Socioeconomic position and adiposity among children and their parents in the Republic of Belarus

Abstract Socioeconomic differences in the prevalence of overweight/obesity may be one factor through which health inequalities arise. Socioeconomic inequalities vary by population and over time, and this variation might contribute to understanding mechanisms of association between socioeconomic position and different outcomes. The Republic of Belarus is a middle-income former Soviet country with features in common with many high-income countries: high adult literacy rates and low infant mortality rates but high rates of adult mortality. Objectives: To examine the association between socioeconomic position (parental educational attainment and highest household occupation) and adiposity among children aged 6.5 years and their parents, in Belarus. Design: A prospective cohort study. Setting: Thirty-one maternity hospitals and their affiliated polyclinics in Belarus. Participants: Children originally enrolled at birth into a breastfeeding promotion trial between June 1996-December 1997, of whom 13,889 (82%) were re-examined at age 6.5 years, and their parents. Outcome measures: Child’s body mass index (BMI), waist circumference, percentage body fat (calculated from subscapular and triceps skinfold measurements) and parent’s BMI. Paediatricians performed duplicate measurements of anthropometry on children at age 6.5 years, and mothers mostly reported both parents’ heights and weights. Results: Approximately 10% of children, 37% of mothers and 53% of fathers were overweight/obese. Children from non-manual households were 26% (95% confidence interval (CI): 9%, 46%) more likely to be overweight/obese, with larger waist circumferences and higher percentage body fat (calculated from subscapular and triceps skinfolds) than those from manual households. Similar associations for being overweight/obese were seen for fathers (odds ratio (OR) 1.10; 95% CI: 1.03, 1.19), but mothers from non-manual households were less likely to be overweight/obese: (OR=0.83; 95% CI: 0.78, 0.89). Associations of childhood and parental adiposity with higher educational status of either parent, were similar to those observed for non-manual households. Conclusion: Socioeconomic differentials in obesity, which may lead to health inequalities, vary in direction, sex, and age in different populations.