Mediators of socioeconomic differences in adiposity among youth: a systematic review

Gebremariam, Mekdes Kebede; Lien, Nanna; Nianogo, Roch A.; Arah, Onyebuchi A.

doi:10.1111/obr.12547

Cited by 40 publications

(54 citation statements)

References 71 publications

(135 reference statements)

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“…First, the finding that more exercise mediated the negative association between SSS and BMI is in line with an earlier review in European children and adolescents [ 36 ]. Second, the association between SSS and BMI was not mediated by consumption of sugar-sweetened carbonated sodas, which is inconsistent with previous research [ 41 , 42 ]. This may partly be influenced by that the sales figures for sugar-sweetened carbonated soda in the last decade have declined by about 20%.…”

Section: Discussioncontrasting

confidence: 96%

Health-Related Behaviors in Adolescents Mediate the Association between Subjective Social Status and Body Mass Index

Bjertnæs

Schwinger

Júlíusson

et al. 2020

IJERPH

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The aim of this study was to explore the association between adolescent subjective social status (SSS) and body mass index (BMI) at two different time points and to determine whether this association was mediated by health-related behaviors. In 2002 (n = 1596) and 2017 (n = 1534), tenth-grade students (15–16 years old) in schools in the District of Oppland, Norway, completed a survey. Four categories of perceived family economy were measured as SSS, and structural equation modeling was performed, including a latent variable for unhealthy behavior derived from cigarette smoking, snuff-use, and alcohol-drinking as well as dietary and exercise as mediators. No linear association was found between SSS and BMI in 2002 (standardized ß −0.02, (95% confidence interval (CI) −0.07, 0.03)). However, an association was present in 2017 (standardized ß −0.05 (95% CI −0.10, −0.001)), indicating that BMI decreased by 0.05 standard deviations (0.05 × 3.1 = 0.16 BMI unit) for every one-category increase in SSS. This association was mediated by exercise (standardized ß −0.013 (95% CI −0.02, −0.004) and unhealthy behavior (standardized ß −0.009 (95% CI −0.002, −0.04)). In conclusion, a direct association between SSS and BMI was found in 2017 in this repeated cross-sectional survey of 15–16-year-old Norwegian adolescents. This association was mediated through health-related behavior.

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Section: Discussioncontrasting

confidence: 96%

Health-Related Behaviors in Adolescents Mediate the Association between Subjective Social Status and Body Mass Index

Bjertnæs

Schwinger

Júlíusson

et al. 2020

IJERPH

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“…Considerable changes took place in the period investigated (1953–2015) in Britain, including changes to several factors that might have ultimately influenced diet and physical activity, which are the plausible yet equivocal mediators of BMI and height inequalities. 24 , 25 , 26 Diets in both the prenatal and postnatal periods are likely to contribute to BMI and height inequalities, 27 and British diets have changed considerably. World War 2-related food rationing continued up to 1954 in the UK; compared with population diet in the 1990s, rationing-based diets were characterised by higher consumption of vegetables, lower consumption of sugar and soft drinks, and higher consumption of fat as a proportion of energy intake.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies

Bann

Johnson

et al. 2018

The Lancet Public Health

166

158

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SummaryBackgroundSocioeconomic inequalities in childhood body-mass index (BMI) have been documented in high-income countries; however, uncertainty exists with regard to how they have changed over time, how inequalities in the composite parts (ie, weight and height) of BMI have changed, and whether inequalities differ in magnitude across the outcome distribution. Therefore, we aimed to investigate how socioeconomic inequalities in childhood and adolescent weight, height, and BMI have changed over time in Britain.MethodsWe used data from four British longitudinal, observational, birth cohort studies: the 1946 Medical Research Council National Survey of Health and Development (1946 NSHD), 1958 National Child Development Study (1958 NCDS), 1970 British Cohort Study (1970 BCS), and 2001 Millennium Cohort Study (2001 MCS). BMI (kg/m2) was derived in each study from measured weight and height. Childhood socioeconomic position was indicated by the father's occupational social class, measured at the ages of 10–11 years. We examined associations between childhood socioeconomic position and anthropometric outcomes at age 7 years, 11 years, and 15 years to assess socioeconomic inequalities in each cohort using gender-adjusted linear regression models. We also used multilevel models to examine whether these inequalities widened or narrowed from childhood to adolescence, and quantile regression was used to examine whether the magnitude of inequalities differed across the outcome distribution.FindingsIn England, Scotland, and Wales, 5362 singleton births were enrolled in 1946, 17 202 in 1958, 17 290 in 1970, and 16 404 in 2001. Low socioeconomic position was associated with lower weight at childhood and adolescent in the earlier-born cohorts (1946–70), but with higher weight in the 2001 MCS cohort. Weight disparities became larger from childhood to adolescence in the 2001 MCS but not the earlier-born cohorts (pinteraction=0·001). Low socioeconomic position was also associated with shorter height in all cohorts, yet the absolute magnitude of this difference narrowed across generations. These disparities widened with age in the 2001 MCS (pinteraction=0·002) but not in the earlier-born cohorts. There was little inequality in childhood BMI in the 1946–70 cohorts, whereas inequalities were present in the 2001 cohort and widened from childhood to adolescence in the 1958–2001 cohorts (pinteraction<0·05 in the later three cohorts but not the 1946 NSHD). BMI and weight disparities were larger in the 2001 cohort than in the earlier-born cohorts, and systematically larger at higher quantiles—eg, in the 2001 MCS at age 11 years, a difference of 0·98 kg/m2 (95% CI 0·63–1·33) in the 50th BMI percentile and 2·54 kg/m2 (1·85–3·22) difference at the 90th BMI percentile were observed.InterpretationOver the studied period (1953–2015), socioeconomic-associated inequalities in weight reversed and those in height narrowed, whereas differences in BMI and obesity emerged and widened. These substantial changes highlight the impact of societal changes o...

