Socioeconomic status in childhood and obesity in adults: a population-based study

Wagner, Katia Jakovljevic Pudla; Bastos, João Luiz Dornelles; Navarro, Albert; Gonzalez-Chica, David Alejandro; Boing, Antonio Fernando

doi:10.11606/S1518-8787.2018052000123

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Sumário

Original Article • Rev. Saúde Pública 52 • 2018 • https://doi.org/10.11606/S1518-8787.2018052000123 copy

Socioeconomic status in childhood and obesity in adults: a population-based study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To test whether there is an association between socioeconomic status in childhood and measures of body mass index, waist circumference and the presence of overall and abdominal obesity in adult life.

METHODS

A cross-sectional analysis of a population-based cohort study, including a sample of adults (22–63 years old) living in Florianópolis, Southern Brazil. The socioeconomic status in childhood was analyzed through the education level of the participant’s parents. Height, weight and waist circumference were measured by previously trained interviewers. Linear and logistic regressions with adjustment for confounding factors and stratification of data according to gender were used.

RESULTS

Of the 1,222 adults evaluated, 20.4% (95%CI 18.1–22.8) presented overall obesity and 24.8% (95%CI 22.4–27.4), abdominal obesity. The body mass index and waist circumference averages among women were, respectively, 1.2 kg/m² (95%CI -2.3– -0.04) and 2.8 cm (95%CI -5.3– -0.2) lower among those with higher socioeconomic status in childhood. Among men, waist circumference was 3.9 cm (95%CI 1.0–6.8) higher in individuals with higher socioeconomic status in childhood. Regarding obesity, women of higher socioeconomic status in childhood had lower odds of abdominal obesity (OR = 0.56, 95%CI 0.34–0.90), and no such association was observed among men.

CONCLUSIONS

The socioeconomic status in childhood influences body mass index, waist circumference and obesity in adults, with a difference in the direction of association according to gender. The higher socioeconomic status among men and the lower socioeconomic status among women were associated with higher adiposity indicators.

Adult; Obesity, epidemiology; Risk Factors; Socioeconomic Factors; Cross-Sectional Studies

Interviewee’s age	Interviewee’s education level	Father’s education level	Mother’s education level

	(years of study and p25–p75)	(years of study and p25–p75)	(years of study and p25–p75)
22–31 years	11 (11–15)	11 (5–15)	11 (5–14)
32–41 years	11 (10–16)	8 (4–13)	8 (4–11)
42–51 years	11 (8–15)	4 (4–11)	4.5 (4–11)
52–63 years	11 (7–15)	4 (4–11)	4 (4–11)

Variable	Men		Women

	Baseline (2009)	First follow-up* (2012)	Baseline (2009)	First follow-up (2012)

	n = 761	n = 522	n = 959	n = 700
	%	%	%	%
Age (years)
20–29	34.2	28,9*	29.2	25,3*
30–39	22.6	22.2	22.9	23.0
40–49	23.8	26.1	26.8	29.9
50 or older	19.4	22.8	21.1	21.9
Education (years)
0–4	9.1	8.3	9.3	9.3
5–8	14.3	12.9	15.1	15.3
9–11	34.7	34.4	31.8	30.8
12 or more	41.9	44.4	43.7	44.6
Nutritional status (BMI)
Low weight	1.1	1.0	2.8	3.0
Eutrophy	46.1	45.1	53.4	51.6
Overweight	37.5	38.4	27.0	26.6
Obesity	15.3	15.5	16.8	18.8

Exposure variable (N)	Women (n = 700)				Men (n = 522)

	BMI	WC	Overall obesity	Abdominal obesity	BMI	WC	Overall obesity	Abdominal obesity

	Average (SD)	Average (SD)	% (95%CI)	% (95%CI)	Average (SD)	Average (SD)	% (95%CI)	% (95%CI)
Total	26.4 (5.2)	83.3 (13.4)	21.2 (18.2–24.5)	29.7 (26.3–33.3)	26.6 (4.2)	92.3 (12.6)	19.3 (16.0–23.1)	18.8 (15.6–22.5)
Father’s education level
Low (n = 598)	26.7 (5.2)	83.8 (13.8)	23.3 (19.0–28.2)	32.0 (27.2–37.2)	26.2 (4.4)	90.3 (12.3)	17.7 (13.2–23.2)	16.9 (12.6–22.2)
High (n = 428)	25.3 (4.7)	80.5 (11.9)	12.8 (9.0–18.0)	19.5 (14.8–25.2)	27.0 (4.0)	95.0 (12.8)	21.7 (16.2–28.3)	21.5 (16.1–28.0)
Mother’s education level
Low (n = 605)	26.8 (5.3)	83.2 (13.0)	23.0 (18.8–27.9)	31.1 (26.3–36.2)	26.2 (4.4)	90.3 (12.5)	17.9 (13.5–23.4)	14.6 (10.6–19.7)
High (n = 466)	25.5 (4.7)	81.8 (12.9)	16.3 (12.0–21.6)	24.3 (19.3–30.1)	26.8 (4.2)	94.0 (13.1)	19.3 (14.3–25.4)	21.7 (16.5–27.9)
Participant’s age (years)
22 to 31 (n = 293)	24.2 (4.7)	76.3 (9.9)	10.9 (6.7–17.5)	13.0 (8.4–19.6)	25.5 (4.2)	86.9 (11.3)	15.4 (10.0–23.1)	10.5 (6.1–17.3)
32 to 41 (n = 279)	26.5 (5.6)	82.2 (13.9)	23.2 (16.9–31.0)	26.2 (19.7–33.9)	26.9 (4.8)	91.9 (13.2)	19.5 (13.1–27.9)	16.9 (11.1–24.9)
42 to 51 (n = 328)	26.7 (4.6)	84.6 (13.0)	21.3 (16.0–27.8)	31.9 (25.9–39.0)	26.9 (3.9)	93.3 (9.4)	19.1 (13.0–27.0)	19.0 (13.0–27.0)
52 to 63 (n = 165)	27.7 (5.1)	88.2 (13.4)	27.0 (20.9–34.0)	43.3 (36.2–50.7)	27.0 (3.9)	96.6 (13.9)	23.2 (16.5–31.5)	26.7 (19.8–35.0)
Current education (years)
0 a 4 (n = 165)	28.5 (5.3)	89.1 (11.8)	35.9 (24.9–48.7)	50.0 (37.7–62.3)	26.5 (4.8)	94.1 (15.8)	25.6 (14.0–42.2)	22.5 (11.8–38.7)
5 to 8 (n = 174)	27.8 (5.7)	86.6 (14.8)	32.0 (23.5–41.9)	37.2 (28.3–47.2)	26.5 (4.2)	90.5 (11.5)	20.6 (12.2–32.7)	17.5 (9.8–29.2)
9 to 11 (n = 394)	26.5 (4.9)	84.6 (14.2)	20.6 (15.4–26.9)	32.5 (26.4–39.3)	26.6 (4.3)	91.8 (12.4)	16.7 (11.7–23.1)	15.5 (10.8–21.7)
12 or more (n = 543)	25.5 (4.9)	79.9 (11.6)	14.5 (10.9–19.2)	20.7 (16.5–25.8)	26.6 (4.2)	92.7 (12.3)	20.0 (15.1–25.9)	20.0 (15.2–25.8)

