Socioeconomic Inequalities in Body Mass Index across Adulthood: Coordinated Analyses of Individual Participant Data from Three British Birth Cohort Studies Initiated in 1946, 1958 and 1970

In a harmonized analysis of socioeconomic and anthropometric data from three cohorts, David Bann and colleagues trace the relationship between socioeconomic status and BMI over time in the UK.

Vyšlo v časopise: Socioeconomic Inequalities in Body Mass Index across Adulthood: Coordinated Analyses of Individual Participant Data from Three British Birth Cohort Studies Initiated in 1946, 1958 and 1970. PLoS Med 14(1): e32767. doi:10.1371/journal.pmed.1002214
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pmed.1002214


In a harmonized analysis of socioeconomic and anthropometric data from three cohorts, David Bann and colleagues trace the relationship between socioeconomic status and BMI over time in the UK.


1. Withrow D, Alter D. The economic burden of obesity worldwide: a systematic review of the direct costs of obesity. Obes Rev. 2011;12(2):131–41. doi: 10.1111/j.1467-789X.2009.00712.x 20122135

2. Global BMI Mortality Collaboration. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;20(88):776–86.

3. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81. doi: 10.1016/S0140-6736(14)60460-8 24880830

4. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2012;377(9765):557–67.

5. NCD Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387(10026):1377–96. doi: 10.1016/S0140-6736(16)30054-X 27115820

6. Johnson W, Li L, Kuh D, Hardy R. How Has the Age-Related Process of Overweight or Obesity Development Changed over Time? Co-ordinated Analyses of Individual Participant Data from Five United Kingdom Birth Cohorts. PLoS Med. 2015;12(5):e1001828. doi: 10.1371/journal.pmed.1001828 25993005

7. McLaren L. Socioeconomic status and obesity. Epidemiol Rev. 2007;29:29–48. doi: 10.1093/epirev/mxm001 17478442

8. Senese LC, Almeida ND, Fath AK, Smith BT, Loucks EB. Associations Between Childhood Socioeconomic Position and Adulthood Obesity. Epidemiol Rev. 2009;31(1):21–51.

9. Shrewsbury V, Wardle J. Socioeconomic Status and Adiposity in Childhood: A Systematic Review of Cross-sectional Studies 1990–2005. Obesity. 2008;16(2):275–84. doi: 10.1038/oby.2007.35 18239633

10. The Marmot Review Team. Fair Society, Healthy Lives: The strategic review of health inequalities in England, post 2010. 2010

11. Stringhini S S. ASsociation of socioeconomic position with health behaviors and mortality. JAMA. 2010;303(12):1159–66. doi: 10.1001/jama.2010.297 20332401

12. World Health Organization. Obesity and inequities: Guidance for addressing inequities in overweight and obesity. Available from: 2014.

13. Wardle J, Boniface D. Changes in the distributions of body mass index and waist circumference in English adults, 1993/1994 to 2002/2003. Int J Obes. 2008;32(3):527–32.

14. Scholes S, Bajekal M, Love H, Hawkins N, Raine R, O'Flaherty M, et al. Persistent socioeconomic inequalities in cardiovascular risk factors in England over 1994–2008: A time-trend analysis of repeated cross-sectional data. BMC Public Health. 2012;12(1):129.

15. Zhu J, Coombs N, Stamatakis E. Temporal trends in socioeconomic inequalities in obesity prevalence among economically-active working-age adults in Scotland between 1995 and 2011: a population-based repeated cross-sectional study. BMJ Open. 2015;5(6).

16. Frederick CB, Snellman K, Putnam RD. Increasing socioeconomic disparities in adolescent obesity. Proc Natl Acad Sci USA. 2014;11(4):1338–42.

