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Erschienen in: BMC Public Health 1/2013

Open Access 01.12.2013 | Research article

The mediating role of dietary factors and leisure time physical activity on socioeconomic inequalities in body mass index among Australian adults

verfasst von: Emma Gearon, Kathryn Backholer, Allison Hodge, Anna Peeters

Erschienen in: BMC Public Health | Ausgabe 1/2013

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Abstract

Background

The relationship between socioeconomic position and obesity has been clearly established, however, the extent to which specific behavioural factors mediate this relationship is less clear. This study aimed to ascertain the contribution of specific dietary elements and leisure-time physical activity (LTPA) to variations in obesity with education in the baseline (1990–1994) Melbourne Collaborative Cohort Study (MCCS).

Methods

18, 489 women and 12, 141 men were included in this cross-sectional analysis. A series of linear regression models were used in accordance with the products of coefficients method to examine the mediating role of alcohol, soft drink (regular and diet), snacks (healthy and sweet), savoury items (healthy and unhealthy), meeting fruit and vegetable guidelines and LTPA on the relationship between education and body mass index (BMI).

Results

Compared to those with lowest educational attainment, those with the highest educational attainment had a 1 kg/m2 lower BMI. Among men and women, 27% and 48%, respectively, of this disparity was attributable to differences in LTPA and diet. Unhealthy savoury item consumption and LTPA contributed most to the mediated effects for men and women. Alcohol and diet soft drink were additionally important mediators for women.

