The impact of familial, behavioural and psychosocial factors on the SES gradient for childhood overweight in Europe. A longitudinal study

Abstract

Background:

In highly developed countries, childhood overweight and many overweight-related risk factors are negatively associated with socioeconomic status (SES).

Objective:

The objective of this study is to investigate the longitudinal association between parental SES and childhood overweight, and to clarify whether familial, psychosocial or behavioural factors can explain any SES gradient.

Methods:

The baseline and follow-up surveys of the identification and prevention of dietary and lifestyle induced health effects in children and infants (IDEFICS) study are used to investigate the longitudinal association between SES, familial, psychosocial and behavioural factors, and the prevalence of childhood overweight. A total of 5819 children (50.5% boys and 49.5% girls) were included.

Results:

The risk for being overweight after 2 years at follow-up in children who were non-overweight at baseline increases with a lower SES. For children who were initially overweight, a lower parental SES carries a lower probability for a non-overweight weight status at follow-up. The effect of parental SES is only moderately attenuated by single familial, psychosocial or behavioural factors; however, it can be fully explained by their combined effect. Most influential of the investigated risk factors were feeding/eating practices, parental body mass index, physical activity behaviour and proportion of sedentary activity.

Conclusion:

Prevention strategies for childhood overweight should focus on actual behaviours, whereas acknowledging that these behaviours are more prevalent in lower SES families.

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References

  1. 1

    Lobstein T, Jackson-Leach R . Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatr Obes 2006; 1: 33–41.

    Article  Google Scholar 

  2. 2

    Pietrobelli A, Espinoza MC, De Cristofaro P . Childhood obesity: looking into the future. Angiology 2008; 59 (2 Suppl): 30S–33S.

    Article  Google Scholar 

  3. 3

    Park MH, Falconer C, Viner RM, Kinra S . The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obes Rev 2012; 13: 985–1000.

    CAS  Article  Google Scholar 

  4. 4

    Kalarchian MA, Marcus MD . Psychiatric comorbidity of childhood obesity. Int Rev Psychiatry 2012; 24: 241–246.

    Article  Google Scholar 

  5. 5

    Reilly JJ, Kelly J . Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond) 2011; 35: 891–898.

    CAS  Article  Google Scholar 

  6. 6

    Karnehed N, Rasmussen F, Hemmingsson T, Tynelius P . Obesity and attained education: cohort study of more than 700,000 Swedish men. Obesity (Silver Spring) 2006; 14: 1421–1428.

    Article  Google Scholar 

  7. 7

    Cawley J, Spiess CK . Obesity and skill attainment in early childhood. Econ Hum Biol 2008; 6: 388–397.

    Article  Google Scholar 

  8. 8

    Shrewsbury V, Wardle J . Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005. Obesity (Silver Spring) 2008; 16: 275–284.

    Article  Google Scholar 

  9. 9

    Ness AR, Leary S, Reilly J, Wells J, Tobias J, Clark E et al. The social patterning of fat and lean mass in a contemporary cohort of children. Int J Pediatr Obes 2006; 1: 59–61.

    Article  Google Scholar 

  10. 10

    Magnusson MB, Sjoberg A, Kjellgren KI, Lissner L . Childhood obesity and prevention in different socio-economic contexts. Prev Med 2011; 53: 402–407.

    Article  Google Scholar 

  11. 11

    Birch LL, Davison KK . Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatr Clin North Am 2001; 48: 893–907.

    CAS  Article  Google Scholar 

  12. 12

    Loth K, Fulkerson JA, Neumark-Sztainer D . Food-related parenting practices and child and adolescent weight and weight-related behaviors. Clin Pract 2014; 11: 207–220.

    CAS  Article  Google Scholar 

  13. 13

    Neumark-Sztainer D, MacLehose R, Loth K, Fulkerson JA, Eisenberg ME, Berge J . What's for dinner? Types of food served at family dinner differ across parent and family characteristics. Public Health Nutr 2014; 17: 145–155.

