Inequalities In Overweight Research Articles

Ten-year postintervention follow-up of adolescents participating in the management of overweight and social inequalities (PRALIMAP-INÈS intervention): the PRALIMAP-CINeCO survey protocol

IntroductionThe short-term effectiveness of the PRomotion de l’ALIMentation et de l’Activité Physique–INÈgalités de Santé’ (PRALIMAP-INÈS) intervention to reduce social inequalities in overweight and obesity management among adolescents between 2012 and...

Did socioeconomic inequalities in overweight and obesity in South African women of childbearing age improve between 1998 and 2016? A decomposition analysis.

Overweight and obesity in adult women contribute to deaths and disability from non-communicable diseases (NCDs) and obesity-related health problems in their offspring. Globally, overweight and obesity prevalence among women of childbearing age (WCBA) has increased, but associated socioeconomic inequality remains unclear. This study, therefore, assesses the changing patterns in the socioeconomic inequality in overweight and obesity among South African non-pregnant WCBA between 1998 and 2016. It uses data from the 1998 and 2016 Demographic and Health Surveys. Socioeconomic inequality in overweight and obesity was assessed using the concentration index (C). The index was decomposed to identify contributing factors to obesity and overweight inequalities. Factors contributing to changes in inequalities between 1998 and 2016 were assessed using the Oaxaca-type decomposition approach. Socioeconomic inequalities in overweight and obesity among WCBA in South Africa increased between 1998 (C of 0.02 and 0.06, respectively) and 2016 (C of 0.04 and 0.08, respectively). Socioeconomic status was the biggest contributor to overweight and obesity inequalities for both years. The Oaxaca-type decomposition showed that race and urban residence are major contributors to changes in overweight and obesity inequalities. Policies such as the current tax on sugar-sweetened beverages and subsidising fruits and vegetables, among others, are needed to prioritise WCBA, especially for those from disadvantaged socioeconomic backgrounds, in addressing inequalities in overweight and obesity in South Africa.

Area-level socioeconomic inequalities in overweight and obesity: Systematic review on moderation by built-environment attributes.

Residents of lower socioeconomic status (SES) areas are at a higher risk of overweight/obesity than those from higher SES areas. Built environment attributes may mitigate such inequalities. This systematic review synthesised findings of studies examining built environment attributes as potential moderators of the associations between area-level SES and overweight/obesity in adults. From five databases, nine eligible studies were identified. The SES-overweight/obesity relationship was stronger in inner areas and suburbs of large cities, while it was weaker in more rural areas. Two studies examined walkability and reported contrasting findings: no moderation in one and marginally significant moderation (less inequality in higher walkability areas) in the other. No evidence of moderation was found for street connectivity, population density, the food environment, access to physical activity facilities and several perceived environmental attributes. Further research is needed on other built environment attributes (e.g., access to, quantity and quality of green spaces, active transport features), and ideally using prospective study designs and objective makers of adiposity.

Explaining gender inequalities in overweight people: a Blinder-Oaxaca decomposition analysis in northern Sweden

BackgroundBeing overweight and obesity are considered serious public health concerns worldwide. At the population level, factors contributing to overweight as well as the differences in overweight between men and women in terms of prevalence or associated factors are relatively well-known. What is less known is what explains the inequalities in overweight between men and women. In this study, we examined the contribution of material, behavioural, and psychosocial factors in explaining the gender differences in overweight among adults in northern Sweden.MethodsThis study was based on the 2018 Swedish Health on Equal Terms survey, which was carried out in Sweden’s four northernmost regions. The analytical sample consisted of 20,855 participants (47% men) aged 20–84 years. Overweight (including obesity) was the outcome, and the selected explanatory variables were grouped according to three theoretical perspectives: material, behavioural and psychosocial. Descriptive statistics and Blinder-Oaxaca decomposition were applied for analysing the data.ResultsOur study showed that the prevalence of overweight was 64% and 52% among men and women, respectively. It, therefore, revealed a gender gap in overweight people of 11.7% points with explanatory factors accounting for 39% of that gap. This gender gap in overweight people was mostly explained by behavioural variables (19.3%), followed by the materialistic variables and age accounting for 16.2% and 3.1%, respectively. Specifically, having low education, being in the lowest income quintile, alcohol drinking and snus usage contributed to explain 8.4%, 8.9%, 2.8% and 6.3% of the gender difference, respectively.ConclusionsWe found a considerable gender inequality in overweight between men and women. The findings highlight that future overweight prevention initiatives would benefit from targeting the uncovered contributing factors to reduce gender inequalities in overweight people.

