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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

School sociodemographic characteristics and obesity in schoolchildren: does the obesity definition matter?

Authors: Silvia Bel-Serrat, Mirjam M. Heinen, John Mehegan, Sarah O’Brien, Nazih Eldin, Celine M. Murrin, Cecily C. Kelleher

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Existing evidence on the role of sociodemographic variables as risk factors for overweight and obesity in school-aged children is inconsistent. Furthermore, findings seem to be influenced by the obesity definition applied. Therefore, this study aimed to investigate if school sociodemographic indicators were associated with weight status in Irish primary schoolchildren and whether this association was sensitive to different obesity classification systems.

Methods

A nationally representative cross-sectional sample of 7542 Irish children (53.9% girls), mean age 10.4 (±1.2SD) years, participating in the Childhood Obesity Surveillance Initiative in the 2010, 2012/2013 or 2015/2016 waves were included. Height, weight and waist circumference were objectively measured. Five definitions of obesity were employed using different approaches for either body mass index (BMI) or abdominal obesity. Associations between overweight and obesity and sociodemographic variables were investigated using adjusted multilevel logistic regression analyses.

Results

Children attending disadvantaged schools were more likely to be overweight and obese than their peers attending non-disadvantaged schools, regardless of the obesity classification system used. Associations remained significant for the BMI-based obesity definitions when the sample was stratified by sex and age group, except for boys aged 8–10.5 years. Only boys aged ≥10.5 years in disadvantaged schools had higher odds of abdominal obesity (UK 1990 waist circumference growth charts: OR = 1.56, 95%CI = 1.09–2.24; waist-to-height ratio: OR = 1.78, 95%CI = 1.14–2.79) than those in non-disadvantaged schools. No associations were observed for school urbanisation level.

