Determinants Associated With Obesity in Children of Low Socioeconomic Status Families: A Narrative Review.

Children of families with low socioeconomic status (SES) are at higher risk for obesity and obesity-related lifestyle behaviors, i.e., unhealthy eating and low physical activity. This review aims to identify changeable determinants of obesity and obesity-related lifestyle behaviors in children aged 0-12, with a focus on those specific to low SES. A literature search was conducted in PsycINFO/Ovid and PubMed, using terms related to SES, obesity, and individual or environmental determinants. We included 42 systematic review/meta-analysis articles, written in English, that focused on children (0-12 years) and assessed obesity or obesity-related lifestyle behavior outcomes. We extracted modifiable individual and environmental determinants, and the role of SES in their association with obesity and obesity-related lifestyle behaviors in children. Nine reviews examined the relationship between determinants and obesity and obesity-related lifestyle behaviors in children, and the role of SES. These reviews focused mainly on environmental determinants (n = 8), particularly family and peer factors (n = 6). The findings suggest that SES may influence obesity and lifestyle behaviors indirectly through parental factors, such as parental BMI, maternal smoking during pregnancy, and parental TV viewing behaviors. SES may also moderate the impact of parental factors, such as parental BMI, maternal depression, or permissive/indulgent parenting. Our review showed that research on determinants of obesity and obesity-related lifestyle behaviors of children with low SES is limited, with scarce and inconsistent evidence and lacking theoretical explanations. The (parent-related) mechanisms which influence child obesity in families with low SES are still unclear. To develop effective (family) interventions to prevent or decrease obesity in children of families with low SES, future research needs to examine individual and environmental determinants and underlying mechanisms through which SES has its influence on childhood obesity.