Abstract
BackgroundThere are stark ethnic inequalities in the prevalence of UK childhood obesity. However, data on adolescent overweight in different ethnic groups are limited. This study assessed ethnic inequalities in overweight prevalence during mid-adolescence using body mass index (BMI) and explored the contribution of socioeconomic and behavioural factors.MethodsWe analyzed data from 10 500 adolescents aged between 13 and 15 years who participated in sweep six of the Millennium Cohort Study. Ethnic inequalities in overweight and mean BMI were assessed using multiple regression models. Results were stratified by sex and adjusted for socioeconomic and behavioural factors.ResultsBlack Caribbean males had significantly higher BMI than White males after full adjustment [excess BMI 2.94, 95% confidence interval (CI) 0.70–5.19] and were over three times more likely to be overweight [odds ratio (OR): 3.32, 95% CI 1.95–5.66]. Black Africans females had significantly higher BMI compared with White females (excess BMI 1.86, 95% CI 0.89–2.83; OR for overweight 2.74, 95% CI 1.64–4.56), while Indian females had significantly lower BMI compared with White females (reduced BMI −0.73, 95% CI −1.37 to −0.09). Socioeconomic and behavioural factors often considered to be associated with overweight were more prevalent in some ethnic minority groups (lower socioeconomic position, lack of breakfast consumption, low fruit and vegetable intake, high sugar-sweetened beverage and fast-food consumption, and infrequent physical activity), but adjustment for these factors did not fully explain ethnic differences in overweight/BMI.ConclusionEthnic inequalities in overweight prevalence are evident in mid-adolescence and vary according to sex. Differences in overweight/BMI between ethnic groups were not fully accounted for by socioeconomic or behavioural factors.
Highlights
Black African females had significantly higher Body Mass Index (BMI) compared to White females, in contrast, Indian females had significantly lower BMI compared to White females
Socioeconomic and behavioural factors often considered to be associated with overweight were more prevalent in some ethnic minority groups, but adjustment for these factors did not fully explain ethnic differences in BMI and overweight
We explore ethnic differences in mid-adolescence overweight as measured by BMI, whilst assessing the contribution of selected socioeconomic and behavioural factors
Summary
The dramatic global rise in the prevalence of childhood obesity over the past 30 years has been described as ‘one of the most serious public health challenges of the 21st century’.1 The United Kingdom (UK) has one of the highest prevalence rates of adult overweight and obesity in Europe 2 ; substantial rises in prevalence are predicted over the 30 years. Obese children are five times more likely to become obese adults, and there are known associations between adult obesity and various chronic diseases. This has important implications for healthcare provision and the associated increased economic burdens on the National Health Service. In addition to these long term concerns, there are welldocumented adverse health consequences of obesity in childhood itself; such as increased risk of hypertension, asthma and psychological problems. Research into childhood overweight and obesity focuses on management, and explores potential explanatory factors; including parental socioeconomic position (SEP), low birthweight, and behavioural factors such as decreased physical activity and dietary composition.. Obese children are five times more likely to become obese adults, and there are known associations between adult obesity and various chronic diseases.. Obese children are five times more likely to become obese adults, and there are known associations between adult obesity and various chronic diseases.3 This has important implications for healthcare provision and the associated increased economic burdens on the National Health Service.. This has important implications for healthcare provision and the associated increased economic burdens on the National Health Service.5 In addition to these long term concerns, there are welldocumented adverse health consequences of obesity in childhood itself; such as increased risk of hypertension, asthma and psychological problems.. This study assessed ethnic inequalities in overweight prevalence during mid-adolescence using Body Mass Index (BMI), and explored the contribution of socioeconomic and behavioural factors
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