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Early-life Poverty, Social Disadvantage and Adiposity from Childhood to Young Adulthood

Stekelenburg KJ, Gaillard R, Jaddoe VW · 21 Aug 2026

Abstract

Abstract Background Early-life family poverty and social disadvantage status may affect body mass index (BMI) and body fat distribution in offspring across the life course. We assessed the associations of early-life poverty and social disadvantage with adiposity measures from early childhood to young adulthood. Methods We performed a population-based prospective cohort study among 7,389 parents and children in the city of Rotterdam, the Netherlands. Exposures were pregnancy parental educational level, low household income, and poverty, defined as low income and experiencing financial difficulties, assessed by questionnaires. Childhood body mass index, total fat mass, visceral adipose tissue, and hepatic fat were assessed by physical examinations, dual-energy X-ray absorptiometry, and magnetic resonance imaging at the ages of 2, 6, 10, 14, and 18 years. Results As compared to children not exposed to early-life poverty, those exposed had a higher offspring BMI from the age of 6 years onwards (difference in BMI standard deviation score [SDS] at the age of 18 years 0.17, 95% confidence interval [CI] 0.01, 0.32), a higher risk of overweight and obesity at ages 6 and 18 years (odds ratio at the age of 18 years 1.45, 95% CI 1.06, 2.00), and a higher total fat mass from the age of 10 years onwards (difference in total fat mass SDS at the age of 18 years 0.17, 95% CI 0.02, 0.33). We observed tendencies for similar associations for household income and both maternal and paternal education. Also, as compared to children not exposed to low household income and lower maternal education, those exposed had a higher android/gynoid fat mass ratio from the age of 10 years onwards (p-values < 0.05). Measures of poverty and social disadvantage were not associated with childhood and visceral fat or liver fat. Conclusions Early-life poverty and social disadvantage are associated with a higher BMI and adverse body fat distribution from early-childhood to young adulthood. Addressing social inequalities in pregnancy and early childhood may contribute to reducing adiposity across the life course.