    Article  Google Scholar 

  14. 14

    Wijtzes AI, Bouthoorn SH, Jansen W, Franco OH, Hofman A, Jaddoe VW et al. Sedentary behaviors, physical activity behaviors, and body fat in 6-year-old children: the generation R study. Int J Behav Nutr Phys Act 2014; 11: 96.

    Article  Google Scholar 

  15. 15

    Reilly JJ . Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention. Proc Nutr Soc 2008; 67: 317–325.

    Article  Google Scholar 

  16. 16

    Stein D, Weinberger-Litman SL, Latzer Y . Psychosocial perspectives and the issue of prevention in childhood obesity. Front Public Health 2014; 2: 104.

    Article  Google Scholar 

  17. 17

    Bammann K, Peplies J, De Henauw S, Hunsberger M, Molnar D, Moreno LA et al. Early life course risk factors for childhood obesity: the IDEFICS case-control study. PLoS ONE 2014; 9: e86914.

    Article  Google Scholar 

  18. 18

    Goisis A, Sacker A, Kelly Y . Why are poorer children at higher risk of obesity and overweight? A UK cohort study. Eur J Public Health 2015; 26: 7–13.

    Article  Google Scholar 

  19. 19

    Bammann K, Gwozdz W, Lanfer A, Barba G, De Henauw S, Eiben G et al. Socioeconomic factors and childhood overweight in Europe: results from the multi-centre IDEFICS study. Pediatr Obes 2013; 8: 1–12.

    CAS  Article  Google Scholar 

  20. 20

    Ahrens W, Bammann K, Siani A, Buchecker K, De Henauw S, Iacoviello L et al. The IDEFICS cohort: design, characteristics and participation in the baseline survey. Int J Obes (Lond) 2011; 35 (Suppl 1): S3–S15.

    Article  Google Scholar 

  21. 21

    Bammann K, Peplies J, Sjöström M, Lissner L, De Henauw S, Galli C et al. Assessment of diet. physical activity and biological, social and environmental factors in a multi-centre European project on diet- and lifestyle-related disorders in children (IDEFICS). J Public Health 2006; 14: 279–289.

    Article  Google Scholar 

  22. 22

    Development OOfEC-oa Growing Unequal? Income distribution and poverty in OECD countries. Development OOfEC-oa: Paris, 2008.

  23. 23

    UNESCO United Nations Educational SaCOIfS ISCED 1997. International Standard Classification of Education. UNESCO United Nations Educational SaCOIfS: Montreal, 2006.

  24. 24

    Harrison E, Rose D . The European Socioeconomic Classification (ESeC). User guide. University of Essex: Colchester, 2006.

    Google Scholar 

  25. 25

    Baughcum AE, Powers SW, Johnson SB, Chamberlin LA, Deeks CM, Jain A et al. Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr 2001; 22: 391–408.

    CAS  Article  Google Scholar 

  26. 26

    Goodman R . The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 1997; 38: 581–586.

    CAS  Article  Google Scholar 

  27. 27

    Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45: 569–581.

    CAS  Google Scholar 

  28. 28

    Bornhorst C, Huybrechts I, Ahrens W, Eiben G, Michels N, Pala V et al. Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls. Br J Nutr 2013; 109: 1257–1265.

    CAS  Article  Google Scholar 

  29. 29

    Bornhorst C, Bel-Serrat S, Pigeot I, Huybrechts I, Ottavaere C, Sioen I et al. Validity of 24-h recalls in (pre-)school aged children: comparison of proxy-reported energy intakes with measured energy expenditure. Clin Nutr 2014; 33: 79–84.

    CAS  Article  Google Scholar 

  30. 30

    Burdette HL, Whitaker RC, Daniels SR . Parental report of outdoor playtime as a measure of physical activity in preschool-aged children. Arch Pediatr Adolesc Med 2004; 158: 353–357.

    Article  Google Scholar 

  31. 31

    Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG . Calibration of two objective measures of physical activity for children. J Sports Sci 2008; 26: 1557–1565.

