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Connecting the Dots in Childhood Obesity Disparities: a Review of Growth Patterns from Birth to Pre-Adolescence

  • Social Epidemiology (JM Oakes, Section Editor)
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Abstract

In this review, we considered how disparities in obesity emerge between birth, when socially disadvantaged infants tend to be small, and later in childhood, when socially disadvantaged groups have high risk of obesity. We reviewed epidemiologic evidence of socioeconomic and racial/ethnic differences in growth from infancy to pre-adolescence. Minority race/ethnicity and lower socioeconomic status was associated with rapid weight gain in infancy but not in older age groups, and social differences in linear growth and relative weight were unclear. Infant feeding practices was the most consistent mediator of social disparities in growth, but mediation analysis was uncommon and other factors have only begun to be explored. Complex life course processes challenge the field of social epidemiology to develop innovative study designs and analytic techniques with which to pose and test challenging yet impactful research questions about how obesity disparities evolve throughout childhood.

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Acknowledgments

The project described was funded by the Office of Research in Women’s Health and the National Institute of Child Health and Human Development, Oregon BIRCWH Award Number K12HD043488-01 (JBH) and National Institute of Diabetes and Digestive and Kidney Diseases, award number K01DK102857-01 (JBH).

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Authors and Affiliations

  1. OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CB669, Portland, OR, 97239-3098, USA

    Janne Boone-Heinonen & Erin E Takemoto

  2. School of Community Health, Portland State University, 470H Urban Center, 506 SW Mill St., Portland, OR, 37201, USA

    Lynne C Messer

  3. Division of Epidemiology & Community Health, University of Minnesota, 1300 S 2nd St, Ste 300, Minneapolis, MN, 55454, USA

    Kate E Andrade

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  1. Janne Boone-Heinonen
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Correspondence to Janne Boone-Heinonen.

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Conflict of Interest

Janne Boone-Heinonen declares grants from National Institute of Child Health and Human Development and from National Institute of Diabetes and Digestive and Kidney Diseases.

Lynne Messer, Kate Andrade, and Erin Takemoto declare that they have no conflict of interest.

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Appendix

Appendix

Literature Search Methods

We searched for publications in PubMed that reported race/ethnic or socioeconomic (income or education) differences in growth in weight, length or height, relative weight (body mass index [BMI] or weight-for-length z-scores), or adiposity. We applied search terms capturing concepts of (a) growth (“weight gain” or [(“body mass index” or “weight” or “height” or “adiposity”) and (growth or trajectory)]), (b) early life (infant or infancy or “early life” or neonatal or newborn), and (c) social divisions (income or race or ethnicity or ethnic or socioeconomic or “social class”). We conducted our search in September 2015, limiting to 3646 papers published or published ahead of print as of September 15, 2015, dating back to January 1, 2000. In addition to keyword searches, we examined references from relevant papers.

We include peer reviewed, published manuscripts that report social (race/ethnicity, income, education, or SES index or proxy measure) predictors of growth in weight, height or length, or BMI or other relative weight measure (at least two time points from birth and pre-adolescence [approximated as 12 years of age]). In order to focus on social disparities in early life growth that occurs within obesogenic environments and that are generalizable to Western societies, we exclude studies conducted in developing countries or Asia, or that focus on stunting or special clinical populations (e.g., HIV, congenital abnormalities). While obesity and obesogenic environments are becoming more prevalent in the developing world, obesity etiology is distinct in countries in which Western diet has recently become prevalent. We also exclude papers that focus on a research question other than social predictors of early life growth and only report our associations of interest in descriptive tables. While the papers presented do not represent the universe of relevant studies, we believe they are representative of the literature on social differences in early life growth as of September 2015.

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Boone-Heinonen, J., C Messer, L., E Andrade, K. et al. Connecting the Dots in Childhood Obesity Disparities: a Review of Growth Patterns from Birth to Pre-Adolescence. Curr Epidemiol Rep 3, 113–124 (2016). https://doi.org/10.1007/s40471-016-0065-9

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