Do family characteristics contribute to a socioeconomic gradient in overweight in early childhood? – Single mediation analyses of data from German preschool children

Children’s overweight is strongly associated with family socioeconomic position (SEP) and family characteristics (FC). There is limited research on the extent to which FC account for a socioeconomic gradient in childhood overweight. This study examined whether FC explain SEP differences in the prevalence of overweight. The study used baseline data of preschool-aged children from the German ‘PReschool INtervention Study’. The sample (n = 872, 48% girls) was recruited at kindergartens in Baden-Württemberg, Germany. Data included children’s measured weight status and parents’ reports on socioeconomic indicators (e.g., school education, vocational education, income) and FC. Variables represent main determinants of overweight (nutrition: sweets consumption in front of TV, soft drink consumption, regular breakfast, child sets table; physical activity: outdoor sports; parental role model). In single mediation analyses indirect effects of SEP on overweight were analysed (OR[95%CI]). Preschool girls and boys with low parental education had higher odds for overweight than children with high parental education. Among boys, low levels of parental education contributed to the odds of overweight via indirect effects by both factors ‘sweets consumption in front of TV’ (OR = 1.31[1.05–1.59]) and ‘no sports’ (OR = 1.14[1.01–1.38]). Among girls, FC measured did not explain SEP differences in overweight. Family nutrition and parental/family physical activity contribute to inequalities in overweight among preschool boys, but not girls. Research is needed to identify FC that explain inequalities in overweight for both.

Trends of socioeconomic inequalities in overweight and obesity in children and adolescents in Germany

Abstract Background Overweight and obesity in early life are risk factors for chronic health conditions in the later life course. Children and adolescents from socioeconomically disadvantaged families are more likely to be overweight or obese than their better-off peers. This study examined post-millennial trends of socioeconomic inequalities in the prevalence of overweight and obesity among young people in Germany. Methods Repeated cross-sectional data were used from the German health interview and examination survey for children and adolescents (KiGGS). Overweight and obesity were assessed by body mass index, based on measured height and weight of 3- to 17-year-old participants in KiGGS baseline (2003-06) and KiGGS wave 2 (2014-17). Socioeconomic position (SEP) was measured using a composite index of parental education, occupation and income. The regression-based slope index of inequality (SII) and relative index of inequality (RII) were calculated to estimate the extent of absolute and relative inequalities in the prevalence of overweight and obesity. Results The overall prevalence of overweight and obesity among 3- to 17-year-olds in Germany did not change over time and was recently 15.4% and 5.9%, respectively. In both survey waves, overweight and obesity were more prevalent in lower SEP-groups. From 2003-06 to 2014-17, overweight increased in the low-SES group, whereas it tended to decrease in those with higher SES. This trend was concomitant with increasing socioeconomic inequalities in overweight over the observation period (SII from 0.11 to 0.19, p = 0.054; RII from 2.1 to 3.7, p = 0.021). No such trend was found for obesity. Conclusions Socioeconomic inequalities in overweight have widened among the young in Germany since the early 2000s. Structural interventions that are effective in preventing and reducing overweight in young people from socially disadvantaged backgrounds are still needed. Key messages

Do family characteristics explain a social gradient in overweight in early childhood?

Abstract Background Children's overweight is associated with many factors, including their living situation, in particular their family's socioeconomic position (SEP) and family characteristics. Research on the extent to which family characteristics account for a social gradient in overweight in early life is scarce. This study evaluated whether family characteristics explain SEP differences in the risk of overweight in early childhood. Methods The study used baseline data of 3-6 year-old children (n = 1,116) from the intervention ‘Ene mene fit’ conducted at kindergartens in Baden-Württemberg, Germany. Data included overweight (body mass index > 90 percentile) and parents’ reports on their education and family characteristics associated with overweight (child consumes: sweets in front of TV, soft drinks; family joined time: outdoor, breakfast, sports; cooking; child sets table; role model). Model-based single mediation analyses decomposed the total effect of highest parental education on overweight into direct (unmediated) and indirect (mediated) effects (OR, 95% CI). Results Girls and boys with low parental education had higher odds for overweight than children with high/medium education. Among boys, low education influenced the risk of overweight via indirect effects of i. ‘sweets consumption in front of TV’ (OR = 1.31, 1.05-1.59) and ii. ‘no joined sports’ (OR = 1.14, 1.00-1.44). The direct effect of low education only remained significant when ‘no joined sports’ was considered (OR = 2.19, 1.11-5.19). Among girls, family characteristics measured here did not explain SEP differences in overweight. Conclusions The family characteristics ‘sweets consumption in front of TV’ and ‘no joined sports’ contribute to inequalities in overweight among boys, but not among girls. Therefore, more gender-sensitive research is needed to identify family risk and protective characteristics that explain health inequalities among both boys and girls.

