Higher family income protects children from the risks of obesity

Family affluence protects children from obesity and unhealthy eating habits, even when they live in an area with a high density of fast-food outlets and other unhealthy food options, new research based on interviews with parents in London found.

A study co-led by researchers at University College London (UCL) examined evidence from four London boroughs and found that family deprivation is strongly linked to childhood obesity. Factors such as low income, lower education, and insecure housing had a greater impact on children’s diet and weight than neighbourhood food environments.

Family affluence can shield children from the risks of obesity, the study concluded.

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Childhood obesity inequalities in England persist despite targeted interventions and Government policies focused on promoting healthy diets and food environments. The research, funded by the National Institute for Health & Care Research (NIHR) and published in the International Journal of Behavioral Nutrition and Physical Activity, shows the importance of addressing structural inequalities and household deprivation.

The study team, which included researchers from UCL, the University of Cambridge, the University of Leeds, and City St George’s, University of London, recruited 728 families with primary school-aged children from four socioeconomically diverse London boroughs in 2022. The researchers collected data on home food environments, parental feeding practices, child eating behaviours and food preferences through a questionnaire interview with parents. The findings were analysed alongside measures of family-level deprivation, neighbourhood food environments, and child BMI measurements.

Families facing higher levels of deprivation were found to be more likely to have an ‘obesogenic’ home food environment, where unhealthy eating promotes excessive weight gain in children. Young people living in the most deprived households displayed more harmful eating habits, such as eating in response to emotions or external triggers rather than hunger and showed a stronger preference for sugary drinks. In addition, parents in less affluent households were more likely to use emotional or pressuring feeding practices with their children and less likely to provide structured meals for children.

The researchers found that although obesogenic food environments outside of the home, such as fast-food outlets close to school settings, impacted childhood levels of obesity, family-level deprivation and the related obesogenic home food environment had a significantly greater impact on children’s weight.

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The findings come as the Government extends free school meals for more children and faces growing pressure to remove the two-child benefit cap, and highlight how welfare reforms could have as much of an impact on children’s health as changes to their local food environment.

Joint lead author Dr Andrea Smith of the MRC Epidemiology Unit at the University of Cambridge said: ‘Our study shows that deprivation has a deep and wide-ranging impact on children’s eating habits, family feeding practices, and ultimately children’s weight. While improving neighbourhood food environments remains important, we cannot ignore the broader social and economic conditions that families face. Tackling deprivation must be central to any strategy aiming to reduce health inequalities in childhood obesity.’

The study provides evidence of how family deprivation can add to issues of childhood obesity and emphasises the need for local authorities and policymakers to tailor interventions to the realities of family deprivation and household stress.

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Senior author Professor Clare Llewellyn, from UCL, added: ‘Tackling childhood obesity means addressing the root causes, including economic hardship and food insecurity. Without policy action on these broader structural issues, efforts to promote healthy eating are unlikely to succeed.’