17. Harper S, Lynch J. Trends in socioeconomic inequalities in adult health behaviors among US states, 1990–2004. Public Health Rep. 2007;122(2):177. 17357360

18. Hajizadeh M, Karen Campbell M, Sarma S. Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses. The European Journal of Health Economics. 2014;15(2):203–21. doi: 10.1007/s10198-013-0469-0 23543117

19. Chang VW, Lauderdale DS. Income disparities in body mass index and obesity in the United States, 1971–2002. Arch Intern Med. 2005;165(18):2122–8. doi: 10.1001/archinte.165.18.2122 16217002

20. Norberg M, Lindvall K, Stenlund H, Lindahl B. The obesity epidemic slows among the middle-aged population in Sweden while the socioeconomic gap widens. Global health action. 2010;3.

21. Jones-Smith JC, Gordon-Larsen P, Siddiqi A, Popkin BM. Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989–2007. Am J Epidemiol. 2011;173(6):667–75. doi: 10.1093/aje/kwq428 21300855

22. Birnie K, Cooper R, Martin RM, Kuh D, Sayer AA, Alvarado BE, et al. Childhood Socioeconomic Position and Objectively Measured Physical Capability Levels in Adulthood: A Systematic Review and Meta-Analysis. PLoS ONE. 2011;6(1):e15564. doi: 10.1371/journal.pone.0015564 21297868

23. Bann D, Cooper R, Wills AK, Adams J, Kuh D. Socioeconomic position across life and body composition in early old age: findings from a British birth cohort study. J Epidemiol Community Health. 2014;68(6):516. doi: 10.1136/jech-2013-203373 24567442

24. Power C, Manor O, Matthews S. Child to adult socioeconomic conditions and obesity in a national cohort. Int J Obes Relat Metab Disord. 2003;27(9):1081–6. doi: 10.1038/sj.ijo.0802323 12917714

25. Strand B, Murray ET, Guralnik J, Hardy R, Kuh D. Childhood social class and adult adiposity and blood-pressure trajectories 36–53 years: gender-specific results from a British birth cohort. J Epidemiol Community Health. 2012;66(6):512–8. doi: 10.1136/jech.2010.115220 21098826

26. Power C, Graham H, Due P, Hallqvist J, Joung I, Kuh D, et al. The contribution of childhood and adult socioeconomic position to adult obesity and smoking behaviour: an international comparison. Int J Epidemiol. 2005;34(2):335–44. doi: 10.1093/ije/dyh394 15659473

27. Langenberg C, Hardy R, Kuh D, Brunner E, Wadsworth M. Central and total obesity in middle aged men and women in relation to lifetime socioeconomic status: evidence from a national birth cohort. J Epidemiol Community Health. 2003;57(10):816–22. doi: 10.1136/jech.57.10.816 14573589

28. Baum CL, Ford WF. The wage effects of obesity: a longitudinal study. Health Econ. 2004;13(9):885–99. doi: 10.1002/hec.881 15362180

29. Tyrrell J, Jones SE, Beaumont R, Astley CM, Lovell R, Yaghootkar H, et al. Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank. BMJ. 2016;352.

30. Lundborg P, Nystedt P, Rooth D-O. Body Size, Skills, and Income: Evidence From 150,000 Teenage Siblings. Demography. 2014;51(5):1573–96. doi: 10.1007/s13524-014-0325-6 25199549

31. Kinge JM. Body mass index and employment status: A new look. Econ Hum Biol. 2016;22:117–25. doi: 10.1016/j.ehb.2016.03.008 27054482

32. King NB, Harper S, Young ME. Use of relative and absolute effect measures in reporting health inequalities: structured review. BMJ. 2012;345.

