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Autret K, Bekelman TA. Socioeconomic Status and Obesity. J Endocr Soc 2024; 8:bvae176. [PMID: 39416425 PMCID: PMC11481019 DOI: 10.1210/jendso/bvae176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Indexed: 10/19/2024] Open
Abstract
Obesity is a pervasive public health problem that causes debilitating complications across the life course. One opportunity for preventing the onset of obesity is to focus on its social determinants. Socioeconomic status (SES), which includes factors such as income, educational attainment, occupational prestige, and access to resources, is a key determinant of obesity. In this scoping mini-review, we summarized review articles and meta-analyses of the SES-obesity association. From the 1980s to the present, cross-sectional studies have demonstrated a persistent socioeconomic gradient in obesity in which the association is negative in developed countries and positive in developing countries. Longitudinal studies have revealed the bidirectionality of the SES-obesity association; some studies demonstrate that socioeconomic adversity precedes the onset of obesity, while others provide evidence of reverse causality. While earlier studies relied on anthropometric assessments of weight and height to define obesity, the use of modern technologies like dual-energy x-ray absorptiometry and bioelectrical impedance have demonstrated that the socioeconomic gradient in obesity is robust across multiple indicators of body composition, including direct measures of lean and fat mass. More recently, examination of mediators and moderators of the SES-obesity association have highlighted causal pathways and potential intervention targets, with a focus on health behaviors, environmental conditions, psychological factors, and biological processes. We describe current gaps in knowledge and propose opportunities for future innovation to reduce the burden of obesity and related socioeconomic disparities.
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Affiliation(s)
- Kristen Autret
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO 80045, USA
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Ekberg KM, Michelini G, Schneider KL, Docherty AR, Shabalin AA, Perlman G, Kotov R, Klein DN, Waszczuk MA. Associations between polygenic risk scores for cardiometabolic phenotypes and adolescent depression and body dissatisfaction. Pediatr Res 2024:10.1038/s41390-024-03323-z. [PMID: 38879627 DOI: 10.1038/s41390-024-03323-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Adolescents with elevated body mass index (BMI) are at an increased risk for depression and body dissatisfaction. Type 2 diabetes (T2D) is an established risk factor for depression. However, shared genetic risk between cardiometabolic conditions and mental health outcomes remains understudied in youth. METHODS The current study examined associations between polygenic risk scores (PRS) for BMI and T2D, and symptoms of depression and body dissatisfaction, in a sample of 827 community adolescents (Mage = 13.63, SDage = 1.01; 76% girls). BMI, depressive symptoms, and body dissatisfaction were assessed using validated self-report questionnaires. RESULTS BMI-PRS was associated with phenotypic BMI (β = 0.24, p < 0.001) and body dissatisfaction (β = 0.17, p < 0.001), but not with depressive symptoms. The association between BMI-PRS and body dissatisfaction was significantly mediated by BMI (indirect effect = 0.10, CI [0.07-0.13]). T2D-PRS was not associated with depression or body dissatisfaction. CONCLUSIONS The results suggest phenotypic BMI may largely explain the association between genetic risk for elevated BMI and body dissatisfaction in adolescents. Further research on age-specific genetic effects is needed, as summary statistics from adult discovery samples may have limited utility in youth. IMPACT The association between genetic risk for elevated BMI and body dissatisfaction in adolescents may be largely explained by phenotypic BMI, indicating a potential pathway through which genetic predisposition influences body image perception. Furthermore, age-specific genetic research is needed to understand the unique influences on health outcomes during adolescence. By identifying BMI as a potential mediator in the association between genetic risk for elevated BMI and body dissatisfaction, the current findings offer insights that could inform interventions targeting body image concerns and mental health in this population.
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Affiliation(s)
- Krista M Ekberg
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
| | - Giorgia Michelini
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Kristin L Schneider
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Anna R Docherty
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Andrey A Shabalin
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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de Roo M, Hartman C, Veenstra R, Nolte IM, Meier K, Vrijen C, Kretschmer T. Gene-Environment Interplay in the Development of Overweight. J Adolesc Health 2023; 73:574-581. [PMID: 37318409 DOI: 10.1016/j.jadohealth.2023.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Overweight in youth is influenced by genes and environment. Gene-environment interaction (G×E) has been demonstrated in twin studies and recent developments in genetics allow for studying G×E using individual genetic predispositions for overweight. We examine genetic influence on trajectories of overweight during adolescence and early adulthood and determine whether genetic predisposition is attenuated by higher socioeconomic status and having physically active parents. METHODS Latent class growth models of overweight were fitted using data from the TRacking Adolescents' Individual Lives Survey (n = 2720). A polygenic score for body mass index (BMI) was derived using summary statistics from a genome-wide association study of adult BMI (N = ∼700,000) and tested as predictor of developmental pathways of overweight. Multinomial logistic regression models were used to examine effects of interactions of genetic predisposition with socioeconomic status and parental physical activity (n = 1675). RESULTS A three-class model of developmental pathways of overweight fitted the data best ("non-overweight", "adolescent-onset overweight", and "persistent overweight"). The polygenic score for BMI and socioeconomic status distinguished the persistent overweight and adolescent-onset overweight trajectories from the non-overweight trajectory. Only genetic predisposition differentiated the adolescent-onset from the persistent overweight trajectory. There was no evidence for G×E. DISCUSSION Higher genetic predisposition increased the risk of developing overweight during adolescence and young adulthood and was associated with an earlier age at onset. We did not find that genetic predisposition was offset by higher socioeconomic status or having physically active parents. Instead, lower socioeconomic status and higher genetic predisposition acted as additive risk factors for developing overweight.
