Relationship between socioeconomic status and weight gain during infancy: The BeeBOFT study

Abstract

BackgroundIncreased weight gain during infancy is a risk factor for obesity and related diseases in later life. The aim of the present study was to investigate the association between socioeconomic status (SES) and weight gain during infancy, and to identify the factors mediating the association between SES and infant weight gain.MethodsSubjects were 2513 parent-child dyads participating in a cluster randomized controlled intervention study. Family SES was indexed by maternal education level. Weight gain in different time windows (infant age 0–3, 0–6, and 6–12 months) was calculated by subtracting the weight for age z-score (WAZ) between the two time-points. Path analysis was performed to examine the mediating pathways linking SES and infant weight gain.ResultsOn average, infants of low-educated mothers had a lower birth weight and caught-up at approximately 6 months. In the period of 0–6 months, infants with low-educated mothers had an 0.42 (95% CI 0.27–0.57) higher gain in weight for age z-score compared to children with high-educated mothers. The association between maternal education level and increased infant weight gain in the period of 0–6 months can be explained by infant birth weight, gestational age at child birth, duration of breastfeeding, and age at introduction of complementary foods. After adjusting all the mediating factors, there was no association between maternal education level and infant weight gain.ConclusionInfants with lower SES had an increased weight gain during the first 6 months of infancy, and the effect can be explained by infant birth weight, gestational age at child birth, and infant feeding practices.

Does socioeconomic status affect fruit and vegetable intake? Evidence from a cross-sectional analysis of the RaNCD Cohort

“…People with a lower SES consume more of highcalorie food groups, such as carbohydrates, fats and sweets, and their food consumption pattern is less in harmony with food guidelines in terms of quality. People's nutritional knowledge also affects their consumption of F&V (Cotugna et al, 1992;Rutter, 2018;Wang et al, 2018). An interesting finding was that place of residence had the main contribution to F&V intake inequality (27.03%).…”

Mediators of differences by parental education in weight-related outcomes in childhood and adolescence in Norway

“…It is important to understand the mechanisms explaining socioeconomic inequalities in excess weight gain in early life and inform public health interventions, given that those children who experienced early rapid growth have a higher likelihood of developing childhood and later life OW/OB and adverse health outcomes 43 . A few studies have explored the mediators explaining socioeconomic inequalities in early rapid growth using the traditional regression-based methods to mediation analysis 40 , 42 and found that maternal smoking, maternal BMI, infant birth weight, gestational age at birth, maternal age and child-feeding practices mediated socioeconomic inequalities in early rapid growth. These studies have limitations in controlling for interactions between exposure and hypothesized mediators given that they have used traditional regression-based mediation analyses.…”

“…In addition, according to the Developmental Origins of Health and Diseases (DOHaD) hypothesis 37 , early-life factors including maternal weight status, maternal history of chronic diseases, smoking during pregnancy, and maternal nutrition 27 , 38 , 39 can play a role in increasing the risk of postnatal early rapid growth and subsequent OW/OB. Studies have documented socioeconomic inequalities in early growth 40 – 42 . Early rapid growth has also been found to be associated with an increased risk of childhood and later life OW/OB and adverse health outcomes 43 .…”

“…Modern causal mediation analysis based on the potential outcomes framework and the structural causal model framework is used to investigate the mechanisms by which an exposure variable influences an outcome variable through other intermediate variables 44 . There is a limited number of studies focusing on mediators of socioeconomic inequalities in early rapid weight growth and subsequent OW/OB among youth 40 , 42 , 45 . Furthermore, most of the existing studies were based on cross-sectional data at a single age point and were based on traditional regression-based approaches that can have limitations in terms of accommodating interactions between multiple mediators.…”

Early onset of overweight among children from low‐income families: The role of exclusive breastfeeding and maternal intake of ultra‐processed food

“…Although improvements in maternal education and income, reduction of fertility rate and maternal malnutrition and the expansion of health care services for pregnant women have promoted significant advances in reducing child undernutrition in Brazil, 28 this progress was not sufficient to overcome other forms of malnutrition 29 . Several studies have shown that poorer children have an increased risk for overweight, which is linked to a higher frequency of early weaning and introduction of age‐inappropriate types of food 30,31 . In addition, populations that have experienced long periods of extreme deprivation, such as those living in Northeast Brazil, tend to perceive childhood obesity not as a problem but as a sign of good health 32 .…”