Inequalities in overweight and obesity among reproductive age group women in India: evidence from National Family Health Survey (2015–16)

BackgroundIn developing nations like India, fertility and mortality have decreased, and diseases related to lifestyle have become more common. Females in India are more prone to being overweight and obese than their male counterparts, more specifically in affluent families than the poor ones. Understanding the overweight and obesity trend may help develop feasible public health interventions to reduce the burden of obesity and associated adverse health outcomes.MethodsThe study utilizes the fourth round of the National Family Health Survey (NFHS-4), 2015–16. Descriptive statistics, bivariate and multivariate analysis was used to check the significant relationship between overweight and obesity, and other background characteristics. Income-related inequality in overweight and obesity among women was quantified by the concentration index and the concentration curve. Further, Wagstaff decomposition analysis was done to decompose the concentration index, into the contributions of each factor to the income-related inequalities.ResultsOverweight & obesity among women had a significant positive association with their age and educational level. The odds of overweight and obesity were 57% more likely among women who ever had any caesarean births than those who did not [AOR: 1.57; CI: 1.53–1.62]. The likelihood of overweight and obesity was 4.31 times more likely among women who belonged to richest [AOR: 5.84; CI: 5.61–6.08] wealth quintile, than those who belonged to poor wealth quintile. Women who ever terminated the pregnancy had 20% higher risk of overweight and obesity than those who did not [AOR: 1.20; CI: 1.17–1.22]. The concentration of overweight and obesity among women was mostly in rich households of all the Indian states and union territories. Among the geographical regions of India, the highest inequality was witnessed in Eastern India (0.41), followed by Central India (0.36).ConclusionThe study results also reveal a huge proportion of women belonging to the BMI categories of non-normal, which is a concern and can increase the risks of developing non-communicable diseases. Hence, the study concludes and recommends an urgent need of interventions catering to urban women belonging to higher socio-economic status which can reduce the risks of health consequences due to overweight and obesity. Development nutrition-specific as well as sensitive interventions can be done for mobilization of local resources that addresses the multiple issues under which a woman is overweight or obese.

Socio-economic inequalities in child growth: Identifying orientation and forward-looking layout

Socio-economic inequalities in child growth: Identifying orientation and forward-looking layout

Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence

We use longitudinal data across a key developmental period, spanning much of childhood and adolescence (age 5 to 17, years 2006–2018) from the UK Millennium Cohort Study, a nationally representative study with an initial sample of just over 19,000. We first examine the extent to which inequalities in overweight, obesity, BMI and body fat over this period are consistent with the evolution of inequalities in health behaviours, including exercise and healthy diet markers (i.e., skipping breakfast) (n = 7,220). We next study the links between SES, health behaviours and adiposity (BMI, body fat), using rich models that account for the influence of a range of unobserved factors that are fixed over time. In this way, we improve on existing estimates measuring the relationship between SES and health behaviours on the one hand and adiposity on the other. The advantage of the individual fixed effects models is that they exploit within-individual changes over time to help mitigate biases due to unobserved fixed characteristics (n = 6,883).We observe stark income inequalities in BMI and body fat in childhood (age 5), which have further widened by age 17. Inequalities in obesity, physical activity, and skipping breakfast are observed to widen from age 7 onwards. Ordinary Least Square estimates reveal the previously documented SES gradient in adiposity, which is reduced slightly once health behaviours including breakfast consumption and physical activity are accounted for. The main substantive change in estimates comes from the fixed effects specification. Here we observe mixed findings on the SES associations, with a positive association between income and adiposity and a negative association with wealth. The role of health behaviours is attenuated but they remain important, particularly for body fat.

Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region.

Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.

