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Reply to ‘Area-level deprivation and adiposity in children: is the relationship linear?’

International Journal of Obesity volume 38, page 160 (2014)Cite this article

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We were interested to read the recent paper by Griffiths et al.1 that reported a nonlinear relation between obesity and deprivation, and reduced prevalence of obesity in the most deprived children, as measured by the Income Deprivation Affecting Children Index (IDACI), along with the accompanying editorial by Kelly.2 We have extensively analysed data from the National Child Measurement Programme (NCMP), which collects around half a million child measurements each year from children in year 6 (age 10–11 years) with a response rate of over 90%.3, 4, 5, 6, 7, 8 NCMP data have consistently shown child obesity prevalence to be highest among the most deprived areas in the country, and lowest in the least deprived areas, with an approximately linear trajectory between these extremes.3, 9

The data presented by Griffiths et al.1 show the highest probability of obesity prevalence around the middle of the IDACI range, which the authors described as ‘middle affluent’. Press coverage of the paper, and the accompanying editorial, described this as ‘middle class’.1, 2, 10, 11 IDACI scores, which range between 0.0 and 1.0, equate to the ‘proportion of children living in income deprived households’. The numerical scores are not distributed evenly across the population; the mean 2007 IDACI score across the country is 0.21, and across the sample in the paper was 0.24. The peaks of obesity prevalence shown by Griffiths et al.1 occur at IDACI scores of approximately 0.30 for girls and 0.45 for boys. Only 26% of all Lower Layer Super Output Areas (LSOAs) in England have an IDACI score >0.30 and just 12% have an IDACI score >0.45. The pattern is similar in Leeds, so the apparent peaks in obesity prevalence described by Griffiths et al.1 therefore occur in areas of above average levels of deprivation, both nationally and locally, not within ‘middle-class’ groups.

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References

  1. Griffiths C, Gately P, Marchant PR, Cooke CB . Area-level deprivation and adiposity in children: is the relationship linear? Int J Obesity 2013; 37: 486–492.

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  2. Kelly SJ . Deprivation indices and childhood BMI: a re-evaluation. Int J Obesity 2013; 37: 475–476.

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  3. Ridler C, Dinsdale H, Rutter H . National Child Measurement Programme: changes in children’s body mass index between 2006/07 and 2011/12. National Obesity Observatory: Oxford, 2013.

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  7. Ridler C, Townsend N, Dinsdale H, Mulhall C, Rutter H . National Child Measurement Programme: detailed analysis of the 2007/08 National Dataset. National Obesity Observatory: Oxford, 2009.

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  8. Dinsdale H, Rutter H . National Child Measurement Programme: detailed analysis of the 2006/07 National Dataset. Department of Health: London, 2008.

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  9. The Health and Social Care Information Centre. National Child Measurement Programme: England, 2011/12 School Year. Health and Social Care Information Centre: London December 2012.

  10. Bennett R Middle class children most likely to be obese, says school study. The Times online 13 February 2013 http://www.thetimes.co.uk/tto/health/news/article3685658.ece (Accessed 19/03/2013).

  11. Dixon H Middle-class children more likely to be obese. The Telegraph online 12 February 2013 http://www.telegraph.co.uk/health/healthnews/9864364/Middle-class-children-more-likely-to-be-obese.html (Accessed 19/03/2013).

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Authors and Affiliations

  1. London School of Hygiene and Tropical Medicine, London, UK

    H Rutter

  2. Obesity Knowledge and Intelligence, Public Health England, Oxford, UK

    C Hancock

  3. Teeside University, Tees Valley, UK

    L Ells

Authors
  1. H Rutter
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  2. C Hancock
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  3. L Ells
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Correspondence to H Rutter.

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Rutter, H., Hancock, C. & Ells, L. Reply to ‘Area-level deprivation and adiposity in children: is the relationship linear?’. Int J Obes 38, 160 (2014). https://doi.org/10.1038/ijo.2013.65

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