Socioeconomic status indicators, physical activity, and overweight/obesity in Brazilian children

Associations of family socioeconomic indicators and physical activity of primary school-aged children: a systematic review

BACKGROUND

Family socioeconomic indicators (education, occupation, and household income) are key determinants influencing children's physical activity (PA). This study aims to systematically review the current research about the association between family socioeconomic indicators and PA among primary school-aged children and to quantify the distribution of reported associations by childs' and parents' sex and according to analysis and assessment methods.

METHODS

A systematic literature research in multiple scientific databases (MEDLINE via PubMed, Web of Science, ScienceDirect, SPORTDiscus and ERIC) was performed for literature published between 1st January 2010 and 31st March 2022. Only studies reporting statistical associations between an SES indicator of at least one parent (education, occupation, income, or an SES index) and different types and intensities of PA in primary school-aged children (6 to 12 years) were included in the analysis. The distributions of the reported associations were evaluated across and differentiated by sub-group analysis of assessment methods (objectively measured vs. self-reported PA) and analysis methods (univariate vs. multivariate models).

RESULTS

Overall, 93 studies reported in 77 publications were included in this review. Most of the studies were conducted in Europe and used self-reports (questionnaires) to assess PA. Most studies used only a single SES indicator (commonly maternal education), and only two studies calculated an SES index. The majority of the studies focused on moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and organized physical activity (OPA). Results showed predominantly positive associations between SES indicators and OPA. In contrast, results regarding different intensities of daily PA (TPA, LPA, MPA, MVPA, VPA, LTPA) were heterogeneous, with overwhelmingly no associations.

CONCLUSION

Overall, the results expand the knowledge about the association between family socioeconomic indicators and children's PA and disprove the hypothesis of a clear positive association. However, large multicenter studies are lacking using a real SES index as a predictor and analyzing gender-specific multivariate models.

Physical activity in early childhood: a five-year longitudinal analysis of patterns and correlates

Background

Knowledge on longitudinal patterns and related factors of young children’s physical activity (PA) is still scarce. Therefore, the aim of this study was to examine patterns and changes of accelerometer-measured PA over time in two to six-year-old children. Furthermore, the aim was to investigate if parental PA, socioeconomic status, sex, weight status, and motor skills are related to child PA over time, using prospective cohort data from a clustered randomized controlled trial.

Methods

One hundred and six children (52% girls) and their parents had PA measured yearly from age two to six with an Actigraph GT3X. The actigraph was worn on the non-dominant wrist for one week; anthropometric data and motor skills, as well as background information, was collected simultaneously. The outcome was counts per minute from the vector magnitude, and linear mixed-effect models were used to answer the research questions.

Results

Among the children, accelerometer-measured PA increased on average by 11% per year from two years of age (mean 3170 cpm (3007-3334 95% CI)) onwards to six years of age (mean 4369 cpm (4207-4533 95% CI)). From three years of age, children were more active on weekdays than on weekend days. The rate of difference varied across low, medium, and highly active children (based on tertiles). No significant differences in weekdays/weekend PA among the lowest active children was found. Despite this, they were still significantly less active on weekend days than the most active children. Maternal, but not paternal PA was found to be significantly positively related to child PA over time, with a medium to large effect size. But no significant relationships were found between child PA and sex, weight status, or socioeconomic status.

Conclusions

PA increased on average with 11% per year, similarly for boys and girls. From three years of age children were more active during weekdays than weekend days. These results indicate that child PA benefits from active stimulation by parents and care takers already from early ages. It is important to identify attributes of possible intervention designs for weekend days for families with young children as well as characterize the least active children.

Trial registration

Early STOPP was prospectively registered in the clinical trials registry: clinicaltrials.gov, ID NCT01198847

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01289-x.

Associations of Socioeconomic Status and Physical Activity With Obesity Measures in Rural Chinese Adults

Background: Although independent association of socioeconomic status (SES) or physical activity (PA) with obesity has been well-documented in urban settings, their independent and joint associations on obesity measures are limited in rural regions.

