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Childhood obesity

Poorer children nearly three times as likely to be obese

Credit: Walter Siegmund
Maternal smoking during pregnancy and a mother's BMI were negatively associated with downward movement across weight categories

A study by researchers from University College London and London School of Economics has questioned why poorer children are at higher risk of obesity compared to their better-off peers. The findings, ‘Why are poorer children at higher risk of obesity and overweight? A UK cohort study’, published in The European Journal of Public Health, reported that at age five, poor children were almost twice as likely to be obese compared with their better off peers.

The researchers tracked nearly 20,000 families from across the UK and used measurements made when the children were aged five and again at age 11. The researchers examined many aspects of a child's environment and health behaviours. The environmental factors looked at were aspects such as whether the mother smoked during pregnancy, how long she breastfed for and whether the child was introduced to solid food before the age of four months. They also factored in the degree to which the mother was herself overweight or obese.

To assess the impact of physical behaviour, the study compared the frequency of sport or exercise, active play with a parent, hours spent watching TV or playing on a computer, journeys by bike and the time that children went to bed. It also compared dietary habits such as whether the child skipped breakfast as well as fruit and sweet drink consumption.

“Intervening in the early years when the family environment has more profound influences on children's healthy development has the potential to be particularly effective,” said senior author Professor Yvonne Kelly. "The 'structural' causes of socioeconomic inequalities have to be addressed along with tackling 'inherited' obesity via lifestyle factors that tend to go with lower incomes. Early intervention with parents clearly has huge potential. And evidence from our work suggests that this should start before birth or even conception."

The study found that doing sport more than three times a week played an important role, as did an earlier bedtime and regular fruit consumption which were both positively associated with downward movement in weight categories. However, maternal smoking during pregnancy and a mother's BMI were negatively associated with downward movement across weight categories. Overall, the study found that markers of 'unhealthy' lifestyle here could mean as much as a 20% additional risk of obesity for a child.

The link between relative poverty and childhood obesity was stark, with 6.6% of children from families in the poorest fifth of the sample obese while the figure for the richest fifth is just 3.5%. By the age of 11 the gap has widened, nearly tripling to 7.9% of the poorest fifth are obese; for the best-off, the figure is 2.9%.

To reduce income inequalities in overweight and obesity and their widening across childhood the results support the need of early interventions which take account of multiple risk factors.

As the processes involved in the development of fat gain in children involve social, environmental and biological factors, future work should be directed at more closely examining different typologies of risk factors and their interaction. More work is needed to establish whether there would be a reduction in inequalities and in the widening of the inequality gap across childhood if poorer families and their children adopted healthier behaviours.

This work has been supported by the UK Economic and Social Research Council’s International Centre for Life Course Studies in Society and Health.

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