Conclusions

School socioeconomic status was a strong determinant of overweight and obesity in Irish schoolchildren, and these associations were age- and sex-dependent. School location was not associated with overweight or obesity. There remains a need to intervene with school-aged children in disadvantaged schools, specifically among those approaching adolescence, to prevent a trajectory of obesity into adult life.
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Literature
1.
go back to reference Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81.CrossRefPubMedPubMedCentral Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81.CrossRefPubMedPubMedCentral
2.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.CrossRefPubMedPubMedCentral
3.
go back to reference Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335(7612):194.CrossRefPubMedPubMedCentral Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335(7612):194.CrossRefPubMedPubMedCentral
4.
go back to reference Wijnhoven TM, van Raaij JM, Spinelli A, Starc G, Hassapidou M, Spiroski I, et al. WHO European childhood obesity surveillance initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health. 2014;14:806.CrossRefPubMedPubMedCentral Wijnhoven TM, van Raaij JM, Spinelli A, Starc G, Hassapidou M, Spiroski I, et al. WHO European childhood obesity surveillance initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health. 2014;14:806.CrossRefPubMedPubMedCentral
5.
go back to reference Bel-Serrat S, Heinen MM, Murrin C, Daly L, Mehegan J, Concannon M, et al. The childhood obesity surveillance initiative (COSI) in the Republic of Ireland. Findings from 2008, 2010, 2012 and 2015. Dublin: Health Service Executive; 2017. Bel-Serrat S, Heinen MM, Murrin C, Daly L, Mehegan J, Concannon M, et al. The childhood obesity surveillance initiative (COSI) in the Republic of Ireland. Findings from 2008, 2010, 2012 and 2015. Dublin: Health Service Executive; 2017.
6.
go back to reference NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017; https://doi.org/10.1016/S0140-6736(17)32129-3. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017; https://​doi.​org/​10.​1016/​S0140-6736(17)32129-3.
7.
go back to reference Keaver L, Webber L, Dee A, Shiely F, Marsh T, Balanda K, et al. Application of the UK foresight obesity model in Ireland: the health and economic consequences of projected obesity trends in Ireland. PLoS One. 2013;8(11):e79827.CrossRefPubMedPubMedCentral Keaver L, Webber L, Dee A, Shiely F, Marsh T, Balanda K, et al. Application of the UK foresight obesity model in Ireland: the health and economic consequences of projected obesity trends in Ireland. PLoS One. 2013;8(11):e79827.CrossRefPubMedPubMedCentral
8.
go back to reference Atay Z, Bereket A. Current status on obesity in childhood and adolescence: prevalence, etiology, co-morbidities and management. Obes Med. 2016;3:1–9.CrossRef Atay Z, Bereket A. Current status on obesity in childhood and adolescence: prevalence, etiology, co-morbidities and management. Obes Med. 2016;3:1–9.CrossRef
9.
go back to reference Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17(1):56–67.CrossRefPubMed Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17(1):56–67.CrossRefPubMed
10.
go back to reference Wu S, Ding Y, Wu F, Li R, Hu Y, Hou J, et al. Socio-economic position as an intervention against overweight and obesity in children: a systematic review and meta-analysis. Sci Rep. 2015;5:11354.CrossRefPubMedPubMedCentral Wu S, Ding Y, Wu F, Li R, Hu Y, Hou J, et al. Socio-economic position as an intervention against overweight and obesity in children: a systematic review and meta-analysis. Sci Rep. 2015;5:11354.CrossRefPubMedPubMedCentral
11.
go back to reference Jabakhanji SB, Pavlova M, Groot W, Boland F, Biesma R. Social class variation, the effect of the economic recession and childhood obesity at 3 years of age in Ireland. Eur J Pub Health. 2017;27(2):234–9. Jabakhanji SB, Pavlova M, Groot W, Boland F, Biesma R. Social class variation, the effect of the economic recession and childhood obesity at 3 years of age in Ireland. Eur J Pub Health. 2017;27(2):234–9.
12.
go back to reference Keane E, Layte R, Harrington J, Kearney PM, Perry IJ. Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9. PLoS One. 2012;7(8):e43503.CrossRefPubMedPubMedCentral Keane E, Layte R, Harrington J, Kearney PM, Perry IJ. Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9. PLoS One. 2012;7(8):e43503.CrossRefPubMedPubMedCentral
13.
go back to reference Bammann K, Gwozdz W, Lanfer A, Barba G, De Henauw S, Eiben G, et al. Socioeconomic factors and childhood overweight in Europe: results from the multi-Centre IDEFICS study. Pediatr Obes. 2013;8(1):1–12.CrossRefPubMed Bammann K, Gwozdz W, Lanfer A, Barba G, De Henauw S, Eiben G, et al. Socioeconomic factors and childhood overweight in Europe: results from the multi-Centre IDEFICS study. Pediatr Obes. 2013;8(1):1–12.CrossRefPubMed
