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Wealth index and risk of childhood overweight and obesity: evidence from four prospective cohorts in Peru and Vietnam



To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children.


Longitudinal data from the Young Lives study were analyzed. Exposure was wealth index in tertiles. Outcome was overweight and obesity. Cumulative incidence per 100 children-years, relative risks (RR), and 95 % confidence intervals (95 % CI) were calculated. A hierarchical approach, including child- and family-related variables, was followed to construct multivariable models.


The cumulative incidence of overweight and obesity was 4.8 (95 % CI 4.1–5.5) and 1.7 (95 % CI 1.3–2.2) in the younger and older Peruvian cohort, respectively; and in Vietnam 1.5 (95 % CI 1.2–1.8) and 0.3 (95 % CI 0.2–0.5), respectively. The incidence of overweight and obesity was higher at the top wealth index tertile in all samples. In the older cohorts, comparing highest versus bottom wealth index tertile, RR of overweight and obesity was four to nine times higher: 4.25 in Peru (95 % CI 2.21–8.18) and 9.11 in Vietnam (95 % CI 1.07–77.42).


The results provide important information for childhood obesity prevention in countries moving ahead with economic, epidemiological and nutritional transitions.

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The data used in this publication come from Young Lives, a 15-year study of the changing nature of childhood poverty in Ethiopia, India (Andhra Pradesh), Peru and Vietnam ( Young Lives is funded by UK aid from the Department for International Development (DFID) and co-funded from 2010 to 2014 by the Netherlands Ministry of Foreign Affairs. The views expressed here are those of the author(s). They are not necessarily those of Young Lives, the University of Oxford, DFID or other funders.

The authors are thankful to Daniel Lopez de Romaña Forga, PhD for his comments on earlier versions of this manuscript.

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Corresponding author

Correspondence to J. Jaime Miranda.

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RMC-L, AB-O, JJM are part of the CRONICAS Center of Excellence in Chronic Diseases, supported by the National Heart, Lung, and Blood Institute Global Health Initiative under the contract Global Health Activities in Developing Countries to Combat Non-Communicable Chronic Diseases (Project Number 268200900033C-1-0-1). AB-O is supported by a Wellcome Trust Research Training Fellowship in Public Health and Tropical Medicine (Grant Number: 103994/Z/14/Z).

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The authors declare no conflict of interests.

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Carrillo-Larco, R.M., Miranda, J.J. & Bernabé-Ortiz, A. Wealth index and risk of childhood overweight and obesity: evidence from four prospective cohorts in Peru and Vietnam. Int J Public Health 61, 475–485 (2016).

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  • Peru
  • Vietnam
  • Developing countries
  • Pediatric obesity
  • Social class
  • Prospective studies