Conclusions

Diet and LTPA are potentially modifiable behavioural risk factors for the development of obesity that contribute substantially to inequalities in BMI. Our findings highlight the importance of specific behaviours which may be useful to the implementation of effective, targeted public policy to reduce socioeconomic inequalities in obesity.
Literatur
1.
Zurück zum Zitat McLaren L: Socioeconomic status and obesity. Epidemiol Rev. 2007, 29: 29-48. 10.1093/epirev/mxm001.CrossRefPubMed McLaren L: Socioeconomic status and obesity. Epidemiol Rev. 2007, 29: 29-48. 10.1093/epirev/mxm001.CrossRefPubMed
2.
Zurück zum Zitat Ball K, Crawford D: Socioeconomic status and weight change in adults: a review. Soc Sci Med. 2005, 60 (9): 1987-2010. 10.1016/j.socscimed.2004.08.056.CrossRefPubMed Ball K, Crawford D: Socioeconomic status and weight change in adults: a review. Soc Sci Med. 2005, 60 (9): 1987-2010. 10.1016/j.socscimed.2004.08.056.CrossRefPubMed
3.
Zurück zum Zitat Hart CL, Gruer L, Watt GCM: Cause specific mortality, social position, and obesity among women who had never smoked: 28 year cohort study. BMJ. 2011, 342: d3785-10.1136/bmj.d3785.CrossRefPubMedPubMedCentral Hart CL, Gruer L, Watt GCM: Cause specific mortality, social position, and obesity among women who had never smoked: 28 year cohort study. BMJ. 2011, 342: d3785-10.1136/bmj.d3785.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Darmon N, Drewnowski A: Does social class predict diet quality?. Am J Clin Nutr. 2008, 87 (5): 1107-1117.PubMed Darmon N, Drewnowski A: Does social class predict diet quality?. Am J Clin Nutr. 2008, 87 (5): 1107-1117.PubMed
6.
Zurück zum Zitat Moreira P, Santos S, Padrao P, Cordeiro T, Bessa M, Valente H, Barros R, Teixeira V, Mitchell V, Lopes C, et al: Food patterns according to sociodemographics, physical activity, sleeping and obesity in Portuguese children. Int J Environ Res Public Health. 2010, 7 (3): 1121-1138. 10.3390/ijerph7031121.CrossRefPubMedPubMedCentral Moreira P, Santos S, Padrao P, Cordeiro T, Bessa M, Valente H, Barros R, Teixeira V, Mitchell V, Lopes C, et al: Food patterns according to sociodemographics, physical activity, sleeping and obesity in Portuguese children. Int J Environ Res Public Health. 2010, 7 (3): 1121-1138. 10.3390/ijerph7031121.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Turrell G, Bentley R, Thomas LR, Jolley D, Subramanian S, Kavanagh AM: A multilevel study of area socio-economic status and food purchasing behaviour. Public Health Nutr. 2009, 12 (11): 2074-2083. 10.1017/S1368980009004911.CrossRefPubMed Turrell G, Bentley R, Thomas LR, Jolley D, Subramanian S, Kavanagh AM: A multilevel study of area socio-economic status and food purchasing behaviour. Public Health Nutr. 2009, 12 (11): 2074-2083. 10.1017/S1368980009004911.CrossRefPubMed
8.
Zurück zum Zitat Proper KI, Cerin E, Brown WJ, Owen N: Sitting time and socio-economic differences in overweight and obesity. Int J Obes (Lond). 2007, 31 (1): 169-176. 10.1038/sj.ijo.0803357.CrossRef Proper KI, Cerin E, Brown WJ, Owen N: Sitting time and socio-economic differences in overweight and obesity. Int J Obes (Lond). 2007, 31 (1): 169-176. 10.1038/sj.ijo.0803357.CrossRef
9.
Zurück zum Zitat Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB: Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011, 364 (25): 2392-2404. 10.1056/NEJMoa1014296.CrossRefPubMedPubMedCentral Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB: Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011, 364 (25): 2392-2404. 10.1056/NEJMoa1014296.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Molarius A: The contribution of lifestyle factors to socioeconomic differences in obesity in men and women–a population-based study in Sweden. Eur J Epidemiol. 2003, 18 (3): 227-234.CrossRefPubMed Molarius A: The contribution of lifestyle factors to socioeconomic differences in obesity in men and women–a population-based study in Sweden. Eur J Epidemiol. 2003, 18 (3): 227-234.CrossRefPubMed
11.
Zurück zum Zitat Kavanagh A, Bentley RJ, Turrell G, Shaw J, Dunstan D, Subramanian SV: Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes. Soc Sci Med. 2010, 71 (6): 1150-1160. 10.1016/j.socscimed.2010.05.038.CrossRefPubMed Kavanagh A, Bentley RJ, Turrell G, Shaw J, Dunstan D, Subramanian SV: Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes. Soc Sci Med. 2010, 71 (6): 1150-1160. 10.1016/j.socscimed.2010.05.038.CrossRefPubMed
12.
Zurück zum Zitat Wamala SP, Wolk A, Orth-Gomer K: Determinants of obesity in relation to socioeconomic status among middle-aged Swedish women. Prev Med. 1997, 26 (5 Pt 1): 734-744.CrossRefPubMed Wamala SP, Wolk A, Orth-Gomer K: Determinants of obesity in relation to socioeconomic status among middle-aged Swedish women. Prev Med. 1997, 26 (5 Pt 1): 734-744.CrossRefPubMed
13.
Zurück zum Zitat Ward H, Tarasuk V, Mendelson R, McKeown-Eyssen G: An exploration of socioeconomic variation in lifestyle factors and adiposity in the Ontario Food Survey through structural equation modeling. Int J Behav Nutr Phys Act. 2007, 4: 8-10.1186/1479-5868-4-8.CrossRefPubMedPubMedCentral Ward H, Tarasuk V, Mendelson R, McKeown-Eyssen G: An exploration of socioeconomic variation in lifestyle factors and adiposity in the Ontario Food Survey through structural equation modeling. Int J Behav Nutr Phys Act. 2007, 4: 8-10.1186/1479-5868-4-8.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Hodge AM, Jenkins AJ, English DR, O'Dea K, Giles GG: NMR-determined lipoprotein subclass profile is associated with dietary composition and body size. Nutr Metab Cardiovasc Dis. 2011, 21 (8): 603-609.PubMed Hodge AM, Jenkins AJ, English DR, O'Dea K, Giles GG: NMR-determined lipoprotein subclass profile is associated with dietary composition and body size. Nutr Metab Cardiovasc Dis. 2011, 21 (8): 603-609.PubMed