Methods: Almost 38,000 (n = 37,922) individuals were included from the Henan Rural Cohort Study. The International Physical Activity Questionnaire (IPAQ) was used to evaluate PA. Obesity was reflected by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI). The independent and interactive effects of SES and PA on obesity were analyzed by logistic regression models and generalized linear regression models, respectively.

Results: Compared with high education level, the OR (95%CI) of obesity defined by BMI with low education level was 1.466 (1.337, 1.608), 1.064 (0.924, 1.225), and 1.853 (1.625, 2.114) in total population, men and women, respectively. Besides, the OR (95%CI) of obesity defined by BMI associated with per capita monthly income were 1.089 (1.015, 1.170), 1.192 (1.055, 1.347), 1.038 (0.951, 1.133) in total population, men and women, respectively. Similar results had been observed in other obesity measures. Negative interactive association of low education level and PA on obesity measures were observed only in women (all P < 0.05).

Conclusions: This study suggests that women are more susceptible to obesity concerning low SES and that adequate PA may be a potential target for mitigating the negative effect of low SES on obesity in women.

Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.

A Median Analysis of Factors Influencing Body Fatness in Urban School-Age Children in Cameroon

Background

Childhood overweight/obesity is a fast growing public health problem in developing countries. The adverse health consequences of obesity have been attributed to higher body fat levels and this has drawn overwhelming attention towards more accurate assessment of body fat. The goal of this study is to evaluate the relationships between selected behavioral factors and percentage body fat (%BF) estimated using bioelectrical impedance analysis in school-age children.

Methods

A cross-sectional analysis was carried out in randomly selected 6- to 11-year-old children (507 boys and 501 girls). Percentage body fat was assessed using bioelectrical impedance analysis. The behavioral factors were reported by parents using a structured questionnaire. Multiple quantile regression analysis was used to evaluate the relationship between the selected behavioral factors and %BF.

Results

With quantile regression, the daily consumption of fruits and vegetables, daily breakfast consumption, and high physical activity (>4–7 times/week) were significantly (p < 0.001) associated with a 4.95, 3.29, and 3.66 decrease in median %BF, respectively. Also, consumption of snacks (>3 times a day) (p < 0.001), high sedentary lifestyle (>3–6 hours/day) (p < 0.001), and motorization to school (p < 0.005) significantly increased the median %BF by 3.69, 3.01, and 1.39, respectively. The largest changes in median %BF were observed in girls.

Conclusions

Efforts are needed using longitudinal studies to clarify the effects of these behavioral factors on %BF in different regions and ethnic groups of Cameroon and also to assess whether any observed differences are of clinical relevance.

Obesity and Overweight Among Brazilian Early Adolescents: Variability Across Region, Socioeconomic Status, and Gender

INTRODUCTION

As with most emerging nations, Brazil lacks up-to-date data on the prevalence of obesity and overweight among its children. Of particular concern is the lack of data on children in early adolescence, considered by many to be the crucial stage for weight-related healthcare.

OBJECTIVE

To assess regional, socioeconomic, and gender differences in the prevalence of obesity and overweight among Brazilian early adolescents.

METHODS

A cross-sectional study was conducted on a racially diverse sample of students aged 10-13 years, from schools in three geographic regions (north, northeast, south) (N = 1,738). Data on gender, age, race, socioeconomic status (SES), weight, and height were obtained. Weight class was calculated from age- and gender-adjusted body mass index, based on children's weight and height. Bivariate and multivariable analyses, with post hoc tests, were conducted to estimate differences between groups and were corrected for multiple comparisons. Procedures were approved by institutional review boards at study sites.

RESULTS

Analyses revealed a higher prevalence of obesity and/or overweight among: (1) children of higher SES; (2) children in southern Brazil; (3) males; and (4) Black females.

CONCLUSION

The most salient predictor of weight risk among Brazilian early adolescents is higher SES. This finding is consistent with previous findings of an inverse social gradient, in weight risk, among emerging-nation population groups.