    Article  Google Scholar 

  32. 32

    Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    CAS  Article  Google Scholar 

  33. 33

    Cole TJ, Flegal KM, Nicholls D, Jackson AA . Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 2007; 335: 194.

    Article  Google Scholar 

  34. 34

    Greenland S . Modeling and variable selection in epidemiologic analysis. Am J Public Health 1989; 79: 340–349.

    CAS  Article  Google Scholar 

  35. 35

    Hosmer DW, Lemeshow S . Applied Logistic Regression. Wiley: New York, 1989.

    Google Scholar 

  36. 36

    Semmler C, Ashcroft J, van Jaarsveld CH, Carnell S, Wardle J . Development of overweight in children in relation to parental weight and socioeconomic status. Obesity (Silver Spring) 2009; 17: 814–820.

    Article  Google Scholar 

  37. 37

    Vollmer RL, Mobley AR . Parenting styles, feeding styles, and their influence on child obesogenic behaviors and body weight. A review. Appetite 2013; 71: 232–241.

    Article  Google Scholar 

  38. 38

    Dubois L, Farmer A, Girard M, Peterson K, Tatone-Tokuda F . Problem eating behaviors related to social factors and body weight in preschool children: a longitudinal study. Int J Behav Nutr Phys Act 2007; 4: 9.

    Article  Google Scholar 

  39. 39

    Musher-Eizenman DR, de Lauzon-Guillain B, Holub SC, Leporc E, Charles MA . Child and parent characteristics related to parental feeding practices. A cross-cultural examination in the US and France. Appetite 2009; 52: 89–95.

    Article  Google Scholar 

  40. 40

    Olsen NJ, Pedersen J, Handel MN, Stougaard M, Mortensen EL, Heitmann BL . Child behavioural problems and body size among 2-6 year old children predisposed to overweight. results from the "healthy start" study. PLoS ONE 2013; 8: e78974.

    CAS  Article  Google Scholar 

  41. 41

    Sawyer MG, Miller-Lewis L, Guy S, Wake M, Canterford L, Carlin JB . Is there a relationship between overweight and obesity and mental health problems in 4- to 5-year-old Australian children? Ambul Pediatr 2006; 6: 306–311.

    Article  Google Scholar 

  42. 42

    Sawyer MG, Harchak T, Wake M, Lynch J . Four-year prospective study of BMI and mental health problems in young children. Pediatrics 2011; 128: 677–684.

    Article  Google Scholar 

  43. 43

    Fulton JE, Dai S, Steffen LM, Grunbaum JA, Shah SM, Labarthe DR . Physical activity, energy intake, sedentary behavior, and adiposity in youth. Am J Prevent Med 2009; 37 (1 Suppl): S40–S49.

    Article  Google Scholar 

  44. 44

    Ness AR, Leary SD, Mattocks C, Blair SN, Reilly JJ, Wells J et al. Objectively measured physical activity and fat mass in a large cohort of children. PLoS Med 2007; 4: e97.

    Article  Google Scholar 

  45. 45

    Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A . Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA 2012; 307: 704–712.

    CAS  Article  Google Scholar 

  46. 46

    Carson V, Rinaldi RL, Torrance B, Maximova K, Ball GD, Majumdar SR et al. Vigorous physical activity and longitudinal associations with cardiometabolic risk factors in youth. Int J Obes (Lond) 2014; 38: 16–21.

    CAS  Article  Google Scholar 

  47. 47

    Riddoch CJ, Leary SD, Ness AR, Blair SN, Deere K, Mattocks C et al. Prospective associations between objective measures of physical activity and fat mass in 12-14 year old children: the Avon Longitudinal Study of Parents and Children (ALSPAC). BMJ 2009; 339: b4544.

    Article  Google Scholar 

  48. 48

    Hjorth P, Davidsen AS, Kilian R, Skrubbeltrang C . A systematic review of controlled interventions to reduce overweight and obesity in people with schizophrenia. Acta Psychiatr Scand 2014; 130: 279–289.