15.
Zurück zum Zitat Ireland P, Jolley D, Giles GG, O'Dea K, Powles J, Rutishauser I, Wahlqvist ML, Williams J: Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr. 1994, 3: 19-31.PubMed Ireland P, Jolley D, Giles GG, O'Dea K, Powles J, Rutishauser I, Wahlqvist ML, Williams J: Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr. 1994, 3: 19-31.PubMed
16.
Zurück zum Zitat MacInnis RJ, English DR, Hopper JL, Haydon AM, Gertig DM, Giles GG: Body size and composition and colon cancer risk in men. Cancer Epidemiol Biomarkers Prev. 2004, 13 (4): 553-559.PubMed MacInnis RJ, English DR, Hopper JL, Haydon AM, Gertig DM, Giles GG: Body size and composition and colon cancer risk in men. Cancer Epidemiol Biomarkers Prev. 2004, 13 (4): 553-559.PubMed
17.
18.
Zurück zum Zitat Walls HL, Wolfe R, Haby MM, Magliano DJ, de Courten M, Reid CM, McNeil JJ, Shaw J, Peeters A: Trends in BMI of urban Australian adults, 1980–2000. Public Health Nutr. 2010, 13 (05): 631-638. 10.1017/S1368980009991455.CrossRefPubMed Walls HL, Wolfe R, Haby MM, Magliano DJ, de Courten M, Reid CM, McNeil JJ, Shaw J, Peeters A: Trends in BMI of urban Australian adults, 1980–2000. Public Health Nutr. 2010, 13 (05): 631-638. 10.1017/S1368980009991455.CrossRefPubMed
19.
Zurück zum Zitat MacKinnon DP: Introduction to statistical mediation analysis. 2008, New York: Psychology Press MacKinnon DP: Introduction to statistical mediation analysis. 2008, New York: Psychology Press
20.
Zurück zum Zitat Backholer K, Pasupathi K, Wong E, Hodge A, Stevenson C, Peeters A: The relationship between body mass index prior to old age and disability in old age. Int J Obes (Lond). 2012, 36: 1180-1186. 10.1038/ijo.2012.99.CrossRef Backholer K, Pasupathi K, Wong E, Hodge A, Stevenson C, Peeters A: The relationship between body mass index prior to old age and disability in old age. Int J Obes (Lond). 2012, 36: 1180-1186. 10.1038/ijo.2012.99.CrossRef
21.
Zurück zum Zitat Harriss LR, English DR, Powles J, Giles GG, Tonkin AM, Hodge AM, Brazionis L, O'Dea K: Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study. Am J Clin Nutr. 2007, 86 (1): 221-229.PubMed Harriss LR, English DR, Powles J, Giles GG, Tonkin AM, Hodge AM, Brazionis L, O'Dea K: Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study. Am J Clin Nutr. 2007, 86 (1): 221-229.PubMed
22.
Zurück zum Zitat Hodge AM, Simpson JA, Gibson RA, Sinclair AJ, Makrides M, O'Dea K, English DR, Giles GG: Plasma phospholipid fatty acid composition as a biomarker of habitual dietary fat intake in an ethnically diverse cohort. Nutr Metab Cardiovasc Dis. 2007, 17 (6): 415-426. 10.1016/j.numecd.2006.04.005.CrossRefPubMed Hodge AM, Simpson JA, Gibson RA, Sinclair AJ, Makrides M, O'Dea K, English DR, Giles GG: Plasma phospholipid fatty acid composition as a biomarker of habitual dietary fat intake in an ethnically diverse cohort. Nutr Metab Cardiovasc Dis. 2007, 17 (6): 415-426. 10.1016/j.numecd.2006.04.005.CrossRefPubMed
23.
Zurück zum Zitat Tubeuf S, Jusot F, Bricard D: Mediating role of education and lifestyles in the relationship between early-life conditions and health: evidence from the 1958 British cohort. Health Econ. 2012, 21 (Suppl 1): 129-150.CrossRefPubMed Tubeuf S, Jusot F, Bricard D: Mediating role of education and lifestyles in the relationship between early-life conditions and health: evidence from the 1958 British cohort. Health Econ. 2012, 21 (Suppl 1): 129-150.CrossRefPubMed
24.
Zurück zum Zitat Hruschka DJ: Do economic constraints on food choice make people fat? A critical review of two hypotheses for the poverty-obesity paradox. Am J Hum Biol. 2012, 24 (3): 277-285. 10.1002/ajhb.22231.CrossRefPubMed Hruschka DJ: Do economic constraints on food choice make people fat? A critical review of two hypotheses for the poverty-obesity paradox. Am J Hum Biol. 2012, 24 (3): 277-285. 10.1002/ajhb.22231.CrossRefPubMed
25.
Zurück zum Zitat Adams J: The mediating role of time perspective in socio-economic inequalities in smoking and physical activity in older English adults. J Health Psychol. 2009, 14 (6): 794-799. 10.1177/1359105309338979.CrossRefPubMed Adams J: The mediating role of time perspective in socio-economic inequalities in smoking and physical activity in older English adults. J Health Psychol. 2009, 14 (6): 794-799. 10.1177/1359105309338979.CrossRefPubMed
26.
Zurück zum Zitat Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP: Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008, 16 (8): 1894-1900. 10.1038/oby.2008.284.CrossRef Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP: Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008, 16 (8): 1894-1900. 10.1038/oby.2008.284.CrossRef
27.
Zurück zum Zitat Lavin PT, Sanders PG, Mackey MA, Kotsonis FN: Intense sweeteners use and weight change among women: a critique of the Stellman and Garfinkel study. J Am Coll Nutr. 1994, 13 (1): 102-105. 10.1080/07315724.1994.10718379.CrossRefPubMed Lavin PT, Sanders PG, Mackey MA, Kotsonis FN: Intense sweeteners use and weight change among women: a critique of the Stellman and Garfinkel study. J Am Coll Nutr. 1994, 13 (1): 102-105. 10.1080/07315724.1994.10718379.CrossRefPubMed
Metadaten
Titel
The mediating role of dietary factors and leisure time physical activity on socioeconomic inequalities in body mass index among Australian adults
verfasst von
Emma Gearon
Kathryn Backholer
Allison Hodge
Anna Peeters
Publikationsdatum
01.12.2013
Verlag
BioMed Central
Erschienen in
BMC Public Health / Ausgabe 1/2013
Elektronische ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-1214

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