Abstract
BackgroundObesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. We examined income as a possible cause of obesity in an East German general population, focusing on appropriate representation of study variables, as well as on confounding and modification of the income-obesity association.MethodsWe used data of 9599 participants in the baseline examination of the LIFE-Adult-Study, conducted in the city of Leipzig from 2011 to 2014. Body mass index (BMI) and waist circumference (WC) as obesity measures were based on standardised measurements, net equivalised income (NEI) on self-reports. We estimated adjusted means of BMI and WC within NEI categories representing the range from risk of poverty to affluence. We stratified the analyses by gender, age, and education.ResultsA substantial part of the age-adjusted associations of income with obesity measures was attributable to other SES indicators. Adjusted for these variables, NEI was comparably associated with BMI and WC. Among women, BMI and WC decreased across NEI categories. The inverse associations tended to be stronger at non-working age (≥ 65 years) than at working age (< 65 years). Conversely, among working-age men, BMI and WC increased with increasing NEI. Among older men, risk of poverty was related to higher values of the obesity measures. The aforementioned associations were predominantly stronger in highly educated participants compared to those with medium/low education. The differences in mean BMI and WC between persons at risk of poverty and higher income groups were rather small, ranging from 1 to 2 kg/m2 for BMI and 2 to 4 cm for WC.ConclusionsOur investigation indicates an association between income and body fatness in an East German adult population that depends on the sociodemographic context of the people. However, it does not suggest that income disparities are a major driver of body fat accumulation in this population. Differential selection of study participants, error in the measurement of long-term income, and possibly reverse causality may have affected our conclusions.
Highlights
Obesity has been postulated to be a consequence of economic disadvantage
6.8% of female and 6.4% of male participants had less than 60% of the Leipzig median net equivalised income (NEI) and were considered at risk of poverty
Risk of poverty was related to higher values of the obesity measures
Summary
Obesity has been postulated to be a consequence of economic disadvantage. epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. Excess body fat essentially results from a long-term positive energy balance, which in turn arises from an interaction between genetic predisposition and environmental factors [4, 5] Among the latter, socioeconomic factors are important because they can influence a variety of more proximal factors in the causal chain such as dietary intake, physical activity, and psychosocial characteristics [6]. (3) Economic deprivation is related to psychosocial traits that favour increased energy intake in energy-rich environments, such as low levels of self-esteem, self-control, and social support, as well as social anxiety [9, 11, 12, 14, 15] Against this background, obesity has been postulated to be “the toxic consequence of economic insecurity and a failing economic environment” [8]
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