33. Mackenbach JP, Martikainen P, Menvielle G, de Gelder R. The arithmetic of reducing relative and absolute inequalities in health: a theoretical analysis illustrated with European mortality data. J Epidemiol Community Health. 2016;70(7):730–6. doi: 10.1136/jech-2015-207018 26945094

34. Mackenbach JP, Kulhánová I, Bopp M, Deboosere P, Eikemo TA, Hoffmann R, et al. Variations in the relation between education and cause-specific mortality in 19 European populations: A test of the fundamental causes theory of social inequalities in health. Soc Sci Med. 2014;127:51. doi: 10.1016/j.socscimed.2014.05.021 24932917

35. Phelan JC, Link BG, Tehranifar P. Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications. J Health Soc Behav. 2010;51(1 suppl):S28–S40. doi: 10.1177/0022146510383498 20943581

36. Kuh D, M P, J A, J D, U E, P F, et al. Updating the cohort profile for the MRC National Survey of Health and Development: a new clinic-based data collection for ageing research. Int J Epidemiol. 2011;40(1):e1–e9. doi: 10.1093/ije/dyq231 21345808

37. Wadsworth M, Kuh D, Richards M, Hardy R. Cohort profile: The 1946 National Birth Cohort (MRC National Survey of Health and Development). Int J Epidemiol. 2006;35(1):49–54. doi: 10.1093/ije/dyi201 16204333

38. Power C, Elliott J. Cohort profile: 1958 British birth cohort (National Child Development Study). Int J Epidemiol. 2006;35(1):34–41. doi: 10.1093/ije/dyi183 16155052

39. Elliott J, Shepherd P. Cohort profile: 1970 British birth cohort (BCS70). Int J Epidemiol. 2006;35(4):836–43. doi: 10.1093/ije/dyl174 16931528

40. Wadsworth M. The origins and innovatory nature of the 1946 British national birth cohort study. Longitudinal and Life Course Studies. 2010;1(2):121–36.

41. Wadsworth ME, Bynner J. A Companion to Life Course Studies: the social and historical context of the British birth cohort studies: Taylor & Francis; 2011.

42. Wadsworth M. The imprint of time: Childhood, history and adult life. Oxford, UK: Clarendon Press; 1991 1991.

43. Stafford M, Black S, Shah I, Hardy R, Pierce M, Richards M, et al. Using a birth cohort to study ageing: representativeness and response rates in the National Survey of Health and Development. European Journal of Ageing. 2013;10:145–57. doi: 10.1007/s10433-013-0258-8 23637643

44. Mostafa T, Wiggins RD. The impact of attrition and non-response in birth cohort studies: a need to incorporate missingness strategies. Longitudinal and Life Course Studies. 2015;6(2):131–46.

45. Atherton K, Fuller E, Shepherd P, Strachan D, Power C. Loss and representativeness in a biomedical survey at age 45 years: 1958 British birth cohort. J Epidemiol Community Health. 2008;62(3):216–23. doi: 10.1136/jech.2006.058966 18272736

46. Wadsworth ME, Mann SL, Rodgers B, Kuh DJ, Hilder WS, Yusuf EJ. Loss and representativeness in a 43 year follow up of a national birth cohort. J Epidemiol Community Health. 1992;46(3):300–4. 1645091

47. Shaw RJ, Green MJ, Popham F, Benzeval M. Differences in adiposity trajectories by birth cohort and childhood social class: evidence from cohorts born in the 1930s, 1950s and 1970s in the west of Scotland. J Epidemiol Community Health. 2014.

48. Elhakeem A, Cooper R, Bann D, Hardy R. Childhood socioeconomic position and adult leisure-time physical activity: a systematic review. International Journal of Behavioral Nutrition and Physical Activity. 2015;12(1):92.

49. Gidlow C, Johnston LH, Crone D, Ellis N, James D. A systematic review of the relationship between socio-economic position and physical activity. Health Educ J. 2006;65(4):338–67.

50. Pechey R, Jebb SA, Kelly MP, Almiron-Roig E, Conde S, Nakamura R, et al. Socioeconomic differences in purchases of more vs. less healthy foods and beverages: analysis of over 25,000 British households in 2010. Soc Sci Med. 2013;92:22–6. doi: 10.1016/j.socscimed.2013.05.012 23849275

51. Giskes K, Avendano M, rug J, unst AE. A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults. Obes Rev. 2010;11(6):413–29. doi: 10.1111/j.1467-789X.2009.00658.x 19889178

52. Maguire ER, Monsivais P. Socio-economic dietary inequalities in UK adults: an updated picture of key food groups and nutrients from national surveillance data. Br J Nutr. 2015;113(01):181–9.

