The Magnitude and Directions of the Associations between Early Life Factors and Metabolic Syndrome Differ across Geographical Locations among Migrant and Non-Migrant Ghanaians—The RODAM Study

Background: Early-life factors (ELFs) such as childhood nutrition and childhood socio-economic status could be the drivers of the increase in metabolic syndrome (MetSyn) among African populations, but data are lacking. This study evaluated whether markers of childhood nutritional status and childhood socio-economic status were associated with MetSyn in adulthood among migrant Ghanaians living in Europe and non-migrant Ghanaians living in Ghana. Methods: Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2008 migrants and 2320 non-migrants aged ≥25 years, were analysed for this study. We used leg-length to height ratio (LHR), which is an anthropometric marker of childhood nutritional status, and parental education, which is a marker of childhood socio-economic status, as proxies. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for demographic and lifestyle factors. Results: Parental education was higher among Ghanaians in Europe than among residents in rural and urban Ghana. The prevalence of MetSyn was 18.5%, 27.7% and 33.5% for rural, urban, and migrant residents, respectively. LHR was inversely associated with MetSyn among migrants. Compared with high paternal education, individuals with low paternal education had lower odds of MetSyn in migrants (AOR 0.71 95% CI 0.54–0.94). In contrast, compared with high maternal education, individuals with intermediate maternal education had higher odds of MetSyn in urban Ghanaians (AOR 4.53 95% CI 1.50–3.74). No associations were found among rural Ghanaians. Conclusion: The magnitude and direction of the associations between ELFs and MetSyn differ across geographical locations. Intermediate maternal education was positively associated with MetSyn among urban Ghanaians, while LHR and low paternal education were inversely associated with MetSyn among migrant Ghanaians. Further research into the interplay of genetics, environment and behaviour is needed to elucidate the underlying pathological mechanisms of MetSyn amongst migrants.

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Early-life circumstances and the risk of function-limiting long-term conditions in later life

Longitudinal and Life Course Studies ◽

10.1332/175795919x15762565000695 ◽

2020 ◽

Vol 11 (2) ◽

pp. 157-180

Author(s):

Matthew H. Iveson ◽

Chris Dibben ◽

Ian J. Deary

Keyword(s):

Life Course ◽

Cognitive Ability ◽

Early Life ◽

Economic Status ◽

Functional Limitation ◽

Later Life ◽

Socio Economic Status ◽

Childhood Cognitive Ability ◽

The Life Course

Older adults are particularly prone to function-limiting health issues that adversely affect their well-being. Previous work has identified factors from across the life course –childhood socio-economic status, childhood cognitive ability and education – that predict later-life functional outcomes. However, the independence of these contributions is unclear as later-in-the-life-course predictors are themselves affected by earlier ones. The present study capitalised on the recent linkage of the Scottish Mental Survey 1947 with the Scottish Longitudinal Study, using path analyses to examine the direct and indirect associations between life-course predictors and the risk of functional limitation at ages 55 (N = 2,374), 65 (N = 1,971) and 75 (N = 1,534). The odds of reporting a function-limiting long-term condition increased across later life. At age 55, reporting a functional limitation was significantly less likely in those with higher childhood socio-economic status, higher childhood cognitive ability and higher educational attainment; these associations were only partly mediated by other predictors. At age 65, adult socio-economic status emerged as a mediator of several associations, although direct associations with childhood socio-economic status and childhood cognitive ability were still observed. At age 75, only childhood socio-economic status and adult socio-economic status directly predicted the risk of a functional limitation, particularly those associated with disease or illness. A consistent pattern and direction of associations was observed with self-rated health more generally. These results demonstrate that early-life and adult circumstances are associated with functional limitations later in life, but that these associations are partly a product of complex mediation between life-course factors.

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The association between household socio-economic status, maternal socio-demographic characteristics and adverse birth and infant growth outcomes in sub-Saharan Africa: a systematic review

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174419000680 ◽

2019 ◽

Vol 11 (4) ◽

pp. 317-334 ◽

Cited By ~ 2

Author(s):

Christian Bwangandu Ngandu ◽

Douglas Momberg ◽

Ansuyah Magan ◽

Lumbwe Chola ◽

Shane A. Norris ◽

...

