Wealthy kids are not always healthy kids

Jul 23 2005

An international team of researchers from the UK, Estonia, Denmark and Norway, have found that children from poorer families are not necessarily less healthy than those with more affluent and better educated parents.

Their findings challenge the widely held belief that adverse social circumstances in childhood lead to unhealthy lifestyles and poor health.

The British Medical Journal study involved 3,189 randomly selected schoolchildren from Denmark, one of the richest countries in Europe, and two poorer countries, Estonia and Portugal.

The study looked at insulin resistance,as a marker of disease, which raises the risk of diabetes and heart disease, in relation to socioeconomic status.

Insulin is a hormone that the body uses to unlock the energy from the sugar that we eat.

If a person is insulin resistant, their body continues to produce insulin but the insulin does not work effectively, which means that the body cells cannot take up enough glucose.

This leads to rising blood sugar levels, and if these levels rise too high the patient may develop Type 2 diabetes.

Insulin resistance is also linked to other conditions, such as high blood pressure and cholesterol problems, which can lead to heart and circulation problems.

The team found that among Danish schoolchildren, those with highly educated and big earning parents were the least insulin resistant, while the opposite was true for children from Estonia and Portugal.

In the Danish children studied, insulin resistance was 24% lower in those whose fathers had the most education compared with those with the least education.

Yet insulin resistance was 15% higher for children in more educated families in Estonia, and 19% higher for Portugal.

The researchers suggest that the higher levels seen in Estonia and Portugal might be because the children have adopted unhealthier Western lifestyles and are eating junk food and doing less exercise.

It was found that these children were more overweight than their less affluent school mates.

Their parents however were more likely to be healthier than less affluent parents, which suggests they themselves might not be following the same unhealthy lifestyle as their children.

The children of better educated parents in Denmark, presumably, might also be leading healthier lifestyles.

In an accompanying editorial however, Swedish experts on health patterns across populations, warn that the findings could be down to other factors not examined.

They say factors such as genes, environment while in the womb and early childhood, as well as socioeconomic status, all play a role in insulin resistance.

They add that anomalies such as those reported for Estonia and Portugal may be of special significance, as they point towards gaps in our understanding and warn against too simplistic a view of health inequalities.

Amanda Vezey, care advisor at Diabetes UK, says insulin resistance, is often a precursor to Type 2 diabetes, and is linked to genetic and lifestyle factors such as being overweight, eating a poor diet and leading a sedentary lifestyle.

Diabetes UK, she says, believes junk food may be the culprit.

Steve Shaffelberg of the British Heart Foundation says the study has to be put into perspective for children in the UK, and reliable research has clearly demonstrated a solid link between poverty and heart disease there.

He believes it would be misleading to suggest that findings from this study override existing evidence that shows social and economic factors are critical factors for heart health.