53. Bartley M, Fitzpatrick R, Firth D, Marmot M. Social distribution of cardiovascular disease risk factors: change among men in England 1984–1993. J Epidemiol Community Health. 2000;54(11):806–14. doi: 10.1136/jech.54.11.806 11027193

54. Mackenbach JP. Can we reduce health inequalities? An analysis of the English strategy (1997–2010). J Epidemiol Community Health. 2011;65(7):568–75. doi: 10.1136/jech.2010.128280 21459930

55. Butland B, Jebb S, Kopelman P, McPherson K, Mardell J, Parry V. Foresight: Tackling Obesities: Future Choices—Project report. London, UK: 2007.

56. Singh AS, Mulder C, Twisk JWR, van Mechelen W, Chinapaw MJM. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–88. doi: 10.1111/j.1467-789X.2008.00475.x 18331423

57. Nandi A, Glymour MM, Kawachi I, VanderWeele TJ. Using marginal structural models to estimate the direct effect of adverse childhood social conditions on onset of heart disease, diabetes, and stroke. Epidemiology (Cambridge, Mass). 2012;23(2):223.

58. Wiggins S, Keats S, Han E, Shimokawa S, Alberto J, Hernandez V, et al. The Rising Cost of a Healthy Diet: Changing Relative Prices of Foods in High-Income and Emerging Economies. Overseas Development Institute Report May. 2015;67.

59. Barton KL, Wrieden WL, Sherriff A, Armstrong J, Anderson AS. Trends in socio-economic inequalities in the Scottish diet: 2001–2009. Public Health Nutr. 2015;18(16):2970–80. doi: 10.1017/S1368980015000361 25771827

60. Swami V. Cultural influences on body size ideals. Eur Psychol. 2015;20:44–51.

61. Pope HG, Olivardia R, Gruber A, Borowiecki J. Evolving ideals of male body image as seen through action toys. Int J Eat Disord. 1999;26(1):65–72. 10349585

62. Leit RA, Pope HG, Gray JJ. Cultural expectations of muscularity in men: The evolution of Playgirl centerfolds. Int J Eat Disord. 2001;29(1):90–3. 11135340

63. Wells JCK, Marphatia AA, Cole TJ, McCoy D. Associations of economic and gender inequality with global obesity prevalence: Understanding the female excess. Soc Sci Med. 2012;75(3):482–90. doi: 10.1016/j.socscimed.2012.03.029 22580078

64. Hardy R, Wadsworth M, Kuh D. The influence of childhood weight and socioeconomic status on change in adult body mass index in a British national birth cohort. Int J Obes. 2000;24(6):725–34.

65. Buckley JP, Hedge A, Yates T, Copeland RJ, Loosemore M, Hamer M, et al. The sedentary office: a growing case for change towards better health and productivity. Expert statement commissioned by Public Health England and the Active Working Community Interest Company. Br J Sports Med. 2015.

66. Ferri E, Bynner J, Wadsworth M. Changing Britain, changing lives: Institute of Education Press; 2003.

67. Davy M. Socio-economic inequalities in smoking: an examination of generational trends in Great Britain. Health Statistics Quarterly. 2007;(34):26. 17580645

68. Heraclides A, Witte D, Brunner E. The association between father's social class and adult obesity is not explained by educational attainment and an unhealthy lifestyle in adulthood. Eur J Epidemiol. 2008;23(8):573–9. doi: 10.1007/s10654-008-9245-3 18409006

69. Braddon FFM, Rodgers B, Wadsworth MEJ, Davies JMC. Onset of Obesity in A 36-Year Birth Cohort Study. Br Med J. 1986;293(6542):299–303.