Sibling Inequalities in Overweight and the Role of Mother’s Education: Evidence From the Indonesian Family Life Survey

Background:Previous studies have shown that sibling inequalities in overweight vary across contexts. Furthermore, research on the extent to which parental factors such as mother’s education can compensate for or reinforce such disparities is considerably rare.Objective:This study analyzes to what extent and how the chances of overweight among children (0-19 years of age) vary systematically by gender, birth order, and number of siblings. We also look at whether mother’s education buffers or aggravates sibling inequalities in overweight.Methods:Data were from the fifth wave of the Indonesian Family Life Survey-5 2014/2015, which comprised 6723 children born in 4784 families. We applied within-family centered birth order dummies to disentangle the effects of birth order from those of number of siblings. Cluster-robust logistic regressions were conducted.Results:Overweight occurred more in eldest and youngest children, and in children of smaller families. Mother’s education amplified sibling inequalities. Odds of overweight in children increased along with more years of education the mothers had. This was greater for boys and eldest children. Further analyses indicated that boys whose mothers spent more years in school consumed high-calorie foods more often.Conclusion:The overall results indicate that mother’s education aggravates sibling inequalities in overweight. Nutrition interventions to reduce overweight in children should target the eldest and the youngest children and children of smaller families. Mothers who had more school years, and particularly their sons, should also be in the target group. Boys should be advised to consume high-calorie foods less often.

Mid-adolescent ethnic variations in overweight prevalence in the UK Millennium Cohort Study.

BackgroundThere are stark ethnic inequalities in the prevalence of UK childhood obesity. However, data on adolescent overweight in different ethnic groups are limited. This study assessed ethnic inequalities in overweight prevalence during mid-adolescence using body mass index (BMI) and explored the contribution of socioeconomic and behavioural factors.MethodsWe analyzed data from 10 500 adolescents aged between 13 and 15 years who participated in sweep six of the Millennium Cohort Study. Ethnic inequalities in overweight and mean BMI were assessed using multiple regression models. Results were stratified by sex and adjusted for socioeconomic and behavioural factors.ResultsBlack Caribbean males had significantly higher BMI than White males after full adjustment [excess BMI 2.94, 95% confidence interval (CI) 0.70–5.19] and were over three times more likely to be overweight [odds ratio (OR): 3.32, 95% CI 1.95–5.66]. Black Africans females had significantly higher BMI compared with White females (excess BMI 1.86, 95% CI 0.89–2.83; OR for overweight 2.74, 95% CI 1.64–4.56), while Indian females had significantly lower BMI compared with White females (reduced BMI −0.73, 95% CI −1.37 to −0.09). Socioeconomic and behavioural factors often considered to be associated with overweight were more prevalent in some ethnic minority groups (lower socioeconomic position, lack of breakfast consumption, low fruit and vegetable intake, high sugar-sweetened beverage and fast-food consumption, and infrequent physical activity), but adjustment for these factors did not fully explain ethnic differences in overweight/BMI.ConclusionEthnic inequalities in overweight prevalence are evident in mid-adolescence and vary according to sex. Differences in overweight/BMI between ethnic groups were not fully accounted for by socioeconomic or behavioural factors.

Socio-economic inequalities in overweight and obesity among women of reproductive age in Bangladesh: a decomposition approach

BackgroundOverweight and obesity of women is a growing concern all over the world. However, an understanding on the socio-economic inequalities in overweight and obesity of women received little attention, especially in the context of Bangladesh. Therefore, the objective of this study was to measure the inequality in overweight and obesity among women of reproductive age in Bangladesh as well as to explore the effect of various socio-economic factors on this inequality.MethodsThis study used data from the Bangladesh Demographic and Health Survey 2014 which is a nationally representative data. The concentration index of overweight and obesity was applied to measure the extent of socio-economic inequality. Finally, the concertation index was decomposed in order to understand the contribution of different socio-economic variables in inequality in overweight and obesity of women.ResultsThis study included a total of 16,624 women of reproductive age. The study found that the prevalence of overweight was about 29% and the rate of obesity was approximately 11%. The value of concentration index for overweight and obesity was 0.37 (p < 0.001). This study also observed that about 52% inequality was explained by household’s wealth status followed by watching television (25%), husband/partner’s educational status (around 7%), women’s educational status (about 5%), place of residence (approximately 4%).ConclusionsThis study found notable level of overweight and obesity among the women of Bangladesh. Various socio-economic factors like wealth status, education levels of women and partners, urban settings, women watching television predominantly contributed to the inequality in overweight and obesity among women of reproductive age. Therefore, the study suggests adopting necessary interventions targeting the women of higher socio-economic status to reduce the risk of life-threatening problems caused by overweight and obesity.

