Letter to the Editor
Reply to Bovet et al.
Bovet et al. provide useful additional information that is
certainly relevant to the broader context of our article (1).
As our review and our search terms focused on the more
commonly used socioeconomic status (SES) indicators
(income/wealth, education, occupation or composite), our
search criteria did not capture the paper mentioned by
Bovet et al. (2), which used type of school (public vs.
private) as SES indicator. Despite our focus on the more
common SES indicators, our search strategy identified one
study on children that did use school type as SES indicator
(3), because the abstract and title of this study did include
terms that matched our search terms, while the Bovet et al.
study did not.
School type may well become a more widely accepted
and validated SES proxy in the future and should then be
included in future systematic reviews, but at present, more
research is needed to examine the validity of the measure.
An encouraging example of one such validation, if in a
different context, is by Piovesan et al. (4).
Nevertheless, the findings of the Bovet et al. paper (2)
still support our conclusion that – based on the still very
limited amount of evidence – obesity/overweight among
children in low and middle income countries appears to
remain more prevalent in higher SES groups (proxied by
private school attendance in [2]) compared with those in
lower SES groups (proxied by public school attendance).
We also note that even though only one study in Africa
fulfilled our search/selection criteria on children, our review
did include six studies undertaken in Africa (including one
in Seychelles) on adults.
Other studies presented in the letter were published
either prior to the period we covered (5) or after (6,7). We
did not review (8) because it was undertaken in developed
countries, although we have cited it (see ref#50 in [1]),
where we found appropriate.
References
1. Dinsa GD, Goryakin Y, Fumagalli E, Suhrcke M. Obesity and
socioeconomic status in developing countries: a systematic review.
Obes Rev 2012; 13: 1067–1079.
2. Bovet P, Chiolero A, Madeleine G, Paccaud F. Prevalence of
overweight and underweight in public and private schools in the
Seychelles. Int J Pediatr Obes 2010; 5: 274–278.
3. Groeneveld IF, Solomons NW, Doak CM. Nutritional status of
urban schoolchildren of high and low socioeconomic status in
Quetzaltenango, Guatemala. Rev Panam Salud Publica 2007; 22:
169–177.
4. Piovesan C, Pádua MC, Ardenghi TM, Mendes FM, Bonini
GC. Can type of school be used as an alternative indicator of
socioeconomic status in dental caries studies? A cross-sectional
study. BMC Med Res Methodol 2011; 11: 37. doi:10.1186/1471-
2288-11-37.
5. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a
standard definition for child overweight and obesity worldwide:
international survey. BMJ 2000; 320: 1240–1243.
6. Wrotniak BH, Malete L, Maruapula SD et al. Association
between socioeconomic status indicators and obesity in adolescent
students in Botswana, an African country in rapid nutrition tran-
sition. Pediatr Obes 2012; 7: e9–e13.
7. Howe LD, Galobardes B, Matijasevich A et al. Measuring
socio-economic position for epidemiological studies in low- and
middle-income countries: a methods of measurement in epidemi-
ology paper. Int J Epidemiol 2012; 41: 871–886.
8. Shrewsbury V, Wardle J. Socioeconomic status and adiposity
in childhood: a systematic review of cross-sectional studies 1990-
2005. Obesity (Silver Spring) 2008; 16: 275–284.
G. D. Dinsa
Norwich Medical School
University of East Anglia
Norwich
UK
g.deye@uea.ac.uk
Y. Goryakin
European Centre on Health of Societies in Transition
Department of Health Services Research and Policy
London School of Hygiene and Tropical Medicine
London
UK
ygoryakin@yahoo.com
E. Fumagalli
Norwich Medical School
University of East Anglia
Norwich
UK
e.fumagalli@uea.ac.uk
M. Suhrcke
Norwich Medical School
University of East Anglia
Norwich
UK
UKCRC Centre for Diet and Activity Research (CEDAR)
Institute of Public Health
Cambridge
UK
E-mail: m.suhrcke@uea.ac.uk
obesity reviews doi: 10.1111/j.1467-789X.2012.01027.x
1081 © 2012 The Author
obesity reviews © 2012 International Association for the Study of Obesity 13, 1081, November 2012