Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study

Abstract Background Obesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. We examined income as a possible cause of obesity in an East German general population, focus...

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Main Authors: Cornelia Enzenbach, Bernd Kowall
Format: Article
Language:English
Published: BMC 2021-07-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-021-11302-w
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spelling doaj-a483c855dcc34f018172ad2624bae89d2021-07-11T11:16:14ZengBMCBMC Public Health1471-24582021-07-0121111310.1186/s12889-021-11302-wIncome in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-StudyCornelia Enzenbach0Bernd Kowall1Institute for Medical Informatics, Statistics, and Epidemiology, University of LeipzigInstitute for Medical Informatics, Biometry, and Epidemiology, University Hospital EssenAbstract Background Obesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. We examined income as a possible cause of obesity in an East German general population, focusing on appropriate representation of study variables, as well as on confounding and modification of the income-obesity association. Methods We used data of 9599 participants in the baseline examination of the LIFE-Adult-Study, conducted in the city of Leipzig from 2011 to 2014. Body mass index (BMI) and waist circumference (WC) as obesity measures were based on standardised measurements, net equivalised income (NEI) on self-reports. We estimated adjusted means of BMI and WC within NEI categories representing the range from risk of poverty to affluence. We stratified the analyses by gender, age, and education. Results A substantial part of the age-adjusted associations of income with obesity measures was attributable to other SES indicators. Adjusted for these variables, NEI was comparably associated with BMI and WC. Among women, BMI and WC decreased across NEI categories. The inverse associations tended to be stronger at non-working age (≥ 65 years) than at working age (< 65 years). Conversely, among working-age men, BMI and WC increased with increasing NEI. Among older men, risk of poverty was related to higher values of the obesity measures. The aforementioned associations were predominantly stronger in highly educated participants compared to those with medium/low education. The differences in mean BMI and WC between persons at risk of poverty and higher income groups were rather small, ranging from 1 to 2 kg/m2 for BMI and 2 to 4 cm for WC. Conclusions Our investigation indicates an association between income and body fatness in an East German adult population that depends on the sociodemographic context of the people. However, it does not suggest that income disparities are a major driver of body fat accumulation in this population. Differential selection of study participants, error in the measurement of long-term income, and possibly reverse causality may have affected our conclusions.https://doi.org/10.1186/s12889-021-11302-wObesityIncomeSocioeconomic statusCross-sectional studyGermany
collection DOAJ
language English
format Article
sources DOAJ
author Cornelia Enzenbach
Bernd Kowall
spellingShingle Cornelia Enzenbach
Bernd Kowall
Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study
BMC Public Health
Obesity
Income
Socioeconomic status
Cross-sectional study
Germany
author_facet Cornelia Enzenbach
Bernd Kowall
author_sort Cornelia Enzenbach
title Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study
title_short Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study
title_full Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study
title_fullStr Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study
title_full_unstemmed Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study
title_sort income in relation to obesity measures in an east german adult population: findings from the life-adult-study
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2021-07-01
description Abstract Background Obesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. We examined income as a possible cause of obesity in an East German general population, focusing on appropriate representation of study variables, as well as on confounding and modification of the income-obesity association. Methods We used data of 9599 participants in the baseline examination of the LIFE-Adult-Study, conducted in the city of Leipzig from 2011 to 2014. Body mass index (BMI) and waist circumference (WC) as obesity measures were based on standardised measurements, net equivalised income (NEI) on self-reports. We estimated adjusted means of BMI and WC within NEI categories representing the range from risk of poverty to affluence. We stratified the analyses by gender, age, and education. Results A substantial part of the age-adjusted associations of income with obesity measures was attributable to other SES indicators. Adjusted for these variables, NEI was comparably associated with BMI and WC. Among women, BMI and WC decreased across NEI categories. The inverse associations tended to be stronger at non-working age (≥ 65 years) than at working age (< 65 years). Conversely, among working-age men, BMI and WC increased with increasing NEI. Among older men, risk of poverty was related to higher values of the obesity measures. The aforementioned associations were predominantly stronger in highly educated participants compared to those with medium/low education. The differences in mean BMI and WC between persons at risk of poverty and higher income groups were rather small, ranging from 1 to 2 kg/m2 for BMI and 2 to 4 cm for WC. Conclusions Our investigation indicates an association between income and body fatness in an East German adult population that depends on the sociodemographic context of the people. However, it does not suggest that income disparities are a major driver of body fat accumulation in this population. Differential selection of study participants, error in the measurement of long-term income, and possibly reverse causality may have affected our conclusions.
topic Obesity
Income
Socioeconomic status
Cross-sectional study
Germany
url https://doi.org/10.1186/s12889-021-11302-w
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