The effects of income during childhood on post-childhood obesity Sophia Damiani, Stephanie Foster, & Sarah Niles Academic Excellence Showcase Division of Health and Exercise Science 5-26-2016

Connection Between Income and Obesity The obesity problem in our nation The link between socioeconomic status and weight- related outcomes, such as obesity, have already been firmly established (Ziol-Guest, Duncan, Kalil, 2009). But how, specifically, does poverty in the early years affect children later in life?

What do the studies show? Ziol-Guest and colleagues alluded to the Fetal Origins Hypothesis which essentially says that insults and stimulants during the prenatal period may result in long-lasting effects on physiology and disease risk (2009). The research determined there may be a correlation between low income during the prenatal period and fetal undernutrition, low birthweight, or slow growth during their first two years of life (Ziol-Guest et al., 2009). What do the studies show? Childhood Sophia

What do the studies show? Adiposity rebound typically occurs between the ages 3 and 7 according to Dawson-McClure and colleagues (2014). A child’s ability to regulate their eating in response to physiological safety cues may be undermined by adverse environmental factors (Dawson-McClure et al., 2014). As of 2014, 1 in 5 U.S. children live in families with incomes below the federal poverty level, a ratio that translates to roughly 16.4 million (Lee et al., 2014). Childhood Continued

What do the studies show? In 2012, Kendzor, Caughy, and Owen examined the relationship between families income trajectories and young adulthood obesity. They examined over 1,000 families from the children's birth through age 15 to see if income correlates with being overweight or obese during adolescence. Income and health status data was collected 13 times throughout the 15 year study from 10 cities across the U.S. Adolescence

Adolescence- WHAT THEY FOUND There were 5 different income “classes” that the families could qualify in Class 1: stable - low income Class 2: unstable - low income Class 3: Low income - Adequate income Class 4: Unstable - Adequate income Class 5: Stable adequate income Children born into families classified as “low income” or born into higher earning families that decreased their income during childhood had higher BMIs, skinfold thickness, and waist circumferences than children born into higher income families.

What do the studies show? Nancy Wells and colleagues (2010) studied 326 youths from rural New York and collected BMI data in three waves throughout their first 17 years of life. They associated this data with the presence (or lack of) poverty in their lives from birth to age 9. They also observed risk factors in connection with poverty to see how they affected the relationship Risk factors measured: crowding noise substandard housing family turmoil child’s separation from parents exposure to violence What do the studies show? Late Adolescence - Young Adulthood

Late Adolescence through Young Adulthood WHAT THEY FOUND BMI percentiles were higher in groups experiencing at least some poverty between birth and age 9. Also, experiencing more risk factors predicted higher BMI levels later in life. When these risk factors were controlled for, they found no connection between early poverty and higher BMI levels later in life...in other words, these risk factors are what make the connection happen!

Association between BMI and childhood poverty (Wells et al., 2010)

What do the studies show? -> In a secondary analysis of household income data from the US Panel of Income Dynamics by Ziol- Guest and colleagues, children born into families were tracked and surveyed between 1968 and 2005. -> Target sample was studied from perinatal period, ages 1-5, and 6-15. They were contacted again in 2005 at the minimum age of 30 to asses the impact of income during that time on adult BMI. -> To the authors’ knowledge, this was the first study to look at the effects of childhood poverty in adult BMI as late as age 37. What do the studies show? Adults Sophia

Adulthood- WHAT THEY FOUND Average BMI in 2005 was 27.4 kg/m^2 for the sample group compared to the national mean of 27.7 kg/m^2 People who were classified as low income during the perinatal period showed significantly higher BMI and rates of overweight and obesity than those who were above the poverty threshold during that period. A $10,000 increase in income during the perinatal period showed a 2.51 kg/m^2 reduction in adult BMI Overnutrition or undernutrition during pregnancy affects, among other things, pancreatic B-cell development and fat cells, which may result in physiological changes that affect their eating behavior throughout their lives. Sophia

What can we do? Targeting risk factors and providing support for these children could help lower risk for being overweight or obese later in life (Wells et al. 2010). Studies call for more research on this subject Develop culturally informed innovations to educate these children on nutrition and get them active. Improving child and parental nutritional knowledge may help lower rates of overweight and obesity later on in life. (Dawson-McClure et al., 2014). Ziol-Guest and colleagues indicated in their article, that the parents of low income children had lower test scores and levels of education than their higher income counterparts. Kendzor, D.E., Caughy, M.O., Owen suggested that “promoting upward economic mobility among disadvantaged families may have a positive impact on obesity related outcomes in adolescence” (2012).

References Dawson-McClure, S., Brotman, L., Theise, R., Palamar, J., Kamboukos, D., Barajas, R., & Calzada, E. (2014). Early childhood obesity prevention in low-income, urban communities. Journal of Prevention & Intervention in the Community, 42(2), 152-166. doi:10.1080/10852352.2014.881194 Kendzor, D.E., Caughy, M.O., Owen, M.T. (2012). Family income trajectory during childhood is associated with adiposity in adolescence: a latent class growth analysis. BMC Public Health, 12(611). Lee, H., Andrew, M., Gebremariam, A., Lumeng, J.C., & Lee, J.M. (2014). Longitudinal associations between poverty and obesity from birth through adolescence. American Journal of Public Health, 104(5), e70-e76. doi:10.2105/AJPH.2013.301806) National Institute of Health. (2012). How are overweight and obesity diagnosed? Retrieved from: http://www.nhlbi.nih.gov/health/health-topics/topics/obe/diagnosis Wells, N.M., Evans, G.W., Beavis, A., & Ong, A.D. (2010). Early childhood poverty, cumulative risk exposure, and body mass index trajectories through young adulthood. American Journal of Public Health, 100(12), 2507-2512. Ziol-Guest, K., Duncan, G., & Kalil, A. (2009). Early childhood poverty and adult body mass index. American Journal of Public Health, 99(3), 527-532. doi:10.2105/AJPH.2007.130575.