Search

Source at https://doi.org/10.18632/aging.101900. Differences in health status by socioeconomic position (SEP) tend to be more evident at older ages, suggesting the involvement of a biological mechanism responsive to the accumulation of deleterious exposures across the lifespan. DNA methylation (DNAm) has been proposed as a biomarker of biological aging that conserves memory of endogenous and exogenous stress during life. We examined the association of education level, as an indicator of SEP, and lifestyle-related variables with four biomarkers of age-dependent DNAm dysregulation: the total number of stochastic epigenetic mutations (SEMs) and three epigenetic clocks (Horvath, Hannum and Levine), in 18 cohorts spanning 12 countries. The four biological aging biomarkers were associated with education and different sets of risk factors independently, and the magnitude of the effects differed depending on the biomarker and the predictor. On average, the effect of low education on epigenetic aging was comparable with those of other lifestyle-related risk factors (obesity, alcohol intake), with the exception of smoking, which had a significantly stronger effect. Our study shows that low education is an independent predictor of accelerated biological (epigenetic) aging and that epigenetic clocks appear to be good candidates for disentangling the biological pathways underlying social inequalities in healthy aging and longevity.

BACKGROUND: Social inequalities in the prevalence of childhood overweight and obesity are well-established, but less is known about when the social gradient first emerges and how it evolves across childhood and adolescence.OBJECTIVE: This study examines maternal education differentials in children's body mass trajectories in infancy, childhood and adolescence using data from four contemporary European child cohorts.METHODS: Prospective data on children's body mass index (BMI) were obtained from four cohort studies-Generation XXI (G21-Portugal), Growing Up in Ireland (GUI) infant and child cohorts, and the Millennium Cohort Study (MCS-UK)-involving a total sample of 41,399 children and 120,140 observations. Children's BMI trajectories were modelled by maternal education level using mixed-effect models.RESULTS: Maternal educational inequalities in children's BMI were evident as early as three years of age. Children from lower maternal educational backgrounds were characterised by accelerated BMI growth, and the extent of the disparity was such that boys from primary-educated backgrounds measured 0.42 kg/m2 (95% CI 0.24, 0.60) heavier at 7 years of age in G21, 0.90 kg/m2 (95% CI 0.60, 1.19) heavier at 13 years of age in GUI and 0.75 kg/m2 (95% CI 0.52, 0.97) heavier in MCS at 14 years of age. The corresponding figures for girls were 0.71 kg/m2 (95% CI 0.50, 0.91), 1.31 kg/m2 (95% CI 1.00, 1.62) and 0.76 kg/m2 (95% CI 0.53, 1.00) in G21, GUI and MCS, respectively.CONCLUSIONS: Maternal education is a strong predictor of BMI across European nations. Socio-economic differentials emerge early and widen across childhood, highlighting the need for early intervention.

Food co-ops are highlighted in UK policy as one way of improving food provisioning systems when formal state and commercial services fail to deliver. This research takes a case study approach to food retail co-ops in England funded under a community outreach programme. The co-ops surveyed had different priorities, some ranking health and food prices as more important than those associated with sustainability. In the majority of cases there were no formal membership structures and no involvement of members in decisionmaking. All operated on a part-time basis, few had business plans for future development, and many were reliant on voluntary labour or inputs from other organisations for their survival. Many food initiatives using the title food co-op were not formally constituted as cooperatives, losing both the potential power and advantages that formal incorporation can provide and opportunities to engage in processes associated with “democracy”. There is potential for a “co-op of co-operatives”, with local food initiatives being members of the larger co-op. This would enable leverage in areas of lobbying and food purchasing and provide additional leverage in terms of changing the food supply system to be more sustainable.

Food welfare for low-income women and children in the UK is an unexplored area of food policy. The current food welfare scheme for low-income women and children in the UK is called Healthy Start, and this replaced the previous Welfare Food Scheme in 2006. The main changes were that Healthy Start was intended to be more health focussed and aimed to influence behaviour change by providing a voucher that could be spent on fresh (and later frozen) fruits and vegetables, milk or infant formula. The previous scheme only provided milk and infant formula. In addition it was intended that there would be more interaction with health professionals as part of the scheme. Little is known about why the Welfare Food Scheme changed to Healthy Start and what influenced the initiation, formation and implementation of Healthy Start. Nor is there substantial information on how Healthy Start operates in practice. The objectives of this thesis were to consider what influenced the development of Healthy Start and to consider how Healthy Start as a policy relates to Healthy Start in practice.\ud \ud After mapping how Healthy Start was developed, what is known about the scheme, undertaking a literature review on subject specific literature, research questions were developed to direct the line of inquiry. A theoretical literature review explored methods of policy analysis that could inform the overarching methodology. Models of policy analysis and literature on the policy process were developed to better understand the policy process that informed Healthy Start.\ud \ud To address the research questions, three phases of research were undertaken. The first was a policy analysis of publically available policy documents using Kingdon’s concept of policy streams to make sense of the process; the second was a series of semi-structured interviews with policy participants to add detail to the first phase. A recurring issue was the role of the Health Professional in delivering Healthy Start, and a case study with health professionals who deliver Healthy Start in one Borough of London was developed to further explore this issue.\ud \ud The findings indicate that the shift from the Welfare Food Scheme to Healthy Start was largely influenced by political factors, with inadequate consideration of public health objectives and practical components of behaviour change. A lack of training and support for health professionals who are gatekeepers of the scheme was apparent at all points of the policy process. By tracking the development of the Healthy Start scheme and its place within food welfare this research highlights the need for more thorough consultation and thoughtful development if complex schemes crossing welfare and food policy are to be successful.