Keyword(s):

Birth Outcomes ◽

Growth And Development ◽

Maternal Education ◽

Economic Status ◽

Infant Growth ◽

Sub Saharan Africa ◽

Adverse Birth Outcomes ◽

Cardiometabolic Diseases ◽

Socio Economic Status ◽

Sub Saharan

AbstractAdverse birth outcomes and infant undernutrition remain the leading causes of morbidity and mortality in sub-Saharan Africa (SSA). Impaired infant growth and development, which often begins during foetal development, may persist during the first 2 years of life and has been associated with higher risks of cardiometabolic diseases. This systematic review assessed the associations between maternal demographic characteristics and household socio-economic status (SES), and preterm birth (PTB), small for gestational age, low birth weight (LBW), stunting, wasting and underweight in children under 2 years of age in SSA countries. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched for publications in three electronic databases (PubMed, Scopus and ScienceDirect). Eleven studies on children under 2 years of age, in four SSA regions, published in English between 1990 and 2018, were included. All the studies were observational in design (cross-sectional or cohort studies). Maternal education was the most commonly explored exposure. Most studies (63.3%) focused on undernutrition during the first 2 years of life: LBW, PTB and stunting. Lower maternal education, maternal unemployment and lower household wealth index were the SES factors most commonly associated with adverse birth outcomes and infant undernutrition. Maternal marital status was not associated with any infant outcomes. The definitions of the SES varied, which may explain discrepancies between studies. Nutrition intervention programs in SSA need to promote education and poverty alleviation in women at reproductive age, starting from pre-pregnancy, to optimise infant growth and development and prevent the increase in the prevalence of cardiometabolic diseases.

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Association between socio-economic status and childhood undernutrition in Bangladesh; a comparison of possession score and poverty index

Public Health Nutrition ◽

10.1017/s1368980010001758 ◽

2010 ◽

Vol 13 (10) ◽

pp. 1498-1504 ◽

Cited By ~ 31

Author(s):

Masuda Mohsena ◽

CG Nicholas Mascie-Taylor ◽

Rie Goto

Keyword(s):

Nutritional Status ◽

Maternal Education ◽

Economic Status ◽

Principal Component ◽

Poverty Index ◽

Socio Economic Status ◽

The Family ◽

Height For Age ◽

Weight For Age ◽

Children Under 5

AbstractObjectiveTo determine how much of the variation in nutritional status of Bangladeshi children under 5 years old can be attributed to the socio-economic status of the family.DesignNutritional status used reference Z-scores of weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ). A ‘possession score’ was generated based on ownership of a radio, television, bicycle, motorcycle and telephone, and the availability of electricity, with categories of 0 to 4+ possessions. A five-point (quintile) ‘poverty index’ was created using principal component analysis.SettingThe Bangladesh Demographic and Health Survey 2004 was the source of data.SubjectsA sample of 4891 children aged <5 years was obtained.ResultsSome 57·8 % of the sample was either stunted, wasted or underweight (7·7 % were stunted, wasted and underweight). Of those stunted (48·4 %), 25·7 % were also underweight. Underweight and wasting prevalences were 40·7 % and 14·3 %, respectively. Mean WAZ, HAZ and WHZ did not differ by sex. Children of mothers with no education or no possessions were, on average, about 1 sd more underweight and stunted than those with higher educated mothers or with 4+ possessions. The possession score provided much greater discrimination of undernutrition than the poverty index. Nearly 50 % of children from households with no possessions were stunted, wasted or underweight (only 27 % in the poorest quintile), compared with only 3–6 % of children from households with 4+ possessions (over 13 % in the richest quintile).ConclusionsMaternal education and possession score were the main predictors of a child’s nutritional status. Possession score was a much better indicator of undernutrition than the poverty index.