70. Crawley H, While D. The diet and body weight of British teenage smokers at 16–17 years. Eur J Clin Nutr. 1995;49(12):904–14. 8925792

71. Kuh D, Hardy R, Langenberg C, Richards M, Wadsworth MEJ. Mortality in adults aged 26–54 years related to socioeconomic conditions in childhood and adulthood: post war birth cohort study. BMJ. 2002;325(7372):1076–80. 12424168

72. Strand BH, Kuh D, Shah I, Guralnik J, Hardy R. Childhood, adolescent and early adult body mass index in relation to adult mortality: results from the British 1946 birth cohort. J Epidemiol Community Health. 2010;66(3):225–32. doi: 10.1136/jech.2010.110155 20889586

73. Flegal KM, Shepherd JA, Looker AC, Graubard BI, Borrud LG, Ogden CL, et al. Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. The American Journal of Clinical Nutrition. 2009;89(2):500–8. doi: 10.3945/ajcn.2008.26847 19116329

74. Li L, Hardy R, Kuh D, Power C. Life-course body mass index trajectories and blood pressure in mid life in two British birth cohorts: stronger associations in the later-born generation. Int J Epidemiol. 2015;44(3):1018–26. doi: 10.1093/ije/dyv106 26078389

75. Howe LD, Tilling K, Galobardes B, Lawlor DA. Loss to follow-up in cohort studies: bias in estimates of socioeconomic inequalities. Epidemiology. 2013;24(1):1–9. doi: 10.1097/EDE.0b013e31827623b1 23211345

76. Mindell JS, Giampaoli S, Goesswald A, Kamtsiuris P, Mann C, Männistö S, et al. Sample selection, recruitment and participation rates in health examination surveys in Europe–experience from seven national surveys. BMC Med Res Methodol. 2015;15(1):1.

77. Rose D, Pevalin D, O'Reilly K. The National Statistics Socio-economic Classification: Origins, Development and Use. Basingstoke, UK: 2005 2005. Report No.

78. Krishna A, Razak F, Lebel A, Davey Smith G, Subramanian S. Trends in group inequalities and interindividual inequalities in BMI in the United States, 1993–2012. The American Journal of Clinical Nutrition. 2015;101(3):598–605. doi: 10.3945/ajcn.114.100073 25733645

79. Bambra C, Hillier F, Cairns J, Kasim A, Moore H, Summerbell C. How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? two systematic reviews. Public health research. 2015;3(1).

80. Adams J, Mytton O, White M, Monsivais P. Why Are Some Population Interventions for Diet and Obesity More Equitable and Effective Than Others? The Role of Individual Agency. PLoS Med. 2016;13(4):e1001990. doi: 10.1371/journal.pmed.1001990 27046234

81. Mytton OT, Clarke D, Rayner M. Taxing unhealthy food and drinks to improve health. BMJ. 2012;344.

82. Powell LM, Chriqui JF, Khan T, Wada R, Chaloupka FJ. Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes. Obes Rev. 2013;14(2):110–28. doi: 10.1111/obr.12002 23174017

83. Mackenbach JP, Kulhánová I, Bopp M, Borrell C, Deboosere P, Kovács K, et al. Inequalities in Alcohol-Related Mortality in 17 European Countries: A Retrospective Analysis of Mortality Registers. PLoS Med. 2015;12(12):e1001909. doi: 10.1371/journal.pmed.1001909 26625134

84. Lorenc T, Petticrew M, Welch V, Tugwell P. What types of interventions generate inequalities? Evidence from systematic reviews. J Epidemiol Community Health. 2013;67(2):190–3. doi: 10.1136/jech-2012-201257 22875078

85. Shackleton N, Hale D, Viner RM. Trends and socioeconomic disparities in preadolescent's health in the UK: evidence from two birth cohorts 32 years apart. J Epidemiol Community Health. 2015;70(2):140–6. doi: 10.1136/jech-2015-205603 26359506

Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine

2017 Číslo 1
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Zabudnuté heslo

Nemáte účet?  Registrujte sa

Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.


Nemáte účet?  Registrujte sa