Stakeholder views on the potential impact of a sugar-sweetened beverages tax on the budgets, dietary intake, and health of lower and higher socioeconomic groups in the Netherlands

BackgroundSocioeconomic inequalities in overweight and obesity exist in many European countries. A sugar-sweetened beverages (SSB) tax may contribute to a reduction of these inequalities. However, in the Netherlands, the government decided to not (yet) introduce an SSB tax, although the government has acknowledged its potential to be pro-equity. Understanding how various stakeholder groups perceive the potential effects of an SSB tax on different socioeconomic groups may provide useful insights into equity-related considerations in the debate whether or not to implement an SSB tax. This study aims to gain insight into the perceptions of stakeholder groups in the Netherlands on (1) the effects of an SSB tax on the budgets of lower and higher socioeconomic groups and (2) the impact of an SSB tax on socioeconomic inequalities in dietary intake and health.MethodsSemi-structured interviews were conducted in 2019 with 27 participants from various stakeholder groups in the Netherlands (i.e. health and consumer organizations, health professional associations, trade associations, academia, advisory bodies, ministries and parliamentary parties). Data were analyzed using a thematic content approach.ResultsParticipants from all stakeholder groups indicated that an SSB tax would have a larger impact on the budgets of lower socioeconomic groups. Participants from nearly all stakeholder groups (except trade associations) mentioned that an SSB tax could have greater health benefits among lower socioeconomic groups as these often have a higher SSB consumption and are more likely to be overweight or obese. Some participants mentioned that an SSB tax may have no or adverse health effects among lower socioeconomic groups (e.g. compensation of lower SSB consumption with other unhealthy behaviours). Some participants emphasised that an SSB tax should only be introduced when accompanied by other interventions (e.g. offering healthy alternatives), to make it easier for lower socioeconomic groups to lower their SSB consumption in response to an SSB tax, and to prevent adverse health effects.ConclusionsParticipants believed an SSB tax could contribute to a reduction in socioeconomic inequalities in dietary intake and health. However, additional interventions facilitating the reduction of SSB consumption in lower socioeconomic groups were recommended.

Social inequalities in overweight and obesity in 26 European countries

Abstract Background Previous studies have shown inequalities in overweight and obesity in disfavor of the socially disadvantaged groups. This study examines the extent of these inequalities in 26 European countries. Methods Data from the 2017 EU Statistics on Income and living Conditions (EU-SILC) were used (18 years and older, n = 482,595). A body mass index of 25.0 to 29.9 kg/m2 was classified as overweight and 30.0 and more as obese. Educational level (EL) was used as socioeconomic indicator. Generalized linear models were fitted to compute low-versus high absolute (RD) and relative (RR) inequality. Absolute inequality amplitude (RDA) was calculated as RD/Prevalence. Results Among men, average EU inequalities for overweight were slightly in disfavor of the low educated (RR = 1.05, RDA=5%). A mixed inequality pattern was observed across countries, as the risk of overweight was higher among high educated men in most Eastern countries, in contrast to other parts of Europe (RR from 0.74 to 1.19, RDA from -27% to 20%). Male obesity showed more pronounced inequalities (RR = 1.22, RDA=18%), and a consistent pattern of higher risk among the low educated and wide variation across countries (RR from 1.20 to 2.18, RDA from 16% to 49%). Among women, significant inequalities in overweight were observed (RR = 1.23, RDA=21%), with a consistent pattern of higher risk among the lowest EL, and substantial variation across countries (RR from 1.06 to 1.53, RDA from 7% to 36%). Inequalities were even larger for female obesity, with average RR and RDA reaching 1.49 and 35%, and wider variation (RR from 1.35 to 2.77, RDA from 12% to 88%). Conclusions Social inequalities in weight status are widespread in Europe, but vary substantially between countries. Inequalities are larger among women. For male overweight, a reverse inequality is observed in most Eastern countries. This study allows countries to benchmark the inequalities observed nationally to the situation in other EU countries. Key messages Social inequalities in weight status are widespread in Europe. The pattern of social inequalities in overweight and obesity varies substantially by country and gender.

Socioeconomic inequalities in obesity in Brazil

The aim of this work was to analyze the socioeconomic inequality in overweight and obesity for the Brazilian adult population and to determine the factors that contribute the most to the observed inequality. Data from the 2013 National Health Survey (Pesquisa Nacional de Saúde - PNS) were used and the inequality was calculated using the concentration index, which was decomposed to analyze the contribution of different factors (demographic, schooling, lifestyle, sanitation, among others). The analyses were stratified by gender and region, in order to identify some heterogeneity. The results for gender showed that the inequality in overweight and obesity in men is concentrated in the richest ones, whereas, for women, the indices did not show inequality. In the analyzes per region, the results showed the same pattern for men, and differences were found for women, suggesting that overweight is more concentrated in rich women in the less developed regions (North and Northeast) and in poor women in more developed regions (South, Southeast and Midwest). Income, demographics, schooling, and lifestyles are the factors that contributed most to the observed inequality. Public policy strategies should aim to reduce such persistence of overweight and obesity, but also seek equity and equality in health.