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What role for the ‘long arm of childhood’ in social gradients in health? An international comparison of high-income contexts

Longitudinal and Life Course Studies ◽

10.1332/175795920x16025975665508 ◽

2020 ◽

Author(s):

Steven A. Haas ◽

Zhangjun Zhou ◽

Katsuya Oi

Keyword(s):

Life Course ◽

Early Life ◽

Economic Status ◽

Functional Limitation ◽

Later Life ◽

High Income ◽

Childhood Health ◽

Relative Contribution ◽

Early Life Factors

Social gradients in health have been a focus of research for decades. Two important lines of social gradient research have examined (1) international variation in their magnitude and (2) their life course / developmental antecedents. The present study brings these two strands together to explore the developmental origins of educational gradients in health. We leverage data spanning 14 high-income contexts from the Health and Retirement Study and its sisters in Europe. We find that early-life health and socio-economic status consistently attenuate educational gradients in multimorbidity and functional limitation. However, the relative contribution of early-life factors to gradients varies substantially across contexts. The results suggest that research on social gradients, and population health broadly, would benefit from the unique insights available from a conceptual and empirical approach that integrates comparative and life course perspectives.<br /><br />Key messages<br /><ul><li>The magnitude of educational gradients in later life health depend, in part, on childhood health and socioeconomic circumstances.</li><br /><li>The role of early life factors in educational gradients in health varies substantially across high income contexts.</li></ul>

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Early-life Socio-economic Status and Adult Health: The Role of Positive Affect

Stress and Health ◽

10.1002/smi.2696 ◽

2016 ◽

Vol 33 (3) ◽

pp. 190-198

Author(s):

Kyle W. Murdock ◽

Angie S. LeRoy ◽

Christopher P. Fagundes

Keyword(s):

Positive Affect ◽

Early Life ◽

Economic Status ◽

Adult Health ◽

Socio Economic Status

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Rich micronutrient fortification of locally produced infant food does not improve mental and motor development of Zambian infants: a randomised controlled trial

British Journal Of Nutrition ◽

10.1017/s0007114511003217 ◽

2011 ◽

Vol 107 (4) ◽

pp. 556-566 ◽

Cited By ~ 15

Author(s):

Daniela Manno ◽

Priscilla K. Kowa ◽

Hellen K. Bwalya ◽

Joshua Siame ◽

Sally Grantham-McGregor ◽

...

Keyword(s):

Motor Development ◽

Maternal Education ◽

Economic Status ◽

Controlled Trial ◽

Psychomotor Development ◽

Infant Food ◽

Development Index ◽

Socio Economic Status ◽

Micronutrient Fortification ◽

Bayley Scales

It is uncertain whether multiple micronutrients benefit the mental and psychomotor development of young children in developing countries. We conducted a randomised double-blind controlled trial to evaluate the effect of a richly micronutrient-fortifiedv.a basal fortified porridge on mental and psychomotor development in Zambian infants. Infants (n743) were randomised at age 6 months to receive either the richly fortified or the basal fortified infant food and were followed up until 18 months of age. All the infants were evaluated monthly for achievement of a series of developmental milestones. The Bayley scales of infant development II were administered to a subsample of 502 infants at 6, 12 and 18 months. Rich micronutrient fortification had no significant benefit on the following: (a) number of developmental milestones achieved (rate ratio at 12 months = 1·00; 95 % CI 0·96, 1·05;P = 0·81, adjusted for sex, socio-economic status and maternal education, with similar results at 15 and 18 months); (b) ages of walking unsupported (hazard ratio (HR) 1·04; 95 % CI 0·88, 1·24;P = 0·63, adjusted for the above covariates) and of speaking three or four clear words (HR 1·01; 95 % CI 0·84, 1·20;P = 0·94, adjusted for the above covariates); (c) mental development index (MDI) and psychomotor development index (PDI) of the Bayley scales (scores difference adjusted for baseline scores, age at the assessment, sex, socio-economic status, maternal education, language, age and HIV status: MDI 0·3 (95 % CI − 0·5, 1·1),P = 0·43; PDI − 0·1 (95 % CI − 0·9, 0·7),P = 0·78). In conclusion, the results do not support the hypothesis that rich micronutrient fortification improves Zambian infants' mental and motor development.

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