Associations between socioeconomic status and risk of obesity and overweight among Chinese children and adolescents

Abstract

Background In China, the threat of obesity and overweight in children and adolescents is developing quickly. It may be possible to lower the risk of obesity and overweight in children and adolescents by understanding the factors that drive these conditions. Therefore, this study aimed to investigate the association between SES and risk of obesity and overweight among children and adolesecnts in China’s provinces of Jiangsu, Anhui, Zhejiang, and Shanghai. Methods Chinese children and adolescents (n = 2,746; 46.3% boys) were recruited using multistage sampling. SES was measured using self-reported questionnaires, the specific indicators were parental education, perceived family wealth, and Family Affluence Scale II. Height and weight were measured and used to calculate body mass index (BMI, categorized into obesity or overweight). The definition of obesity or overweight was based on the Chinese standard "Screening for obesity and overweight among school-age children and adolescents". Descriptive statistics, independent sample t-tests, and a Chi-square test were used to report the sample characteristics and analyse BMI differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with BMI in children and adolescents. Results Overall, 22.5% of children and adolescents were obese or overweight. Participants with medium and high maternal education levels were 1.48 [95% CI 1.15–1.91] and 1.47 [95% CI 1.03–2.11] times more likely to be obese/overweight. Girls with medium maternal education levels were 1.70[95% CI 1.21–2.40] times more likely to be obese/overweight. For boys, no association was observed. Junior middle school students with medium maternal education levels were 1.51[95% CI 1.10–2.07] times more likely to be obese/overweight. Participants with medium or high FAS, perceived family wealth, or paternal education levels were not associated with obesity/overweight. Conclusions The findings of this study indicated a positive association between SES and risk of overweight/obesity in girls, suggesting that maternal education level may have a substantial impact on future prevention efforts for these conditions in girls. To increase the effectiveness of interventions, longitudinal studies are necessary to better understand the causal association between SES and obesity/overweight.

Do maternal socioeconomic status influence child overweight?

“…Other similar studies conducted in China have largely focused on school-aged children in specific provinces or regions [ 28 , 40 , 44 , 54 ], but this study extends its scope encompassing preschool-aged children, thus, covering the entire crucial growth period of early childhood in China. This study departs from other studies that have employed limited criteria for assessing overweight and relying solely on children's BMI, which lacks adjustments for age and gender, hence, resulting in inaccurate overweight or obesity evaluations [ 27 , 39 , 47 ]. Primarily, this study captures the protective effect of mothers with only junior high school education against childhood overweight under 5.…”

“…On contrary, a survey conducted on childhood obesity among children aged 9–17 in coastal provinces of the Yangtze River Delta region, uncovered a positive relationship between higher socioeconomic status and overweight in girls. This effect was particularly pronounced when mothers had completed high school education or higher [ 27 ]. An investigation into obesity inequality among children aged 9–12 in the northeastern region found that at both extremes of socioeconomic status, children from the lowest-educated parents and the highest-educated parents experienced a lower risk of obesity.…”

“…A substantial population of obese children has become a pressing public health threat in China. Research on the socioeconomics determinants of obesity have gained attention but most of the studies are confined to certain regions, specific provinces or individual municipalities [ [24] , [25] , [26] , [27] , [28] ]. The research done has mostly concentrated on obesity among school-aged children and adolescents, which leave a glaring gap in the examination of early intervention phase for children under the age of 5.…”

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“…Y Ke et al found similar result identical to our study. The observed higher prevalence rates of obese children in upper class may be because of sedentary lifestyles, altered eating patterns and increased sugar and fat content of their diet Poor Physical life style was more often present in overweight and obese children as compared to not overweight children 23 . Findings of the study revealed that age group between 9-11, 8.1% obese and 16.3% were overweight children and age group between 12-14, 7.1% obese and 18.2% were overweight.…”

The role of family socioeconomic status on maternal weight gain during pregnancy

“…This revelation may have public health implications. When studying the health habits of people with high socio-economic status, it is essential to consider how educational attainment may influence the prevalence of overweight or obesity (18). Longitudinal studies are needed to improve the effectiveness of interventions and better understand the causal relationship between socioeconomic status and BMI.…”