Socioeconomic Status: The Missing Link Between Obesity and Diabetes Mellitus?

Volaco, Alexei; Cavalcanti, Ana Maria Salustiano; Pecoits‐Filho, Roberto; Précoma, Dalton Bertolim

doi:10.2174/1573399813666170621123227

Cited by 118 publications

(67 citation statements)

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“…Low socioeconomic status (SES), assessed mainly based on income, occupation and educational level, is an independent T2DM risk factor [ Table 1] [9,15,[80][81][82][83][84]. Systematic review and meta-analysis data have shown that increased T2DM incidence is associated with low SES in high-, middle-and low-income countries [15].…”

Section: Socioeconomic Statusmentioning

confidence: 99%

“…obesity, diet, physical activity and alcohol intake) accounting for 33 to 50% of this association [83]. The remaining part may be attributed to various other factors relating to psychosocial stress, hopelessness, material deprivation, restricted autonomy, and limited access to healthy food, exercise facilities and health services [83][84][85].…”

Section: Socioeconomic Statusmentioning

confidence: 99%

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Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe

et al. 2020

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Background: Type 2 diabetes mellitus (T2DM) comprises the vast majority of all diabetes cases in adults, with alarmingly increasing prevalence over the past few decades worldwide. A particularly heavy healthcare burden of diabetes is noted in Europe, where 8.8% of the population aged 20-79 years is estimated to have diabetes according to the International Diabetes Federation. Multiple risk factors are implicated in the pathogenesis of T2DM with complex underlying interplay and intricate gene-environment interactions. Thus, intense research has been focused on studying the role of T2DM risk factors and on identifying vulnerable groups for T2DM in the general population which can then be targeted for prevention interventions. Methods: For this narrative review, we conducted a comprehensive search of the existing literature on T2DM risk factors, focusing on studies in adult cohorts from European countries which were published in English after January 2000. Results: Multiple lifestyle-related and sociodemographic factors were identified as related to high T2DM risk, including age, ethnicity, family history, low socioeconomic status, obesity, metabolic syndrome and each of its components, as well as certain unhealthy lifestyle behaviors. As Europe has an increasingly aging population, multiple migrant and ethnic minority groups and significant socioeconomic diversity both within and across different countries, this review focuses not only on modifiable T2DM risk factors, but also on the impact of pertinent demographic and socioeconomic factors. Conclusion: In addition to other T2DM risk factors, low socioeconomic status can significantly increase the risk for prediabetes and T2DM, but is often overlooked. In multinational and multicultural regions such as Europe, a holistic approach, which will take into account both traditional and socioeconomic/socioecological factors, is becoming increasingly crucial in order to implement multidimensional public health programs and integrated community-based interventions for effective T2DM prevention.

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Section: Socioeconomic Statusmentioning

confidence: 99%

Section: Socioeconomic Statusmentioning

confidence: 99%

Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe

et al. 2020

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“…As of 2012, 28% of Medicare enrollees had a formal diagnosis of diabetes ( CDC, 2012a ). Previous research has largely attributed the T2D epidemic to individual behaviors, such as sedentary lifestyle and poor diet ( Kelly and Ismail, 2015 , Volaco et al, 2017 ). Unfortunately, very few interventions focusing on behavior modification alone have resulted in clinically meaningful differences in patient outcomes ( Yoon et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Early Life Determinants of Type-II Diabetes Using a Project Talent-Medicare Linked Data-set

Horner

Strombotne

Huang

et al. 2018

SSM - Population Health

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The increasing prevalence of Type II Diabetes (T2D) presents a serious health and financial public crisis. Our study examines the hypothesis that adolescents’ perceptions of economic insecurity, along with absolute and relative socioeconomic status (SES), can contribute to T2D prevalence later in life. Project Talent (PT) Survey data, collected on high school students in 1960, have been linked to Medicare records from 2012, presenting a unique opportunity to examine measures gathered in adolescence and T2D prevalence later-in-life among a large, national, and diverse sample (n=88,849). Our results provide compelling evidence that real, perceived, and relative SES in adolescence have persistent impacts on later-in-life diabetes risk, even when controlling for possible confounders such as cognitive ability, conscientiousness, and early-adulthood educational attainment.

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“…In turn, low to moderate physical exercise during pregnancy, particularly in the second and third trimester, has been shown to reduce the risk for cesarean delivery 57 , 58 . In addition, maternal obesity is a known indication of CS in general and elective CS in particular, and is strongly inversely associated with both socioeconomic position and PA, particularly in high-HDI countries 59 , 60 . That is to say, although we controlled for socioeconomic position through a range of relevant covariates it is possible that our main analyses are still impacted by unmeasured residual socioeconomic confounding.…”

Section: Discussionmentioning

confidence: 99%

The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males

Ekström

Ahlqvist

Persson

et al. 2020

Sci Rep

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Birth by cesarean section is increasing worldwide and associates with offspring morbidities capable of adversely impacting cardiorespiratory fitness later in life. Whether birth by cesarean section associates with lower levels of cardiorespiratory fitness later in life is unknown and is of interest to public health. Four Swedish national registers were linked to follow 339,451 singleton males, born between 1973–1987 until December 31 2005, for Watt-maximum achieved on a cycle ergometer test at conscription into the Swedish military. Main exposure was birth by cesarean section which was compared to vaginal birth. A sub-population of 45,999 males born between 1982–1987 was identified to explore differentiated associations between elective and non-elective cesarean section with Watt-maximum. Within-family analyses of 34,252 families with 70,632 biological male siblings, who conscripted during the study period, were performed to explore the role of familial confounding on Watt-maximum. Swedish males born by cesarean section achieved lower mean Watt-maximum (− 2.32 W, 95%C.I. − 2.90 to − 1.75) and displayed excess odds of low cardiorespiratory fitness (aOR = 1.08, 95%C.I. 1.05 to 1.11) at conscription in the eighteenth life-year compared to males born vaginally after adjusting for birth characteristics, maternal morbidities and parental socioeconomic position. In the sub-population, males born 1982–1987, there was a greater negative association of elective cesarean section with cardiorespiratory fitness (− 4.42 W, 95%C.I. − 6.27 to − 2.57, p < 0.001) than non-elective cesarean sections (− 1.96 W, 95%C.I. − 3.77 to − 0.16, p = 0.033) as compared to vaginal births. No associations between modes of cesarean delivery and cardiorespiratory fitness levels persisted in the within-family analyses where biological male siblings were compared whilst controlling for factors shared within families. Males born by cesarean section had lower levels of cardiorespiratory fitness eighteen years later compared to males born vaginally. These findings appear to be largely explained by factors of familial confounding.

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Socioeconomic Status: The Missing Link Between Obesity and Diabetes Mellitus?

Cited by 118 publications

References 0 publications

Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe

Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe

Investigating the Early Life Determinants of Type-II Diabetes Using a Project Talent-Medicare Linked Data-set

The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males

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