Mediators of socioeconomic differences in adiposity among youth: a systematic review

Summary Background Youth with a low socioeconomic position in developed countries are at a disproportionately higher risk of being overweight or obese than their counterparts. Tackling these inequalities requires that the mechanisms behind them are well understood. Objectives The aim of this review was to summarize existing evidence regarding the factors that mediate or contribute to the explanation of the relationship between socioeconomic position and adiposity among youth. Methods and results A systematic literature search, conducted using the databases Medline, Embase, Web of Science and PsycINFO, yielded 28 eligible studies. These studies were of low to moderate methodological quality. The most consistent mediators of the association between socioeconomic position and adiposity identified in this review were as follows: consumption of sugar‐sweetened beverages, television viewing, computer use, parental body mass index, breastfeeding duration, breakfast consumption, maternal smoking during pregnancy and infant feeding practices. The mediating role of physical activity as well as fruit and vegetable consumption was found to be indeterminate. Other potential mediators were explored in too few studies to make conclusions about their mediating role. Conclusion The review found several modifiable factors that could be targeted as feasible in interventions aimed at reducing socioeconomic differences in overweight and obesity among youth.