Socioeconomic status throughout life and body mass index: a systematic review and meta-analysis

Abstract

This article aimed to systematically review the association between socioeconomic status according to the life course models and the body mass index (BMI) in adults. A review was performed following the guidelines of the PRISMA. The studies were identified in the MEDLINE/PubMed, LILACS and Web of Science databases. The eligible articles investigated the association between at least one life course model (risk accumulation, critical period or social mobility) and BMI. In order to assess the quality of the selected articles, the NOS checklist was applied to each study. Eleven articles were selected for the systematic review, and seven articles were selected for the meta-analysis. The average score and the median in the NOS checklist were 6.4, within a maximum possible score of 8 points. The most used model was social mobility. Regarding meta-analysis, there was association between lower life course socioeconomic status and BMI among women. BMI mean difference (MD) was higher among those who remained with low socioeconomic status throughout life when compared with those who maintained a high socioeconomic status (MD: 2.17, 95%CI: 1.48; 2.86). Before that, the BMI MD was higher among those with upward mobility, compared with those who maintained a high socioeconomic status throughout life (MD: 1.20, 95%CI: 0.73; 1.68). The risk of overweight was also higher among women who maintained low socioeconomic status (summary RR: 1.70, 95%CI: 1.05; 2.74); however, according to the GRADE, the studies presented very low quality evidence. For men, no association was observed. Having low socioeconomic status sometime during life is associated with higher BMI in adulthood.

Intergenerational social mobility and body mass index trajectories – A follow-up study from Finland

“…We found some widening differences between stable low and high SEP groups among men from the younger birth cohort, but these differences were not greater at any age compared to the differences found among women. Our results support the strong evidence from previous studies where stable low SEP has been associated with higher BMI, particularly among women in high-income countries ( Newton et al, 2017 ; Vieira et al, 2019 ). Vulnerability to weight gain among constantly disadvantaged women has been explained, for example, by a greater stress response to social disadvantage and greater weight-related social and occupational discrimination compared to men ( Pudrovska et al, 2014 ).…”

“…Since the youngest participants were 40 years old in Phase 1, we can assume that most of the participants (and their parents) completed their highest education before the follow-up; thus, further social mobility after Phase 1 is not probable among the participants. Although different SEP measures are not interchangeable because they capture different aspects of SEP ( Braveman et al, 2005 ), the selection between education and occupation as an SEP measure in high-income Western countries has not substantially affected the findings of the SEP inequalities in BMI ( McLaren, 2007 ; Vieira et al, 2019 ). Education encompasses not only material aspects of SEP but also non-material aspects, such as knowledge, literacy, and cognitive capacity ( Braveman et al, 2005 ; Galobardes et al, 2006 ).…”

“…Stable low SEP has consistently been associated with a higher adulthood BMI, especially among women from high-income countries, but the evidence on upward and downward social mobility remains weak ( Newton et al, 2017 ; Vieira et al, 2019 ). Mostly, the BMIs of people with upward and downward social mobility seem to be somewhere between the BMIs of stable high and stable low SEP groups ( Hart et al, 2008 ; Langenberg et al, 2003 ).…”

“…Additionally, upward social mobility has been associated with lower BMI compared to those with stable low SEP among women ( Aitsi-Selmi et al, 2013 ; Ball & Mishra, 2006 ), and in some studies, among men as well ( Langenberg et al, 2003 ). However, for men, there is no consensus that social mobility is associated with BMI ( Vieira et al, 2019 ).…”

Double Burden of Malnutrition and Inequalities in the Nutritional Status of Adults: A Population-Based Study in Brazil, 2019

“…On the other hand, a research with data of the adult Brazilian population has found that the prevalence of overweight and obesity increased in all levels of education between 2006 and 2013, while the increase in the prevalence of BMI >40 kg/m 2 was more significant in the higher level of education [32]. Another recent review and meta-analysis that aimed to assess the association between socioeconomic status and BMI in adults found a higher risk of overweight in women with low socioeconomic status [33], in line with the findings of our study.…”