Regional inequalities in adiposity in England: distributional analysis of the contribution of individual-level characteristics and the small area obesogenic environment

We use nationally representative English data to examine regional variations in body mass index (BMI) and waist circumference (WC), and to explore their underlying sources. Beyond our “at the mean” analysis, Shapley decomposition combined with unconditional quantile regression analysis allow us to explore the relative contribution of small-area level proxies of the obesogenic environment as opposed to our set of individual-level characteristics, across the whole adiposity distribution. We find that the regional BMI differences, that are more evident towards the right tails of its distribution, are fully accounted for by the neighbourhood obesogenic environment. The latter exerts an independent contribution to excess adiposity over and above the potential mediating role of individual-level lifestyle and socio-economic position (SEP). Overall, the relative contribution of demographics (age and gender) becomes less evident moving to higher quantiles of the BMI distribution, while that of obesogenic environment, individual-level lifestyle and SEP measures becoming more relevant. The neighbourhood obesogenic environment is also much more relevant in the tails of the WC distribution. The role of the obesogenic environment on excess adiposity is more pronounced for women than men. Overall, our results highlight that policies that aim to tackle excess adiposity should address both people and places.

Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England

BackgroundGeographical inequalities in overweight and obesity prevalence among children are well established in cross-sectional research. We aimed to examine how environmental area characteristics at birth are related to these outcomes in childhood.MethodsAnonymised antenatal and birth data recorded by University Hospital Southampton linked to school-measured weight and height data for children within Southampton, UK, were utilised (14,084 children at ages 4–5 and 5637 at ages 10–11). Children’s home address at birth was analysed at the Lower and Middle layer Super Output Area (LSOA/MSOA) levels (areas with average populations of 1500 and 7000, respectively). Area-level indices (walkability, relative density of unhealthy food outlets, spaces for social interaction), natural greenspace coverage, supermarket density and measures of air pollution (PM2.5, PM10 and NOx) were constructed using ArcGIS Network Analyst. Overweight/obesity was defined as a body mass index (BMI; kg/m2) greater than the 85th centile for sex and age. Population-average generalised estimating equations estimated the risk of being overweight/obese for children at both time points. Confounders included maternal BMI and smoking in early pregnancy, education, ethnicity and parity. We also examined associations for a subgroup of children who moved residence between birth and outcome measurement.ResultsThere were mixed results between area characteristics at birth and overweight/obesity at later ages. MSOA relative density of unhealthy food outlets and PM10 were positively associated with overweight/obesity, but not among children who moved. LSOA greenspace coverage was negatively associated with the risk of being overweight/obese at ages 10–11 in all children (relative risk ratio 0.997, 95% confidence interval 0.995–0.999, p = 0.02) and among children who moved.ConclusionsLocal access to natural greenspaces at the time of birth was inversely associated with becoming overweight or obese by age 10–11, regardless of migration. Increased access/protection of greenspace may have a role in the early prevention of childhood obesity.

Trends in social inequality in overweight and obesity among adolescents in Denmark 1998-2018.

The aim was to analyze trends in overweight and obesity in relation to socioeconomic position among Danish adolescents in the 20-year period 1998-2018. The study used data on self-reported height and weight and parents' occupational social class (OSC) from 11-, 13- and 15-year-old schoolchildren in 1998, 2002, 2006, 2010, 2014 and 2018, n = 22,177. The analyses included absolute social inequality in overweight/obesity (prevalence difference between low and high OSC) and relative social inequality (OR for overweight/obesity). In the total sample, the prevalence of overweight and obesity was 9.7% and 1.4%, respectively, with significantly higher prevalence in low than high OSC. There were significantly increasing trends in both overweight and obesity 1998-2018 in low OSC and no significant increase in high OSC. The OR for overweight was 1.59 (1.42-1.74) in middle and 2.16 (1.89-2.46) in low OSC, OR for obesity 1.74 (1.29-2.34) in middle and 2.97 (2.15-4.11) in low OSC. Associations were not modified by survey year. There was a persistent absolute and relative social inequality in overweight and obesity 1998-2018 among Danish adolescents.