    CAS  Article  Google Scholar 

  49. 49

    Mitchell JA, Mattocks C, Ness AR, Leary SD, Pate RR, Dowda M et al. Sedentary behavior and obesity in a large cohort of children. Obesity (Silver Spring) 2009; 17: 1596–1602.

    Article  Google Scholar 

  50. 50

    De Henauw S, Verbestel V, Marild S, Barba G, Bammann K, Eiben G et al. The IDEFICS community-oriented intervention programme: a new model for childhood obesity prevention in Europe? Int J Obes (Lond) 2011; 35 Suppl 1: S16–S23.

    CAS  Article  Google Scholar 

  51. 51

    Hense S, Pohlabeln H, Michels N, Marild S, Lissner L, Kovacs E et al. Determinants of attrition to follow-up in a multicentre cohort study in children. Results from the IDEFICS study. Epidemiol Res Int 2013; 2013: 936365.

    Google Scholar 

  52. 52

    Goodman R . Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 2001; 40: 1337–1345.

    CAS  Article  Google Scholar 

  53. 53

    Jackson C, Henriksen L, Foshee VA . The Authoritative Parenting Index: predicting health risk behaviors among children and adolescents. Health Educ Behav 1998; 25: 319–337.

    CAS  Article  Google Scholar 

  54. 54

    Cullen KW, Baranowski T, Rittenberry L, Cosart C, Hebert D, de Moor C . Child-reported family and peer influences on fruit, juice and vegetable consumption: reliability and validity of measures. Health Educ Res 2001; 16: 187–200.

    CAS  Article  Google Scholar 

  55. 55

    Bornhorst C, Bel-Serrat S, Pigeot I, Huybrechts I, Ottavaere C, Sioen I et al. Validity of 24-h recalls in (pre-)school aged children: comparison of proxy-reported energy intakes with measured energy expenditure. Clin Nutr 2013; 33: 79–84.

    Article  Google Scholar 

  56. 56

    Gibson RS . Principles of Nutritional Assessment 2nd edn Oxford University Press: Oxford, 2005.

    Google Scholar 

  57. 57

    Stomfai S, Ahrens W, Bammann K, Kovacs E, Marild S, Michels N et al. Intra- and inter-observer reliability in anthropometric measurements in children. Int J Obes (Lond) 2011; 35 (Suppl 1): S45–S51.

    Article  Google Scholar 

  58. 58

    Ojiambo R, Konstabel K, Veidebaum T, Reilly J, Verbestel V, Huybrechts I et al. Validity of hip-mounted uniaxial accelerometry with heart-rate monitoring vs. triaxial accelerometry in the assessment of free-living energy expenditure in young children: the IDEFICS Validation Study. J Appl Physiol 2012; 113: 1530–1536.

    Article  Google Scholar 

  59. 59

    Viswanath K . Public communications and its role in reducing and eliminating health disparities. In: Thomson GE (ed), Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. National Academies Press: Washington, DC, USA, 2006.

    Google Scholar 

  60. 60

    Pena MM, Dixon B, Taveras EM . Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management. Child Obes 2012; 8: 23–27.

    Article  Google Scholar 

  61. 61

    Marmot M, Bell R, Goldblatt P . Action on the social determinants of health. Revue d'epidemiologie et de sante publique 2013; 61 (Suppl 3): S127–S132.

    Article  Google Scholar 

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Acknowledgements

This work was done as part of the IDEFICS Study (www.idefics.eu). We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract Number 016181 (FOOD). We thank the IDEFICS children and their parents for their participation.

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Correspondence to K Bammann.

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Bammann, K., Gwozdz, W., Pischke, C. et al. The impact of familial, behavioural and psychosocial factors on the SES gradient for childhood overweight in Europe. A longitudinal study. Int J Obes 41, 54–60 (2017). https://doi.org/10.1038/ijo.2016.137

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