Obesity, SES, and economic development: A test of the reversal hypothesis

Pampel, Fred C.; Denney, Justin T.; Krueger, Patrick M.

doi:10.1016/j.socscimed.2011.12.028

Cited by 192 publications

(182 citation statements)

References 44 publications

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“…Our findings are consistent with studies from Sub-Saharan Africa (SSA) [47,56]. In LMIC, there is evidence that people with low SES have limited resources, negatively affecting their food consumption [57]. Moreover, they are more likely to be involved in physically demanding jobs, while those with a higher SES may have sufficient resources for access to more food and may engage in less physically demanding occupations and may use mechanized transportation [57].…”

Section: Discussionsupporting

confidence: 91%

“…In LMIC, there is evidence that people with low SES have limited resources, negatively affecting their food consumption [57]. Moreover, they are more likely to be involved in physically demanding jobs, while those with a higher SES may have sufficient resources for access to more food and may engage in less physically demanding occupations and may use mechanized transportation [57]. Alternatively, a low SES is associated with the consumption of low quality, highly processed and refined foods that are also cheap and affordable [58].…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, a low SES is associated with the consumption of low quality, highly processed and refined foods that are also cheap and affordable [58]. Interestingly, the relationship of SES and obesity in developed countries is reversed, with a high SES being associated with a lower BMI [55,57]. Unlike LMIC, a high SES status in developed countries is associated with a greater concern around the health costs of excess weight and associated diseases and concomitant healthier diets and other lifestyle interventions, which may not be accessible to a lower SES status [57].…”

Section: Discussionmentioning

confidence: 99%

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Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Mashinya

Alberts

Cook

et al. 2018

Global Health Action

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Background: The study was conducted in the Dikgale Health and Demographic Surveillance System (DHDSS) site where we have observed increasing obesity levels, particularly in women, despite evidence of high physical activity (PA) and a relatively low daily energy intake. Objective: This study aimed to assess the socio-demographic, behavioural and biological determinants of body mass index (BMI) in adult residents permanently residing in the DHDSS. Methods: A cross-sectional study was conducted in which socio-demographic, behavioural and biological characteristics from 1143 participants (aged 40–60 years) were collected using a paper questionnaire and standard anthropometric measures. Human immunodeficiency virus (HIV) testing was performed on all participants except those who indicated that they had tested positive. Chi-square and Mann-Whitney tests were used to analyze categorical and continuous variables, respectively, while hierarchical multivariate regression was used to analyze predictors of BMI. Results: The median age of women and men was 51 (46–56) and 50 (45–55) years, respectively. The prevalence of overweight-obesity was 76% in women and 21% in men. A significant negative association of BMI with HIV and smoking and a significant positive association with socio-economic status (SES) was observed in both sexes. In women, BMI was negatively associated with sleep duration (p = 0.015) and age (p = 0.012), but positively associated with sugar-sweetened beverages (SSBs) (p = 0.08). In men, BMI was negatively associated with alcohol use (p = 0.016) and positively associated with being married (p < 0.001). PA was not associated with BMI in either sexes. Full models explained 9.2% and 20% of the variance in BMI in women and men, respectively. Conclusion: BMI in DHDSS adults is not associated with physical inactivity but is associated wealth, marital status, sleep, smoking, alcohol use, and HIV status. Future studies should explore the contribution of nutrition, stunting, psycho-social and genetic factors to overweight and obesity in DHDSS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Mashinya

Alberts

Cook

et al. 2018

Global Health Action

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“…The latter observation mirrors reports from other low- and middle-income countries (LMIC) [6,41,42] but differs from many findings emanating from western countries which have often reported higher BMI among families with lower SES [43]. The data from LMICs may be due to a high purchasing power of those with higher SES who undergo a faster nutritional transition onto energy-dense foods.…”

Section: Discussionsupporting

confidence: 59%

Socio-demographic and behavioural determinants of body mass index among an adult population in rural Northern Ghana: the AWI-Gen study

Nonterah

Debpuur

Agongo

et al. 2018

Global Health Action

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Background: Obesity and associated cardiometabolic diseases are increasing in urban sub-Saharan Africa due to a complex epidemiological and nutritional transition. Related data on rural communities is scarce. Objectives: The study characterized the socio-demographic and behavioural factors influencing body mass index (BMI) among adults in rural Northern Ghana Methods: A population-based cross-sectional study involving adults aged 40–60 years residing in the Kassena-Nankana districts was undertaken. Demographic, socio-economic and behavioural data were collected along with measures of anthropometry. We determined factors associated with BMI among women and men. Results: A total of 2014 adults were studied. The median age was 51 (IQR 45–57) years and 54% were women. The prevalence of overweight/obesity was higher among women than men (18.4% vs. 7.2%; p < 0.001), whilst underweight was more prevalent in men (18.3% vs. 13.1%; p = 0.001). Participants with the highest level of education and a high household socio-economic status had higher BMIs than those in the lowest strata in both men (β = 0.074, p = 0.028 and β = 0.072, p < 0.001, respectively) and women (β = 0.174, p = 0.001 and β = 0.109, p < 0.001, respectively). Men (β = −0.050; p < 0.001) and women (β = −0.073; p < 0.001) of the Nankana ethnic group had a lower BMI than the Kassena ethnic group. Among men, alcohol consumption (β = −0.021; p = 0.001) and smoking (β = −0.216; p < 0.001) were associated with lower BMI. Smokeless tobacco was associated with lower BMI among women. Pesticide exposure was associated with higher BMI (β = 0.022; p = 0.022) among men. Conclusion: Age, sex, ethno-linguistic group and prevailing socio-demographic and behavioural factors within this rural community in Northern Ghana influence BMI. The observed positive association between pesticide use and BMI warrants further investigation.

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“…The finding that income-at the district level-increases the risk of overweight among boys in Shanghai, China suggests that despite high rates of childhood overweight and obesity, the patterning of overweight/obesity by SES in this sample reflects that of a low-GDP country [39]. Research shows that more developed countries show a reversal in the positive association between SES and overweight/obesity, which has not yet happened for children in Shanghai, China.…”

Section: Discussionmentioning

confidence: 71%

Child Overweight and Obesity in Shanghai, China: Contextualizing Chinese Socioeconomic and Gender Differences

et al. 2017

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Purpose Childhood overweight and obesity is on the rise in China and in Chinese cities in particular. The aim of this study is to explore the extent of income differences in childhood overweight in Shanghai, China, and examine demographic, social, and behavioral explanations for these differences. Methods Using the 2014 Child Well-Being Study of Shanghai, China-a survey that included extensive contextual information on children and their families in China's most populous city, prevalence rates and adjusted odds ratios of child overweight and obesity at age 7 were calculated by income tercile controlling for a wide variety of sociodemographic variables. Results District aggregate income increases the odds of child overweight/obesity, but only for boys. In contrast, rural hukou status was associated with lower odds of overweight/obesity for girls. Conclusions Boys at age 7 are more likely to be overweight and obese than girls. District income further increases this likelihood for boys, while rural hukou status decreases this likelihood for girls, suggesting that preferences for boys and thinness ideals for girls may play a role in the income patterning of childhood overweight and obesity.

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Obesity, SES, and economic development: A test of the reversal hypothesis

Cited by 192 publications

References 44 publications

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Socio-demographic and behavioural determinants of body mass index among an adult population in rural Northern Ghana: the AWI-Gen study

Child Overweight and Obesity in Shanghai, China: Contextualizing Chinese Socioeconomic and Gender Differences

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