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Affiliation(s)
- Marthe de Roo
- Faculty of Behavioral and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, the Netherlands.
| | - Catharina Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - René Veenstra
- Faculty of Behavioral and Social Sciences, Department of Sociology, University of Groningen, Groningen, the Netherlands
| | - Ilja Maria Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Karien Meier
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Charlotte Vrijen
- Faculty of Behavioral and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, the Netherlands
| | - Tina Kretschmer
- Faculty of Behavioral and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, the Netherlands
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Huangfu Y, Palloni A, Beltrán-Sánchez H, McEniry MC. Gene-environment interactions and the case of body mass index and obesity: How much do they matter? PNAS NEXUS 2023; 2:pgad213. [PMID: 37441616 PMCID: PMC10335730 DOI: 10.1093/pnasnexus/pgad213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/07/2022] [Accepted: 06/13/2023] [Indexed: 07/15/2023]
Abstract
We investigate the demographic and population health implications of gene-environment interactions (GxE) in the case of body mass index (BMI) and obesity. We seek to answer two questions: (a) what is the first-order impact of GxE effects on BMI and probability of obesity, e.g. the direct causal effect of G in different E's? and (b) how large is the impact of GxE effects on second-order health outcomes associated with BMI and obesity, such as type 2 diabetes (T2D) and disability? In contrast to most of the literature that focuses on estimating GxE effects, we study the implications of GxE effects for population health outcomes that are downstream of a causal chain that includes the target phenotype (in this case BMI) as the initial cause. To limit the scope of the paper, we focus on environments defined by birth cohorts. However, extensions to other environments (education, socioeconomic status (SES), early conditions, and physical settings) are straightforward.
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Affiliation(s)
- Yiyue Huangfu
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Alberto Palloni
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI 53706, USA
- Instituto de Economía, Geografía y Demografía (IEGD), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Madrid 28006, Spain
| | - Hiram Beltrán-Sánchez
- Fielding School of Public Health and California Center for Population Research, UCLA, CA 90095, USA
| | - Mary C McEniry
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI 53706, USA
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Bann D, Wright L, Hardy R, Williams DM, Davies NM. Polygenic and socioeconomic risk for high body mass index: 69 years of follow-up across life. PLoS Genet 2022; 18:e1010233. [PMID: 35834443 PMCID: PMC9282556 DOI: 10.1371/journal.pgen.1010233] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/03/2022] [Indexed: 11/29/2022] Open
Abstract
Genetic influences on body mass index (BMI) appear to markedly differ across life, yet existing research is equivocal and limited by a paucity of life course data. We thus used a birth cohort study to investigate differences in association and explained variance in polygenic risk for high BMI across infancy to old age (2-69 years). A secondary aim was to investigate how the association between BMI and a key purported environmental determinant (childhood socioeconomic position) differed across life, and whether this operated independently and/or multiplicatively of genetic influences. Data were from up to 2677 participants in the MRC National Survey of Health and Development, with measured BMI at 12 timepoints from 2-69 years. We used multiple polygenic indices from GWAS of adult and childhood BMI, and investigated their associations with BMI at each age. For polygenic liability to higher adult BMI, the trajectories of effect size (β) and explained variance (R2) diverged: explained variance peaked in early adulthood and plateaued thereafter, while absolute effect sizes increased throughout adulthood. For polygenic liability to higher childhood BMI, explained variance was largest in adolescence and early adulthood; effect sizes were marginally smaller in absolute terms from adolescence to adulthood. All polygenic indices were related to higher variation in BMI; quantile regression analyses showed that effect sizes were sizably larger at the upper end of the BMI distribution. Socioeconomic and polygenic risk for higher BMI across life appear to operate additively; we found little evidence of interaction. Our findings highlight the likely independent influences of polygenic and socioeconomic factors on BMI across life. Despite sizable associations, the BMI variance explained by each plateaued or declined across adulthood while BMI variance itself increased. This is suggestive of the increasing importance of chance ('non-shared') environmental influences on BMI across life.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, Social Research Institute, UCL, London, United Kingdom
- * E-mail: (DB); (LW)
| | - Liam Wright
- Centre for Longitudinal Studies, Social Research Institute, UCL, London, United Kingdom
- * E-mail: (DB); (LW)
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- Social Research Institute, UCL, London, United Kingdom
| | - Dylan M. Williams
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Neil M. Davies
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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