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Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence

Libuy, N; Bann, D; Fitzsimons, E; (2021) Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence. SSM - Population Health , 16 , Article 100978. 10.1016/j.ssmph.2021.100978. Green open access

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Abstract

We use longitudinal data across a key developmental period, spanning much of childhood and adolescence (age 5 to 17, years 2006–2018) from the UK Millennium Cohort Study, a nationally representative study with an initial sample of just over 19,000. We first examine the extent to which inequalities in overweight, obesity, BMI and body fat over this period are consistent with the evolution of inequalities in health behaviours, including exercise and healthy diet markers (i.e., skipping breakfast) (n = 7,220). We next study the links between SES, health behaviours and adiposity (BMI, body fat), using rich models that account for the influence of a range of unobserved factors that are fixed over time. In this way, we improve on existing estimates measuring the relationship between SES and health behaviours on the one hand and adiposity on the other. The advantage of the individual fixed effects models is that they exploit within-individual changes over time to help mitigate biases due to unobserved fixed characteristics (n = 6,883). We observe stark income inequalities in BMI and body fat in childhood (age 5), which have further widened by age 17. Inequalities in obesity, physical activity, and skipping breakfast are observed to widen from age 7 onwards. Ordinary Least Square estimates reveal the previously documented SES gradient in adiposity, which is reduced slightly once health behaviours including breakfast consumption and physical activity are accounted for. The main substantive change in estimates comes from the fixed effects specification. Here we observe mixed findings on the SES associations, with a positive association between income and adiposity and a negative association with wealth. The role of health behaviours is attenuated but they remain important, particularly for body fat.

Type: Article
Title: Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ssmph.2021.100978
Publisher version: https://doi.org/10.1016/j.ssmph.2021.100978
Language: English
Additional information: © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Body mass index; Obesity; Childhood; Adolescence; Socioeconomic inequalities; Physical activity; Diet; United Kingdom
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10140676
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