Title:Socioeconomic Status: The Missing Link Between Obesity and Diabetes Mellitus?
VOLUME: 14 ISSUE: 4
Author(s):Alexei Volaco*, Ana Maria Cavalcanti, Roberto Pecoits Filho and Dalton Bertolim Précoma
Affiliation:Pontificia Universidade Católica do Parana – Postgraduate Program in Health Sciences, Curitiba, Pontificia Universidade Católica do Parana – Postgraduate Program in Health Sciences, Curitiba, Pontificia Universidade Católica do Parana – Postgraduate Program in Health Sciences, Curitiba, Pontificia Universidade Católica do Parana – Postgraduate Program in Health Sciences, Curitiba
Keywords:Lower socioeconomic status, obesity, diabetes mellitus, weight, carbohydrates, insulin.
Abstract:Background: Currently, there is an epidemic expansion of obesity rates worldwide. The increasing
number of obese individuals associated with the aging of population leads to increasing number
of individuals with type 2 diabetes mellitus (T2DM) at the same rate. The traditional factors that
link obesity to T2DM are related to genetics, hypercaloric diet, sedentary lifestyle, and stress. Individuals
from lower Socioeconomic Status (SES) have restricted autonomy and opportunities that could
lead to more stress and consequently increase in stress hormones, such as cortisol, catecholamines,
glucagon, and growth hormone, which might ultimately change fat deposition, increasing visceral fat
and increasing the risk of T2DM development.
Methods: We conducted a review of the literature on the effects of low SES and the risk of developing
T2DM in obese persons.
Results: 191 studies were found. The obesity of lower SES individuals is more central than that for individuals
from higher socioeconomic position. It is also proposed that the quality of food seems to be
lower, with more intake of fat and simple carbohydrates and less of fruits, vegetables and whole wheat
bread, in the more disadvantaged social classes. The lower income neighborhoods, without exercise
facilities and unsafety are also associated with higher indices of physical inactivity. Cross sectional and
prospective studies confirm the relationship between lower socioeconomic status and obesity and
diabetes. The lower SES is associated to metabolic implications that are linked to insulin resistance
and possibly may also interfere with the ability of beta cell to secrete insulin and change the gut microbiota,
increasing even more the future risk of developing diabetes.