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“…no. reviews contributing termsReviews contributing terms‘Place’Place of residence5No-5No-5[10–14]‘Race’Race / ethnicity / culture / language3Yes →69No-9[11, 15–22]Occupation6No-6No-6[11], [13], [16], [23], [24], [25]‘Gender’Gender / sex1Yes →67No-7[16], [17], [18], [19], [26], [27], [28]Religion0Yes →11Yes →23[17, 29, 30]Education7No-7No-7[11, 13, 16, 24, 25, 31, 32]‘SES’Socio-economic status12No-12No-12[11], [13], [15], [23], [24], [25], [31], [32], [33], [34], [35], [36]Social capital0Yes →11Yes →45[17, 37–40]Other category not encompassed by PROGRESS-Plus6No-...…”

Section: Resultsmentioning

confidence: 99%

Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen

Prady

Uphoff

Power

et al. 2018

BMC Med Res Methodol

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BackgroundHealth inequalities, worse health associated with social and economic disadvantage, are reported by a minority of research articles. Locating these studies when conducting an equity-focused systematic review is challenging due to a deficit in standardised terminology, indexing, and lack of validated search filters. Current reporting guidelines recommend not applying filters, meaning that increased resources are needed at the screening stage.MethodsWe aimed to design and test search filters to locate studies that reported outcomes by a social determinant of health. We developed and expanded a ‘specific terms strategy’ using keywords and subject headings compiled from recent systematic reviews that applied an equity filter. A ‘non-specific strategy’ was compiled from phrases used to describe equity analyses that were reported in titles and abstracts, and related subject headings. Gold standard evaluation and validation sets were compiled. The filters were developed in MEDLINE, adapted for Embase and tested in both. We set a target of 0.90 sensitivity (95% CI; 0.84, 0.94) in retrieving 150 gold standard validation papers. We noted the reduction in the number needed to screen in a proposed equity-focused systematic review and the proportion of equity-focused reviews we assessed in the project that applied an equity filter to their search strategy.ResultsThe specific terms strategy filtered out 93-95% of all records, and retrieved a validation set of articles with a sensitivity of 0.84 in MEDLINE (0.77, 0.89), and 0.87 (0.81, 0.92) in Embase. When combined (Boolean ‘OR’) with the non-specific strategy sensitivity was 0.92 (0.86, 0.96) in MEDLINE (Embase 0.94; 0.89, 0.97). The number needed to screen was reduced by 77% by applying the specific terms strategy, and by 59.7% (MEDLINE) and 63.5% (Embase) by applying the combined strategy. Eighty-one per cent of systematic reviews filtered studies by equity.ConclusionsA combined approach of using specific and non-specific terms is recommended if systematic reviewers wish to filter studies for reporting outcomes by social determinants. Future research should concentrate on the indexing standardisation for equity studies and further development and testing of both specific and non-specific terms for accurate study retrieval.Electronic supplementary materialThe online version of this article (10.1186/s12874-018-0567-x) contains supplementary material, which is available to authorized users.

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Mediators of socioeconomic differences in adiposity among youth: a systematic review

Abstract: The review found several modifiable factors that could be targeted as feasible in interventions aimed at reducing socioeconomic differences in overweight and obesity among youth.

Cited by 40 publications

References 71 publications

Health-Related Behaviors in Adolescents Mediate the Association between Subjective Social Status and Body Mass Index

Health-Related Behaviors in Adolescents Mediate the Association between Subjective Social Status and Body Mass Index

Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies

Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen

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