14.
go back to reference Valdes Pizarro J, Royo-Bordonada MA. Prevalence of childhood obesity in Spain: National Health Survey 2006-2007. Nutr Hosp. 2012;27(1):154–60.PubMed Valdes Pizarro J, Royo-Bordonada MA. Prevalence of childhood obesity in Spain: National Health Survey 2006-2007. Nutr Hosp. 2012;27(1):154–60.PubMed
15.
go back to reference Lazzeri G, Pammolli A, Simi R, Pilato V, Giacchi MV. BMI from nutritional surveillance of 8-9 years old children in Tuscany (Italy). J Prev Med Hyg. 2011;52(4):181–5.PubMed Lazzeri G, Pammolli A, Simi R, Pilato V, Giacchi MV. BMI from nutritional surveillance of 8-9 years old children in Tuscany (Italy). J Prev Med Hyg. 2011;52(4):181–5.PubMed
16.
go back to reference Biehl A, Hovengen R, Groholt EK, Hjelmesaeth J, Strand BH, Meyer HE. Adiposity among children in Norway by urbanity and maternal education: a nationally representative study. BMC Public Health. 2013;13:842.CrossRefPubMedPubMedCentral Biehl A, Hovengen R, Groholt EK, Hjelmesaeth J, Strand BH, Meyer HE. Adiposity among children in Norway by urbanity and maternal education: a nationally representative study. BMC Public Health. 2013;13:842.CrossRefPubMedPubMedCentral
17.
go back to reference Hassapidou M, Tzotzas T, Makri E, Pagkalos I, Kaklamanos I, Kapantais E, et al. Prevalence and geographic variation of abdominal obesity in 7- and 9-year-old children in Greece; World Health Organization childhood obesity surveillance initiative 2010. BMC Public Health. 2017;17(1):126.CrossRefPubMedPubMedCentral Hassapidou M, Tzotzas T, Makri E, Pagkalos I, Kaklamanos I, Kapantais E, et al. Prevalence and geographic variation of abdominal obesity in 7- and 9-year-old children in Greece; World Health Organization childhood obesity surveillance initiative 2010. BMC Public Health. 2017;17(1):126.CrossRefPubMedPubMedCentral
18.
go back to reference Sjoberg A, Moraeus L, Yngve A, Poortvliet E, Al-Ansari U, Lissner L. Overweight and obesity in a representative sample of schoolchildren - exploring the urban-rural gradient in Sweden. Obes Rev. 2011;12(5):305–14.CrossRefPubMed Sjoberg A, Moraeus L, Yngve A, Poortvliet E, Al-Ansari U, Lissner L. Overweight and obesity in a representative sample of schoolchildren - exploring the urban-rural gradient in Sweden. Obes Rev. 2011;12(5):305–14.CrossRefPubMed
19.
go back to reference Keke LM, Samouda H, Jacobs J, di Pompeo C, Lemdani M, Hubert H, et al. Body mass index and childhood obesity classification systems: a comparison of the French, international obesity task force (IOTF) and World Health Organization (WHO) references. Rev Epidemiol Sante Publique. 2015;63(3):173–82.CrossRefPubMed Keke LM, Samouda H, Jacobs J, di Pompeo C, Lemdani M, Hubert H, et al. Body mass index and childhood obesity classification systems: a comparison of the French, international obesity task force (IOTF) and World Health Organization (WHO) references. Rev Epidemiol Sante Publique. 2015;63(3):173–82.CrossRefPubMed
20.
go back to reference Gonzalez-Casanova I, Sarmiento OL, Gazmararian JA, Cunningham SA, Martorell R, Pratt M, et al. Comparing three body mass index classification systems to assess overweight and obesity in children and adolescents. Rev Panam Salud Publica. 2013;33(5):349–55.CrossRefPubMed Gonzalez-Casanova I, Sarmiento OL, Gazmararian JA, Cunningham SA, Martorell R, Pratt M, et al. Comparing three body mass index classification systems to assess overweight and obesity in children and adolescents. Rev Panam Salud Publica. 2013;33(5):349–55.CrossRefPubMed
21.
go back to reference Shields M, Tremblay MS. Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. Int J Pediatr Obes. 2010;5(3):265–73.CrossRefPubMed Shields M, Tremblay MS. Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. Int J Pediatr Obes. 2010;5(3):265–73.CrossRefPubMed
22.
go back to reference Maffeis C, Banzato C, Talamini G. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. J Pediatr. 2008;152(2):207–13.CrossRefPubMed Maffeis C, Banzato C, Talamini G. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. J Pediatr. 2008;152(2):207–13.CrossRefPubMed
23.
go back to reference Lehingue Y. The European childhood obesity group (ECOG) project: the European collaborative study on the prevalence of obesity in children. Am J Clin Nutr. 1999;70(1):166s–8s.CrossRef Lehingue Y. The European childhood obesity group (ECOG) project: the European collaborative study on the prevalence of obesity in children. Am J Clin Nutr. 1999;70(1):166s–8s.CrossRef
24.
go back to reference Irish Medical Organisation. Position paper on health inequalities. Dublin: Irish Medical Organisation; 2012. Irish Medical Organisation. Position paper on health inequalities. Dublin: Irish Medical Organisation; 2012.
25.
