Socio-economic status over the life course and obesity: Systematic review and meta-analysis.

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obesity 62 Title: PLoS ONESocio-economic status over the life course and obesity : Systematic review and meta-analysisAlternative Title: Life course socio-economic status and obesity
obesity 163 obesity: Systematic review and meta-analysisAlternative Title: Life course socio-economic status and obesity reviewSuzy NewtonDejana BraithwaiteTomi F. Akinyemiju [1]Department of Epidemiology, University of Alabama
obesity 967 literature on the association of childhood, adulthood and life course socio-economic status (SES) with obesity between January 1990 and June 2015.MethodsThe major medical electronic databases were searched to identify
obesity 1144 electronic databases were searched to identify studies that examined SES over the life-course in relation to obesity . A total of 219 studies were identified through the initial search, and 35 qualified for full review.
obesity 1458 upper-middle income countries.ResultsThere was a consistent association between lower life course SES and obesity among women (summary OR: 1.35, 95% CI: 1.04, 1.76), but not among men (summary OR: 0.92, 95% CI: 0.60,
obesity 2069 difference: -0.10, 95% CI: -0.11, -0.08).ConclusionThe inverse relationship between life course SES and obesity among women was consistent, based mostly on studies in developed countries. Nevertheless, critical information
obesity 2262 Nevertheless, critical information gaps remain in relation to the impact of childhood and life course SES on obesity in developing countries.Data AvailabilityAll relevant data are within the paper and its Supporting Information
obesity 2431 are within the paper and its Supporting Information files.BackgroundAlthough the global prevalence of obesity nearly doubled between 1980 and 2008, obesity rates have risen faster in low- and middle- income countries
obesity 2477 Information files.BackgroundAlthough the global prevalence of obesity nearly doubled between 1980 and 2008, obesity rates have risen faster in low- and middle- income countries (LMICs) compared with high income countries
obesity 3047 health, and a recent Institute of Medicine report recognized that chronic disease risk factors, such as obesity , are likely shaped over the life course during critical windows of development from childhood to adolescence
obesity 3440 chronic diseases [[10]]. These observations, coupled with evidence of increasing global prevalence of obesity and obesity-associated chronic diseases, which are also socio-economically patterned, highlight the
obesity 3452 diseases [[10]]. These observations, coupled with evidence of increasing global prevalence of obesity and obesity -associated chronic diseases, which are also socio-economically patterned, highlight the importance of
obesity 3607 socio-economically patterned, highlight the importance of understanding the socio-economic patterns of obesity over the life course.Current recommendations from the World Cancer Research Fund (WCRF) state that median
obesity 3946 transition from low to middle income, understanding the demographic and socio-economic patterns of obesity across the life course will be critical for avoiding the obesity trend observed as middle-income countries
obesity 4011 demographic and socio-economic patterns of obesity across the life course will be critical for avoiding the obesity trend observed as middle-income countries transition to high-income[[2]]. Progress on reducing obesity
obesity 4114 obesity trend observed as middle-income countries transition to high-income[[2]]. Progress on reducing obesity and obesity-associated chronic diseases requires a thorough understanding of risk factors starting in
obesity 4126 observed as middle-income countries transition to high-income[[2]]. Progress on reducing obesity and obesity -associated chronic diseases requires a thorough understanding of risk factors starting in early life
obesity 4254 diseases requires a thorough understanding of risk factors starting in early life in order to inform obesity prevention strategies that have the best chance of success. In this systematic review and meta-analysis,
obesity 4444 review and meta-analysis, we summarize the existing literature on the link between life course SES and obesity , and assessed similarities and differences between studies from developed and developing countries.MethodsData
obesity 5107 ‘father’s’, ‘mother’s’ combined with any of the following keywords: ‘body mass index’, ‘ obesity ’, ‘adiposity’, and ‘weight change’. Included studies were those focused on adults and published
obesity 5887 prevalence) and standard errors (SE or 95% confidence interval) between life course SES and a measure of obesity (weight, BMI, waist-to-hip ratio, adiposity). If there was no data on confidence interval or standard
obesity 6667 country of the study, study design, study population demographics, sample size, SES construct, BMI or obesity measure and study covariates. We extracted estimates and 95% CI or standard errors for the two most
obesity 9974 [18]–[20], [22], [23], [25]] provided estimates of the association between life course SES and measures of obesity that were adjusted for confounders, while six studies [[4], [12], [13], [17], [21], [24]] reported only
obesity 10264 and selection results.10.1371/journal.pone.0177151.t001Table 1Studies reviewing life course SES and obesity , published 1990–2015.Author, yearCountryDesignPopulationMeasure of Lifecourse SESNEstimate Low vs.
