Obesity in Adolescents Linked to Family Income and Education

Rising rates of obesity in children and teens in the United States — a key factor in insulin resistance and type 2 diabetes — are linked to growing disparities in family income and education, according to a new analysis published in the journal JAMA Pediatrics.

Diabetes in children and teens is a growing problem, with rates of both type 1 and type 2 diabetes — and prediabetes — on the rise. Obesity is a major factor behind the rise in prediabetes and type 2 diabetes in young people — and can have serious health consequences, both immediately and over time. Children with obesity are more likely to experience mental health problems as well as high blood pressure, which can lead to long-term cardiovascular problems. Obesity is also linked to lower bone mass in younger adults, potentially leading to a higher fracture risk as they get older.

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While dietary patterns are linked to the risk for obesity in children and teens, diet isn’t the only likely factor in rising obesity rates. For example, food insecurity — lacking reliable access to nutritious foods — which affects one in 10 children in the United States, has been shown to make it harder to lose weight. And as further evidence that social and psychological factors play a significant role in obesity, early positive interactions between parents and children have been shown to reduce the children’s risk for obesity later on.

For the latest analysis, researchers looked at data from the U.S. National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018, to examine trends in childhood and teenage obesity during this period. They defined adolescent obesity as having a body-mass index (BMI, a measure of body weight that takes height into account) greater than that of 95% of study participants of the same age and sex between the ages of 10 and 19. There were 21,296 participants in the defined age group, with an average age of 14.5.

The researchers grouped adolescent participants based on whether their family income fell above, or equal to or below, 138% of the federal poverty level. Participants were also separately grouped according to the education level of the household’s main income earner, and by race or ethnicity.

Lower income, education levels linked to increased risk of obesity

Overall, the rate of obesity increased over the study period, particularly for participants from households with a lower income or education level. Being from a lower-income household was linked to a 4.2–percentage point higher rate of obesity, while being from a lower-education household was linked to a 9.0–percentage point higher rate of obesity.

What’s more, the gap in adolescent obesity rates between lower-income households and other households increased during the study period. Compared with 1999-2002, this gap was 6.4 percentage points greater in 2015-2018. A similar trend was seen for the gap in adolescent obesity rates between lower-education and other households, with this gap increasing by 4.2 percentage points between 199902002 and 2015-2018.

“The larger obesity prevalence among adolescents from lower-[income and -education] households may exacerbate socioeconomic disparities in chronic diseases into adulthood,” the researchers wrote. “Future studies should assess strategies to reduce socioeconomic disparities in obesity among U.S. adolescents and evaluate their long-term health consequences.”

Want to learn more about prediabetes and insulin sensitivity? Read “What Is Prediabetes? Symptoms, Treatments, and More” and “Insulin Resistance: Your Questions Answered.”