMI trajectories and risks of overweight and obesity during adolescence across ethnic groups.MethodsMixed‐effects fractional polynomial and multinomial regression models were applied to estimate socio‐economic differences in BMI trajectories (3‐14 years) and risk of overweight/obesity at 14 years, respectively, in the UK Millennium Cohort Study (n = 15 996). Analysis was stratified by ethnicity.ResultPoverty was associated with higher BMI in children of White and South Asian origins, with a small difference at 3 years, which widened with age to 0.75 kg/m2 (95% CI, 0.59‐0.91) and 0.77 kg/m2 (0.26‐1.27) at 14 years for the White and South Asian groups, respectively. There was a reverse income‐BMI association in children of Black (African‐Caribbean) origin with the poverty group having a lower BMI (−0.37 kg/m2 [−0.71 to ‐0.04] at 5 years; −0.95 kg/m2 [−1.79 to −0.11] at 14 years). These patterns also presented with maternal education as a SEP indicator and for obesity at 14 years.ConclusionsSocio‐economic advantage may not be universally associated with lower BMI, which should be considered when planning obesity interventions. The positive SEP‐BMI association in children of Black origin requires replication and merits further investigation into underpinning mechanisms.
Highlights
Obesity is a global public health challenge.[1]
Recent research suggests that the association between socioeconomic position (SEP) and body mass index (BMI) in children may differ by ethnic group
Income deprivation was associated with higher BMI in the White and South Asian groups but with lower BMI in the Black African-Caribbean group. (b) A difference in BMI between poverty and nonpoverty groups was established as early as 3 years in the White and South Asian groups, and overall increased with age across all ethnic groups. (c) Similar socio-economic patterns presented when using maternal education as the alternative SEP indicator in sensitivity analyses and were found for the risk of obesity at 14 years
Summary
Obesity is a global public health challenge.[1]. In many higher-income countries, levels of body mass index (BMI)[2,3] and obesity[4] are socially patterned, with disadvantaged population groups having higher mean BMI and more likely to be affected by obesity, possibly because of their disproportionally greater exposure to risk factors such as consumption of energy-dense foods.[5]. One study used data from the National Child Measurement Programme and found that the variation in BMI by area deprivation group is smaller in the South Asian and Black groups than in the White group in London.[13] A recent cross-sectional analysis of the UK Millennium Cohort Study (MCS)[14] showed the relationship between low SEP and increased risk of overweight/obesity at 7 years in White children reversed in Black African/Caribbean children Examination of these patterns throughout childhood will lend greater support to these findings (if replicated) and point towards when (and potentially, why) these differences occur and whether they persist into adolescence
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