title: A Review of the Relationship Between Socioeconomic Position and the Early-Life Predictors of Obesity.
abstract: A range of important early-life predictors of later obesity have been identified. Children of lower socioeconomic position (SEP) have a steeper weight gain trajectory from birth with a strong socioeconomic gradient in child and adult obesity prevalence. An assessment of the association between SEP and the early-life predictors of obesity has been lacking. The review involved a two-stage process: Part 1, using previously published systematic reviews, we developed a list of the potentially modifiable determinants of obesity observable in the pre-natal, peri-natal or post-natal (pre-school) periods; and part 2, conducting a literature review of evidence for socioeconomic patterning in the determinants identified in part 1. Strong evidence was found for an inverse relationship between SEP and (1) pre-natal risk factors (pre-pregnancy maternal body mass index (BMI), diabetes and pre-pregnancy diet), (2) antenatal/peri natal risk factors (smoking during pregnancy and low birth weight) and (3) early-life nutrition (including breastfeeding initiation and duration, early introduction of solids, maternal and infant diet quality, and some aspects of the home food environment), and television viewing in young children. Less strong evidence (because of a lack of studies for some factors) was found for paternal BMI, maternal weight gain during pregnancy, child sleep duration, high birth weight and lack of physical activity in young children. A strong socioeconomic gradient exists for the majority of the early-life predictors of obesity suggesting that the die is cast very early in life (even pre-conception). Lifestyle interventions targeting disadvantaged women at or before child-bearing age may therefore be particularly important in reducing inequality. Given the likely challenges of reaching this target population, it may be that during pregnancy and their child's early years are more feasible windows for engagement.
authors.affiliation: World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia. adrian.cameron@deakin.edu.au.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Cameron
authors.affiliation: School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia.
authors.forename: Alison C
authors.initials: AC
authors.lastname: Spence
authors.affiliation: School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia.|Centre for Obesity Prevention and Management Research Excellence in Primary Health Care, Sydney, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Laws
authors.affiliation: School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia.
authors.forename: Kylie D
authors.initials: KD
authors.lastname: Hesketh
authors.affiliation: INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early Origins of Child Health and Development Team (ORCHAD), Villejuif, F-94807, France.|Paris-Descartes University, Paris, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Lioret
authors.affiliation: School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia.|Centre for Obesity Prevention and Management Research Excellence in Primary Health Care, Sydney, Australia.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Campbell
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D004032:Diet; D005260:Female; D006801:Humans; D007223:Infant; D008019:Life Style; D009765:Obesity / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors
keywords: Infant; Nutrition; Physical activity; Socioeconomic position