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Epidemiology and Population Health

Socioeconomic inequalities in weight, height and body mass index from birth to 5 years

International Journal of Obesity volume 42, pages 1671–1679 (2018)Cite this article

Subjects

Abstract

Background/Objectives

Studies in high-income countries show that despite the positive association of weight with socioeconomic position at birth, an inverse socioeconomic gradient in overweight (OW) appears later in childhood. The objectives were to understand the natural history of socioeconomic inequalities in weight, height and body mass index (BMI), by investigating their associations with maternal educational level between birth and 5 years, separately in boys and girls.

Subjects/Methods

A published work of growth modelling between birth and 5 years allowed us to calculate predicted weight, height and BMI at 1 month, 6 months, 1, 3 and 5 years for 1735 children from the French EDEN mother–child cohort. Associations between maternal education and predicted measures of body size were analysed with marginal linear and logistic models, stratified by sex.

Results

In girls, despite a positive association between maternal education and birthweight, an inverse socioeconomic gradient was observed as early as 1 month for BMI. Girls whose mothers had low education levels were shorter on the whole than their counterparts with better-educated mothers, despite their similar weights. In boys, no socioeconomic gradient in BMI was observed at any age, including birth, but positive associations were found as early as 1 month for both weight and height.

Conclusions

The emergence of an inverse socioeconomic gradient in BMI and OW apparently results from a complex pattern of socioeconomic inequalities in weight and height from 1 month onwards. The very start of life thus appears to be an important window of opportunity for addressing socioeconomic inequalities in growth.

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Acknowledgements

We are extremely grateful to all the families who took part in this study, the midwives and psychologists who recruited and followed them, and the whole EDEN team, including research scientists, engineers, technicians and managers and especially Josiane Sahuquillo and Edith Lesieux for their commitment and their role in the success of the study. We also acknowledge the commitment of the members of the EDEN Mother–Child Cohort Study Group listed below. We thank Jo Ann Cahn for her help in preparing the manuscript.

Members of the EDEN Mother–Child Cohort Study Group

I. Annesi-Maesano, J.Y. Bernard, J. Botton, M.A. Charles, P. Dargent-Molina, B. de Lauzon-Guillain, P. Ducimetière, M. de Agostini, B. Foliguet, A. Forhan, X. Fritel, A. Germa, V. Goua, R. Hankard, B. Heude, M. Kaminski, B. Larroque†, N. Lelong, J. Lepeule, G. Magnin, L. Marchand, C. Nabet, F Pierre, R. Slama, M.J. Saurel-Cubizolles, M. Schweitzer and O. Thiebaugeorges.

Author contributions

MB, SL, BH and JB conceived and designed the work, with advice from MAC. MB analysed the data with advice from BH, JB and SL. MB, BH and SL drafted and revised the manuscript. All authors interpreted the data and criticised the manuscript for important intellectual content. MAC and BH designed and led the EDEN mother–child cohort. AF is responsible for the EDEN data management. JB and SC have fitted weight and height growth trajectories using the Jenss–Bayley nonlinear model and provided the relevant data. All authors have read and approved the final version of the manuscript. This article is the work of the authors. MB serves as guarantor for the contents of this article. All authors had full access to all of the data (including statistical reports and tables) in the study and take the responsibility for the integrity of the data and the accuracy of the data analysis. All researchers are independent of the funding bodies. All members in the EDEN –child cohort study group designed the study and revised the draft manuscript.

Funding

Support for the EDEN study (Étude des Déterminants pré- et postnatals précoces du développement et de la santé de l’ENfant) was provided by the following organisations: Fondation pour la Recherche Médicale, French Ministry of Research, Institut Fédératif de Recherche and Cohort Program, INSERM Nutrition Research Program, French Ministry of Health Perinatal Program, French Agency for Environment Security (AFFSET), French National Institute for Population Health Surveillance (INVS), Paris-Sud University, French National Institute for Health Education (INPES), Nestlé, Mutuelle Générale de l'Éducation Nationale, French Speaking Association for the Study of Diabetes and Metabolism (Alfediam), National Agency for Research (ANR nonthematic program), and National Institute for Research in Public Health (IRESP TGIR Cohorte Santé 2008 Program). The study sponsors were not involved in the study design, data collection or data analyses.

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Authors and Affiliations

  1. Paris Descartes University, Paris, France

    M. Ballon, J. Botton, M. A. Charles, S. Carles, B. de Lauzon-Guillain, A. Forhan, B. Heude & S. Lioret

  2. U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Early Origin of the Child’s Health and Development Team (ORCHAD), Inserm, Villejuif, France

    M. Ballon, J. Botton, M. A. Charles, S. Carles, B. de Lauzon-Guillain, A. Forhan, B. Heude & S. Lioret

  3. Faculty of Pharmacy, Université Paris-Sud, Université Paris-Saclay, 92296, Châtenay-Malabry, France

    J. Botton

  4. Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC, Australia

    A. J. Cameron

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  1. M. Ballon
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on behalf of the EDEN Mother–Child Cohort Study Group

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Correspondence to M. Ballon.

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Members of the EDEN Mother–Child Cohort Study Group are listed below Acknowledgements.

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Ballon, M., Botton, J., Charles, M.A. et al. Socioeconomic inequalities in weight, height and body mass index from birth to 5 years. Int J Obes 42, 1671–1679 (2018). https://doi.org/10.1038/s41366-018-0180-4

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