obesity 12528 7–12Parental material endowments, skills, knowledge, material, human, and social capital+own of above12940RRR obesity (BMI) incidence (CI): M: 1.18(.82–1.7); F: 3.01(1.95–4.66); RRR obesity (BMI) persistence (CI):
obesity 12604 capital+own of above12940RRR obesity (BMI) incidence (CI): M: 1.18(.82–1.7); F: 3.01(1.95–4.66); RRR obesity (BMI) persistence (CI): M: 1.98(1.25–3.15); F: 3.56(2.01–6.3)ageMen were slightly more likely to
obesity 15199 fruit/veg consumption, strenuous exerciseWomen in the stable low lifecourse SES group had twice the odds of obesity compared to women in the stable high lifecourse SES group, but this was not statistically significantEbrahim,
obesity 15456 60–79 yearsFather's occupation+ own occupation2936PR (CI): 1.88(1.63–2.87)ageThe prevalence of obesity was higher among women with low lifecourse SES (adult and childhood manual occupation) compared with
obesity 15705 2004[[24]]SpainCross-sectionalMales and females aged 60 and olderFather's occupation+own occupation4009General obesity PR (CI): M: 1.01 (.84–1.21); F: 1.21(1.06–1.38); Abdominal obesity PR (CI): M: 1.02(.9–1.16);
obesity 15776 occupation+own occupation4009General obesity PR (CI): M: 1.01 (.84–1.21); F: 1.21(1.06–1.38); Abdominal obesity PR (CI): M: 1.02(.9–1.16); F: 1.11(1.04–1.18)noneThe prevalence of general obesity was higher among
obesity 15863 1.21(1.06–1.38); Abdominal obesity PR (CI): M: 1.02(.9–1.16); F: 1.11(1.04–1.18)noneThe prevalence of general obesity was higher among women of low lifecourse SES (working class childhood and adulthood) compared with high
obesity 18875 life course SES and BMI categoriesSeven studies examined life course SES in relation to the odds of obesity (Fig 3) among males and females [[14]–[16], [18], [19], [21], [24]], while two other studies examined
obesity 19296 Singapore, and one middle-income country- Brazil. There was no significant difference in the odds of obesity by life course SES among males (Summary OR: 0.92, 95% CI: 0.60–1.40). In contrast, females of lower
obesity 19455 95% CI: 0.60–1.40). In contrast, females of lower life course SES had significantly higher odds of obesity compared with those of higher life course SES (Summary OR: 1.76, 95% CI: 1.38–2.25). Two studies reported
obesity 19676 estimates that were un-stratified by gender [[22], [23]], and also showed a higher summary odds ratio of obesity among lower life course SES compared with higher life course SES (Summary OR: 1.88, 95% CI: 1.6402.17).