go back to reference Wijnhoven TM, van Raaij JM, Spinelli A, Rito AI, Hovengen R, Kunesova M, et al. WHO European childhood obesity surveillance initiative 2008: weight, height and body mass index in 6-9-year-old children. Pediatr Obes. 2013;8(2):79–97.CrossRefPubMed Wijnhoven TM, van Raaij JM, Spinelli A, Rito AI, Hovengen R, Kunesova M, et al. WHO European childhood obesity surveillance initiative 2008: weight, height and body mass index in 6-9-year-old children. Pediatr Obes. 2013;8(2):79–97.CrossRefPubMed
26.
go back to reference Wijnhoven T, Branca F. WHO European childhood obesity surveillance initiative. Protocol, version January 2008. Copenhagen: WHO Regional Office for Europe; 2008. Wijnhoven T, Branca F. WHO European childhood obesity surveillance initiative. Protocol, version January 2008. Copenhagen: WHO Regional Office for Europe; 2008.
27.
go back to reference de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–7.CrossRefPubMedPubMedCentral de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–7.CrossRefPubMedPubMedCentral
28.
go back to reference Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat. 2002;11(246):1–190. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat. 2002;11(246):1–190.
29.
go back to reference Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics. 2007;120(Suppl 4):S193–228.CrossRefPubMed Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics. 2007;120(Suppl 4):S193–228.CrossRefPubMed
30.
go back to reference Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995;73(1):17–24.CrossRefPubMedPubMedCentral Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995;73(1):17–24.CrossRefPubMedPubMedCentral
31.
go back to reference Central Office Statistics (CSO). Profile 1 - town and country. Dublin: Central Office Statistics; 2012. Central Office Statistics (CSO). Profile 1 - town and country. Dublin: Central Office Statistics; 2012.
34.
go back to reference Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol. 1995;57(1):289–300. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol. 1995;57(1):289–300.
35.
go back to reference Brambilla P, Bedogni G, Heo M, Pietrobelli A. Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents. Int J Obes. 2013;37(7):943–6.CrossRef Brambilla P, Bedogni G, Heo M, Pietrobelli A. Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents. Int J Obes. 2013;37(7):943–6.CrossRef
36.
go back to reference Morgan K, McGee H, Watson D, Perry I, Barry M, Shelley E, et al. SLAN 2007: survey of lifestyle, attitudes & nutrition in Ireland: main report. Dublin: Department of Health and Children; 2008. Morgan K, McGee H, Watson D, Perry I, Barry M, Shelley E, et al. SLAN 2007: survey of lifestyle, attitudes & nutrition in Ireland: main report. Dublin: Department of Health and Children; 2008.
37.
go back to reference National Nutrition Surveillance Centre. Annual report: dietary habits of the Irish population - results from SLÁN. Dublin: Government Publications Office; 2003. National Nutrition Surveillance Centre. Annual report: dietary habits of the Irish population - results from SLÁN. Dublin: Government Publications Office; 2003.
38.
go back to reference Rush E, Reed PW, Simmons D, Coppinger T, McLennan S, Graham D. Baseline measures for a school-based obesity control programme: project energize: differences by ethnicity, rurality, age and school socio-economic status. J Pediatr Child Health. 2013;49(4):E324–31.CrossRef Rush E, Reed PW, Simmons D, Coppinger T, McLennan S, Graham D. Baseline measures for a school-based obesity control programme: project energize: differences by ethnicity, rurality, age and school socio-economic status. J Pediatr Child Health. 2013;49(4):E324–31.CrossRef
39.
go back to reference Heavey P, McGloin A, Kilroe J, Daly L, O’Mahony D, Kelleher C. Childhood obesity surveillance initiative in Ireland - main report. Dublin: Health Service Executive; 2009. Heavey P, McGloin A, Kilroe J, Daly L, O’Mahony D, Kelleher C. Childhood obesity surveillance initiative in Ireland - main report. Dublin: Health Service Executive; 2009.
40.
go back to reference Heinen MM, Murrin C, Daly L, O'Brien J, Heavey P, O'Brien M, Scully H, Mulhern LM, Lynam A, Eldin N, Kelleher CC. The childhood obesity surveillance initiative (COSI) in the Republic of Ireland: Descriptives of childhood obesity risk factors. Dublin: Health Service Executive; 2016. Heinen MM, Murrin C, Daly L, O'Brien J, Heavey P, O'Brien M, Scully H, Mulhern LM, Lynam A, Eldin N, Kelleher CC. The childhood obesity surveillance initiative (COSI) in the Republic of Ireland: Descriptives of childhood obesity risk factors. Dublin: Health Service Executive; 2016.
Metadata
Title
School sociodemographic characteristics and obesity in schoolchildren: does the obesity definition matter?
Authors
Silvia Bel-Serrat
Mirjam M. Heinen
John Mehegan
Sarah O’Brien
Nazih Eldin
Celine M. Murrin
Cecily C. Kelleher
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5246-7

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