Exposure variable	BMI			WC

	Gross coefficient (95%CI)	Adjusted coefficient (95%CI)^a	Adjusted coefficient (95%CI)^b	Gross coefficient (95%CI)	Adjusted coefficient (95%CI)^a	Adjusted coefficient (95%CI)^b
Women
Father’s education level	p = 0.019	p = 0.004	p = 0.043	p = 0.013	p = 0.001	p = 0.033
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	-1.3 (-2.4– -0.2)	-1.6 (-2.7– -0.5)	-1.2 (-2.3– -0.04)	-3.5 (-6.2– -0.7)	-4.4 (-6.9– -1.9)	-2.8 (-5.3– -0.2)
Mother’s education level	p = 0,012	p = 0.001	p = 0.032	p = 0.304	p = 0.039	p = 0.729
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	-1.3 (-2.4– -0.3)	-1.7 (-2.6– -0.7)	-1.1 (-2.1– -0.1)	-1.4 (-4.0–1.3)	-2.5 (-4.8– -0.1)	-0.4 (-2.7–1.9)
Men
Father’s education level	p = 0.066	p = 0.140	p = 0.100	p = 0.002	p = 0.007	p = 0.009
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	0.8 (-0.05–1.7)	0.6 (-0.2–1.5)	0.7 (-0.1–1.5)	4.7 (1.8–7.6)	3.9 (1.1–6.6)	3.9 (1.0–6.8)
Mother’s education level	p = 0,111	p = 0.283	p = 0.340	p = 0.011	p = 0.075	p = 0.092
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	0.6 (-0.1–1.4)	0.4 (-0.3–1.2)	0.4 (-0.4–1.2)	3.6 (0.8–6.3)	2.4 (-0.2–5.1)	2.4 (-0.4–5.3)

Exposure variable	Overall obesity			Abdominal obesity

	Gross OR (95%CI)	Adjusted OR (95%CI)^a	Adjusted OR (95%CI)^b	Gross OR (95%CI)	Adjusted OR (95%CI)^a	Adjusted OR (95%CI)^b
Women
Father’s education level	p = 0.032	p = 0.016	p = 0.086	p = 0.017	p = 0.002	p = 0.018
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	0.56 (0.33–0.95)	0.51 (0.29–0.88)	0.61 (0.35–1.07)	0.55 (0.34–0.89)	0.48 (0.30–0.76)	0.56 (0.34–0.90)
Mother’s education level	p = 0.089	p = 0.038	p = 0.317	p = 0.412	p = 0.024	p = 0.308
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	0.66 (0.41–1.07)	0.60 (0.37–0.97)	0.78 (0.48–1.27)	0.80 (0.48–1.36)	0.61 (0.40–0.94)	0.79 (0.51–1.24)
Men
Father’s education level	p = 0.454	p = 0.466	p = 0.505	p = 0.310	p = 0.433	p = 0.443
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	1.23 (0.71–2.13)	1.22 (0.70–2.12)	1.23 (0.66–2.27)	1.33 (0.76–2.35)	1.26 (0.70–2.30)	1.28 (0.68–2.41)
Mother’s education level	p = 0.818	p = 0.906	p = 0.938	p = 0.064	p = 0.122	p = 0.161
Low	Ref	Ref	Ref	Ref	Ref	Ref
High	1.06 (0.66–1.70)	1.03 (0.64–1.66)	0.98 (0.53–1.79)	1.64 (0.97–2.77)	1.54 (0.89–2.65)	1.54 (0.84–2.84)

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[1] Correspondence: Katia Jakovljevic Pudla Wagner. Universidade Federal de Santa Catarina – Campus Curitibanos. Centro de Educação Profissional Professor Enori Pozzo – CEDUP. Av. Adv. Sebastião Calomeno, s/n São Francisco. 89520-000 Curitibanos, SC, Brasil. E-mail: katia.wagner@ufsc.br