Life course socioeconomic position and body composition in adulthood: a systematic review and narrative synthesis

Abstract

Introduction Multiple systematic reviews have investigated the relation between socioeconomic position (SEP) and body mass index (BMI) throughout the life course. However, BMI does not capture quantity and distribution of fat and muscle, which are better indicators of obesity than BMI, and have been independently linked to adverse health outcomes. Less is known about the relation between SEP and body composition, and the literature has not been reviewed. We therefore systematically reviewed the literature on the association between life course SEP and body composition in adulthood. Methods A protocol was registered on PROSPERO (CRD42019119937), and the review followed PRISMA guidelines. An electronic search of three databases (MEDLINE, Embase Classic + Embase and SPORTDiscus) was conducted. Original studies in the English language were included that examine the association between any recognised measure of SEP at any age and body composition (fat mass, fat-free mass, ratio and distribution) in adulthood, measured using a direct technique, i.e., not an anthropometric measure. A narrative synthesis was conducted. Results A total of 47 papers were included in the final review, none were from low-income countries (LICs). Greater advantage in childhood and adulthood was associated with lower fat levels in high-income countries (HICs). Associations in the opposite direction were found exclusively in middle-income countries (MICs). No studies in MICs reported associations for childhood SEP. For measures of lean mass, the majority of papers reported no association, or greater advantage in adulthood associated with higher lean mass, with little variation between HICs and MICs. Associations in HICs are more often observed in women than men. Conclusion The results indicate that fat measures follow similar patterns to those seen for BMI, and that women in HICs are more likely to experience inequalities in both fat and lean measures. Further research in LICs and MICs is needed.

Meal preparation behaviour and obesity: time spent cooking in the Czech Republic

“…We found a negative correlation between education and obesity/being overweight. The inverse relationship between education level and risk of obesity has been extensively documented in developed countries (Bridger Staatz et al. , 2021; Li et al.…”

“…We found a negative correlation between education and obesity/being overweight. The inverse relationship between education level and risk of obesity has been extensively documented in developed countries (Bridger Staatz et al, 2021;Li et al, 2021a;Witkam et al, 2021;Faka et al, 2019;Oshan et al, 2020;Hern andez-Yumar et al, 2019;Choi and Cawley, 2018;Samouda et al, 2018;Newton et al, 2017;Cohen et al, 2013;Devaux et al, 2011). As the meta-analysis conducted by Cohen et al (2013) revealed the relationship between education and obesity is consistent and robust even when different measures of obesity or education are used.…”

Longitudinal change in physical activity and adiposity in the transition from adolescence to early adulthood: the 1993 Pelotas cohort study

“…Although empirical data are limited from LMICs, it appears that the development of body fat is differently influenced by societal factors in high-income countries vs. middle income countries [20]. For example, a prior study reported a negative association between socioeconomic status and fat mass in high-income countries, but a positive or no association in middle-income countries [20].…”

“…Although obesity is a health risk shared by low-, middle-, and high-income countries [18], studies in low-and middle-income countries (LMIC) are particularly limited [19]. The data that are available suggest that the influences of societal factors on PA and adiposity are different in LMIC compared to high income countries [20]. The aim of this study was to compare changes in body fat mass according to whether meeting the youth and adult PAGs from late adolescence to early adulthood (age 18 to 22 years) in a large sample of the Brazilian population.…”

Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China Health and Nutrition Survey

“…These conditions contribute to the differences in weight gain between low SES groups and wealthy individuals in developing countries. Studies have showed that socioeconomic status in early life and perhaps even in earlier generations have significant influence on adult obesity development (23)(24)(25). However, this relationship still varies across countries with different levels of development.…”