Early life disadvantage and adult adiposity: tests of sensitive periods during childhood and behavioural mediation in adulthood. (1st October 2018)

• Record Type: Journal Article
• Authors: Gilman, Stephen E; Huang, Yen-Tsung; Jimenez, Marcia P; Agha, Golareh; Chu, Su H; Eaton, Charles B; Goldstein, Risë B; Kelsey, Karl T; Buka, Stephen L; Loucks, Eric B
• Is Part Of: International journal of epidemiology. Volume 48:Number 1(2019)
• Page Start: 98
• Page End: 107
• Publication Date: 2018-10-01
• Subjects: Socioeconomic disadvantage -- adiposity -- body mass index -- fat mass -- sensitive period -- mediation -- depressive symptoms -- education; Epidemiology -- Periodicals; 614.4
• DOI: 10.1093/ije/dyy199
• Languages: English
• ISSNs: 0300-5771

Abstract

Abstract: Background: Early exposure to socioeconomic disadvantage is associated with obesity. Here we investigated how early, and conducted mediation analyses to identify behavioural factors in adulthood that could explain why. Methods: Among 931 participants in the New England Family Study, we investigated the associations of family socioeconomic disadvantage measured before birth and at age 7 years with the following measures of adiposity in mid-adulthood (mean age = 44.4 years): body mass index (BMI), waist circumference and, among 400 participants, body composition from dual-energy X-ray absorption scans. Results: In linear regressions adjusting for age, sex, race and childhood BMI Z-score, participants in the highest tertile of socioeconomic disadvantage at birth had 2.6 additional BMI units in adulthood [95% confidence interval (CI) = 1.26, 3.96], 5.62 cm waist circumference (95% CI = 2.69, 8.55), 0.73 kg of android fat mass (95% CI = 0.25, 1.21), and 7.65 higher Fat Mass Index (95% CI = 2.22, 13.09). Conditional on disadvantage at birth, socioeconomic disadvantage at age 7 years was not associated with adult adiposity. In mediation analyses, 10–20% of these associations were explained by educational attainment and 5–10% were explained by depressive symptoms. Conclusions: Infancy may be a sensitive period for exposure to socioeconomic disadvantage, as exposure in the earliest years of life confers a larger risk for overall and central adiposity in mid-adulthood than exposure during childhood. Intervention on these two adult risk factors for adiposity would, if all model assumptions were satisfied, only remediate up to one-fifth of the excess adult adiposity among individuals born into socioeconomically disadvantaged households.