obesity 19932 studies was 1.35 (1.04–1.76). While all of the included studies for females reported higher OR for obesity among lower life course SES participants, two out of the seven studies of males reported lower ORs among
obesity 20634 designs, and based in the U.S. and U.K.10.1371/journal.pone.0177151.g003Fig 3Summary odds ratio for obesity by life course SES.Association between life course SES and waist circumferenceThree studies examined
obesity 21884 by life course SES.DiscussionWe focused our review on the influence of SES across the life course on obesity . Whereas we observed that there were somewhat consistent findings for the association between life course
obesity 22006 observed that there were somewhat consistent findings for the association between life course SES and obesity in developed countries[[4], [13], [14], [16], [18]–[20], [22], [23], [26], [27]], there was very little
obesity 23563 consistent with Monteiro’s and Dinsa’s reviews indicating that the association between SES and obesity becomes inverted as countries transition into higher income [[31], [32]]. Singapore was an interesting
obesity 24282 is needed to illuminate the socio-economic transition that occurred in Singapore, and the impact of obesity and associated chronic diseases in adulthood.The studies included in this review sought to determine
obesity 24415 diseases in adulthood.The studies included in this review sought to determine the influence of SES on obesity from childhood through adulthood, providing a comprehensive investigation of reported differences in
obesity 24635 developed and developing countries. Although some studies find that the effects of childhood SES on adult obesity were attenuated when adult SES was accounted for[[4], [6], [13], [14], [20], [22], [23], [27], [33]–[45]],
obesity 25662 with a few studies in middle-income countries where the association between childhood SES and adult obesity remains inconsistent. This highlights the need for more studies in developing countries, where chronic
obesity 26219 developing countries suggest that there may be opposite, but consistent associations between adult SES and obesity which may also vary by gender. Several reviews of the literature have been conducted focusing on adult
obesity 26338 also vary by gender. Several reviews of the literature have been conducted focusing on adult SES and obesity across countries, with most concluding that there are no consistent associations between obesity and
obesity 26435 and obesity across countries, with most concluding that there are no consistent associations between obesity and SES among men [[8], [31], [32]]. High-income countries consistently show an inverse relationship
obesity 26566 [31], [32]]. High-income countries consistently show an inverse relationship between adult SES and obesity [[4]–[9], [49]]. Data from middle-income countries are somewhat less consistent, but this is most likely
obesity 26835 in previous literature reviews, in which the authors concluded that the association between SES and obesity in women changes from a positive association to an inverse association as a country’s GDP increases
obesity 27276 suggest this link is complicated and changes as nations become more developed. The decreasing levels of obesity in higher SES women observed in more recent studies could be attributed to the availability of more
obesity 27620 the opposite shift in women, with low-income groups transitioning from excessive under-nutrition to obesity within 20 years[[50]]. Public health messages on obesity prevention and physical activity should target
obesity 27677 transitioning from excessive under-nutrition to obesity within 20 years[[50]]. Public health messages on obesity prevention and physical activity should target both higher SES adults as well as lower SES adults in
obesity 27967 from developed countries where, as high SES adults became more aware of the negative health impact of obesity , consumption of food with low dietary quality was reduced, but similar reductions were not observed
obesity 29731 related deaths are preventable through prevention strategies focused on modifiable risk factors such as obesity , physical activity and nutrition [[60]–[63]]. Specifically, recent studies estimate that when started
obesity 29965 proportion of chronic diseases like cancer and cardiovascular diseases are preventable by reducing obesity and excess weight, and increasing physical activity [[62], [63]]. This systematic review and meta-analysis
obesity 30150 systematic review and meta-analysis summarizes the existing literature on the association between SES and obesity , highlighting the need for public health strategies in population subgroups most vulnerable to obesity
obesity 30253 obesity, highlighting the need for public health strategies in population subgroups most vulnerable to obesity (due to easy access to cheap, unhealthy foods and lack of physical activity) and the need for effective
obesity 30414 lack of physical activity) and the need for effective strategies that have the best chance of reducing obesity at early ages. The lack of information regarding the association between childhood and life course SES
obesity 30529 early ages. The lack of information regarding the association between childhood and life course SES and obesity in developing countries highlights the need for empirical studies to inform obesity prevention strategies
obesity 30613 course SES and obesity in developing countries highlights the need for empirical studies to inform obesity prevention strategies in developing countries. Ethical Approval: This study was conducted using data

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