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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2003 Oct;57(10):816–822. doi: 10.1136/jech.57.10.816

Central and total obesity in middle aged men and women in relation to lifetime socioeconomic status: evidence from a national birth cohort

C Langenberg 1, R Hardy 1, D Kuh 1, E Brunner 1, M Wadsworth 1
PMCID: PMC1732299  PMID: 14573589

Abstract

Study objective: To investigate the influence of social class in childhood, young adulthood and middle age, and intergenerational mobility, on adult central and total obesity.

Design: Prospective, population based, birth cohort study.

Participants and Setting: 1472 men and 1563 women born in 1946 in England, Scotland, and Wales.

Outcome measures: Waist-hip ratio, waist-height ratio, waist circumference, and body mass index at age 53 years.

Main results: Father's social class at participant's age 4 years was inversely associated with adult central and total obesity at age 53 years in men and women. For example, the mean difference of waist-hip ratio (95% confidence intervals) between father's professional social class I and unskilled manual social class V was 2.6% (0.7 to 4.6) for men and 2.5% (0.5 to 4.4) for women. The effect of father's social class remained after adjustment for participant's own social class in young adulthood and middle age. Both adult social classes were inversely related to obesity among women, but not men, after adjustment for childhood circumstances. Upwardly mobile men and women were less obese than participants remaining in their father's social class and their levels of obesity tended to be between the class they left and the class they joined.

Conclusions: The effect of social class on adult obesity differed according to the stage in the life course at which social class was measured, and gender. Childhood circumstances had enduring influences on adult obesity, although our results on intergenerational mobility indicate potential reversibility of early life disadvantage.

