title: Why are poorer children at higher risk of obesity and overweight? A UK cohort study.
abstract: BACKGROUND
  There is limited evidence on which risk factors attenuate income inequalities in child overweight and obesity; whether and why these inequalities widen as children age.
  
  
  METHODS
  Eleven thousand nine hundred and sixty five singletons had complete data at age 5 and 9384 at age 11 from the Millennium Cohort Study (UK). Overweight (age 5 : 15%; age 11 : 20%) and obesity (age 5 : 5%; age 11 : 6%) were defined using the International Obesity Taskforce body mass index cut-points. To measure socioeconomic inequalities, we used quintiles of family income and as risk factors, we considered markers of maternal health behaviours and of children's physical activity, sedentary behaviours and diet. Binary and multinomial logistic regression models were used.
  
  
  RESULTS
  The unadjusted analyses revealed stark income inequalities in the risk of obesity at age 5 and 11. At age 5, children in the bottom income quintile had 2.0 (95% CI: 1.4-2.8) increased relative risk of being obese whilst at age 11 they had 3.0 (95% CI: 2.0-4.5) increased risk compared to children in the top income quintile. Similar income inequalities in the risk of overweight emerged by age 11. Physical activity and diet were particularly important in explaining inequalities. Income inequalities in obesity and overweight widened significantly between age 5 and 11 and a similar set of risk factors protected against upward and promoted downward movements across weight categories.
  
  
  CONCLUSIONS
  To reduce income inequalities in overweight and obesity and their widening across childhood the results support the need of early interventions which take account of multiple risk factors.
authors.affiliation: Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK Department of Social Policy, London School of Economics, Houghton Street, London, WC2A 2AE, UK y.kelly@ucl.ac.uk.
authors.forename: Alice
authors.initials: A
authors.lastname: Goisis
authors.affiliation: Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Sacker
authors.affiliation: Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK y.kelly@ucl.ac.uk.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D004032:Diet; D015444:Exercise; D005192:Family Health; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D050177:Overweight / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors