title: The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan.
abstract: BACKGROUND
  We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn.
  
  
  METHODS
  Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight.
  
  
  RESULTS
  Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02-1.24); girls=1.35 (1.23-1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09-1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group.
  
  
  CONCLUSIONS
  Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence.
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Ueda
authors.affiliation: Department of Health and Social Behaviour/Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D057172:Economic Recession; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D050177:Overweight / Q000191:economics / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D013851:Thinness / Q000191:economics / Q000453:epidemiology*