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Selected References

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  1. Baik I., Ascherio A., Rimm E. B., Giovannucci E., Spiegelman D., Stampfer M. J., Willett W. C. Adiposity and mortality in men. Am J Epidemiol. 2000 Aug 1;152(3):264–271. doi: 10.1093/aje/152.3.264. [DOI] [PubMed] [Google Scholar]
  2. Björkelund C., Lissner L., Andersson S., Lapidus L., Bengtsson C. Reproductive history in relation to relative weight and fat distribution. Int J Obes Relat Metab Disord. 1996 Mar;20(3):213–219. [PubMed] [Google Scholar]
  3. Blane D., Hart C. L., Smith G. D., Gillis C. R., Hole D. J., Hawthorne V. M. Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood. BMJ. 1996 Dec 7;313(7070):1434–1438. doi: 10.1136/bmj.313.7070.1434. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Braddon F. E., Rodgers B., Wadsworth M. E., Davies J. M. Onset of obesity in a 36 year birth cohort study. Br Med J (Clin Res Ed) 1986 Aug 2;293(6542):299–303. doi: 10.1136/bmj.293.6542.299. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brunner E. J., Marmot M. G., Nanchahal K., Shipley M. J., Stansfeld S. A., Juneja M., Alberti K. G. Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study. Diabetologia. 1997 Nov;40(11):1341–1349. doi: 10.1007/s001250050830. [DOI] [PubMed] [Google Scholar]
  6. Brunner E., Juneja M., Marmot M. Abdominal obesity and disease are linked to social position. BMJ. 1998 Jan 24;316(7127):308–309. doi: 10.1136/bmj.316.7127.308a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Brunner E., Shipley M. J., Blane D., Smith G. D., Marmot M. G. When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood. J Epidemiol Community Health. 1999 Dec;53(12):757–764. doi: 10.1136/jech.53.12.757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. 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 Relat Metab Disord. 2000 Jun;24(6):725–734. doi: 10.1038/sj.ijo.0801238. [DOI] [PubMed] [Google Scholar]
  9. Heslop P., Smith G. D., Macleod J., Hart C. The socioeconomic position of employed women, risk factors and mortality. Soc Sci Med. 2001 Aug;53(4):477–485. doi: 10.1016/s0277-9536(00)00350-6. [DOI] [PubMed] [Google Scholar]
  10. Kaplan G. A., Keil J. E. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993 Oct;88(4 Pt 1):1973–1998. doi: 10.1161/01.cir.88.4.1973. [DOI] [PubMed] [Google Scholar]
  11. Krieger N., Chen J. T., Selby J. V. Comparing individual-based and household-based measures of social class to assess class inequalities in women's health: a methodological study of 684 US women. J Epidemiol Community Health. 1999 Oct;53(10):612–623. doi: 10.1136/jech.53.10.612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kunst A. E., Groenhof F., Mackenbach J. P., Health E. W. Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ. 1998 May 30;316(7145):1636–1642. doi: 10.1136/bmj.316.7145.1636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lahmann P. H., Lissner L., Gullberg B., Berglund G. Sociodemographic factors associated with long-term weight gain, current body fatness and central adiposity in Swedish women. Int J Obes Relat Metab Disord. 2000 Jun;24(6):685–694. doi: 10.1038/sj.ijo.0801219. [DOI] [PubMed] [Google Scholar]
  14. Lapidus L., Bengtsson C., Larsson B., Pennert K., Rybo E., Sjöström L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984 Nov 10;289(6454):1257–1261. doi: 10.1136/bmj.289.6454.1257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lemieux S., Prud'homme D., Bouchard C., Tremblay A., Després J. P. Sex differences in the relation of visceral adipose tissue accumulation to total body fatness. Am J Clin Nutr. 1993 Oct;58(4):463–467. doi: 10.1093/ajcn/58.4.463. [DOI] [PubMed] [Google Scholar]
  16. Lovejoy J. C. The influence of sex hormones on obesity across the female life span. J Womens Health. 1998 Dec;7(10):1247–1256. doi: 10.1089/jwh.1998.7.1247. [DOI] [PubMed] [Google Scholar]
  17. Manson J. E., Willett W. C., Stampfer M. J., Colditz G. A., Hunter D. J., Hankinson S. E., Hennekens C. H., Speizer F. E. Body weight and mortality among women. N Engl J Med. 1995 Sep 14;333(11):677–685. doi: 10.1056/NEJM199509143331101. [DOI] [PubMed] [Google Scholar]
  18. Nelson T. L., Vogler G. P., Pedersen N. L., Miles T. P. Genetic and environmental influences on waist-to-hip ratio and waist circumference in an older Swedish twin population. Int J Obes Relat Metab Disord. 1999 May;23(5):449–455. doi: 10.1038/sj.ijo.0800840. [DOI] [PubMed] [Google Scholar]
  19. Ohlson L. O., Larsson B., Svärdsudd K., Welin L., Eriksson H., Wilhelmsen L., Björntorp P., Tibblin G. The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes. 1985 Oct;34(10):1055–1058. doi: 10.2337/diab.34.10.1055. [DOI] [PubMed] [Google Scholar]
  20. Osler M., Gerdes L. U., Davidsen M., Brønnum-Hansen H., Madsen M., Jørgensen T., Schroll M. Socioeconomic status and trends in risk factors for cardiovascular diseases in the Danish MONICA population, 1982-1992. J Epidemiol Community Health. 2000 Feb;54(2):108–113. doi: 10.1136/jech.54.2.108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Parsons T. J., Power C., Logan S., Summerbell C. D. Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord. 1999 Nov;23 (Suppl 8):S1–107. [PubMed] [Google Scholar]
  22. Rexrode K. M., Carey V. J., Hennekens C. H., Walters E. E., Colditz G. A., Stampfer M. J., Willett W. C., Manson J. E. Abdominal adiposity and coronary heart disease in women. JAMA. 1998 Dec 2;280(21):1843–1848. doi: 10.1001/jama.280.21.1843. [DOI] [PubMed] [Google Scholar]
  23. Rimm E. B., Stampfer M. J., Giovannucci E., Ascherio A., Spiegelman D., Colditz G. A., Willett W. C. Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol. 1995 Jun 15;141(12):1117–1127. doi: 10.1093/oxfordjournals.aje.a117385. [DOI] [PubMed] [Google Scholar]
  24. Rose K. M., Newman B., Mayer-Davis E. J., Selby J. V. Genetic and behavioral determinants of waist-hip ratio and waist circumference in women twins. Obes Res. 1998 Nov;6(6):383–392. doi: 10.1002/j.1550-8528.1998.tb00369.x. [DOI] [PubMed] [Google Scholar]
  25. Rosmond R., Björntorp P. Psychosocial and socio-economic factors in women and their relationship to obesity and regional body fat distribution. Int J Obes Relat Metab Disord. 1999 Feb;23(2):138–145. doi: 10.1038/sj.ijo.0800782. [DOI] [PubMed] [Google Scholar]
  26. Rosmond R., Lapidus L., Björntorp P. The influence of occupational and social factors on obesity and body fat distribution in middle-aged men. Int J Obes Relat Metab Disord. 1996 Jul;20(7):599–607. [PubMed] [Google Scholar]
  27. Sarlio-Lähteenkorva S., Lahelma E. The association of body mass index with social and economic disadvantage in women and men. Int J Epidemiol. 1999 Jun;28(3):445–449. doi: 10.1093/ije/28.3.445. [DOI] [PubMed] [Google Scholar]
  28. Smith G. D., Hart C., Blane D., Gillis C., Hawthorne V. Lifetime socioeconomic position and mortality: prospective observational study. BMJ. 1997 Feb 22;314(7080):547–552. doi: 10.1136/bmj.314.7080.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Sobal J., Stunkard A. J. Socioeconomic status and obesity: a review of the literature. Psychol Bull. 1989 Mar;105(2):260–275. doi: 10.1037/0033-2909.105.2.260. [DOI] [PubMed] [Google Scholar]
  30. Wadsworth M. E., Mann S. L., Rodgers B., Kuh D. J., Hilder W. S., Yusuf E. J. Loss and representativeness in a 43 year follow up of a national birth cohort. J Epidemiol Community Health. 1992 Jun;46(3):300–304. doi: 10.1136/jech.46.3.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Wannamethee S. G., Whincup P. H., Shaper G., Walker M. Influence of fathers' social class on cardiovascular disease in middle-aged men. Lancet. 1996 Nov 9;348(9037):1259–1263. doi: 10.1016/S0140-6736(96)02465-8. [DOI] [PubMed] [Google Scholar]
  32. Wardle Jane, Waller Jo, Jarvis Martin J. Sex differences in the association of socioeconomic status with obesity. Am J Public Health. 2002 Aug;92(8):1299–1304. doi: 10.2105/ajph.92.8.1299. [DOI] [PMC free article] [PubMed] [Google Scholar]

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