In high-income countries, childhood obesity follows a clear socioeconomic gradient with greater prevalence in children with lower socioeconomic status (SES). The extent to which the trend of other social vulnerabilities over time and the accumulation of these vulnerabilities can affect children’s weight is still unknown.


In the IDEFICS study, 8624 children aged 2.0–9.9 years from eight European countries were examined at baseline and after 2 years. Sociodemographic variables, maternal body mass index (BMI), and lifestyle were reported by parents. Children were measured and classified as thin, normal weight, and overweight/obese using the extended IOTF criteria. Four vulnerable groups were defined: children whose parents were migrants, children whose parents lack a social network, children from non-traditional families (children not living with both biological parents), and children with unemployed parents. Logistic mixed-effects models were used to study the association between vulnerabilities and children’s weight at baseline and follow-up, temporal trends in vulnerabilities and children’s weight and accumulation of vulnerabilities and children’s weight. Models were adjusted for lifestyle, maternal BMI, parental education, and income.


Children whose parents lost their social support at follow-up were more likely to be thin than non-vulnerable children (OR = 1.69, 99% CI = 1.03–2.78). Children whose parents had a migrant background (OR = 1.30, 99% CI 1.04–1.62), children from non-traditional families at both time points (OR = 1.40, 99% CI 1.03–1.90) and whose parents were unemployed at baseline and follow-up (OR = 2.03, 99% CI 1.03–3.99) were more likely to be overweight/obese compared to non-vulnerable children. Cross-sectionally, we did not find an association between parental lack of network, non-traditional family structure, or employment and children’s weight status.


Policy actions are required to tackle inadequate weight loss and gain among vulnerable children (especially those exposed over the long term) since they are at a higher risk of thinness and overweight.

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This work has been done as part of the IDEFICS Study (http://www.idefics.eu). The authors gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD). II has been financed by the FPU (grant reference FPU014/00922) Predoctoral Programmes (Spanish Ministry of Education and Science). We thank the IDEFICS children and their parents who generously volunteered and participated in this project.

Author contributions

II carried out the statistical analysis and drafted the manuscript along with LAM. NM and CB designed the statistical analyses. KB, JMF-A, WG, AS, and PR developed the measurement instruments; WA, LL, LR, MT, LAM, and TV supervised the national data collection. Authors read and critically reviewed the manuscript.

Author information

Author notes

  1. These authors contributed equally: Claudia Börnhorst, Luis A. Moreno.


  1. GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain

    • Isabel Iguacel
    • , Juan M. Fernández-Alvira
    •  & Luis A. Moreno
  2. Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain

    • Isabel Iguacel
    •  & Luis A. Moreno
  3. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain

    • Isabel Iguacel
    •  & Luis A. Moreno
  4. Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain

    • Isabel Iguacel
    •  & Luis A. Moreno
  5. Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain

    • Juan M. Fernández-Alvira
  6. Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany

    • Wolfgang Ahrens
    • , Karin Bammann
    •  & Claudia Börnhorst
  7. Institute of Statistics, University of Bremen, Bremen, Germany

    • Wolfgang Ahrens
  8. Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany

    • Karin Bammann
  9. Copenhagen Business School, Copenhagen, Denmark

    • Wencke Gwozdz
    •  & Lucia Reisch
  10. Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden

    • Lauren Lissner
  11. Department of Public Health, Ghent University, Ghent, Belgium

    • Nathalie Michels
  12. Institute of Food Sciences, National Research Council, Avellino, Italy

    • Paola Russo
  13. Department of Paediatrics, University of Pécs, Pécs, Hungary

    • Aliz Szommer
  14. Research and Education Institute of Child Health, Strovolos, Cyprus

    • Michael Tornaritis
  15. Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia

    • Toomas Veidebaum


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  1. on behalf of the IDEFICS consortium

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    The authors declare that they have no conflict of interest.

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    Correspondence to Isabel Iguacel.

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