Abstract
BackgroundThe main objective of this study was to investigate the interaction effect of school socioeconomic composition (SEC) and adolescent socioeconomic status (SES) in the prevalence of overweight and obesity among a representative sample of French adolescents of the third most populous département of France.Methods1038 adolescents agreed to participate (response rate: 91.4%). They self-reported anthropomorphic variables, SES, school lunch and physical activity. The body mass index was divided into six categories according to the Center for Disease Control. Multivariable binary logistic regressions analysis without and with interaction term were performed on overweight or obesity. Models fit was compared using the Aikaike Information Criterion. Odds-ratios (OR) and their 95% accelerated-bootstrap confidence interval (95%BCa CI) were computed to estimate overweight or obesity risk.Results8.9% of the adolescents were overweight. 3.4% were obese. No school-SEC effect was observed among low-SES adolescents. Medium-SES adolescents were at greater risk in low-SEC (OR = 10.75, 95%BCa CI = 2.67–64.57) and medium-SEC (OR = 5.08, 95%BCa CI = 1.55–24.84) compared with high-SEC schools. High-SES adolescents in low-SEC schools were at greater risk compared with those in medium-SEC (OR = 5.94, 95%BCa CI = 1.94–17.29) and high-SEC schools (OR = 4.99, 95%BCa CI = 1.71–13.14). A social gradient was observed in medium-SEC (ORlow/high = 2.79, 95%BCa CI = 1.22–7.41) and high-SEC (ORlow/medium = 6.86, 95%BCa CI = 1.06–5.22*106) schools.ConclusionsPhysical activity and lunch at and outside school help to understand these differences. Implications for obesity prevention initiatives are discussed.
Highlights
The main objective of this study was to investigate the interaction effect of school socioeconomic composition (SEC) and adolescent socioeconomic status (SES) in the prevalence of overweight and obesity among a representative sample of French adolescents of the third most populous département of France
Overweight|obesity prevalence in this area was below national prevalence among adolescents aged 13–15 (18.0% vs. 12.2%)
School lunch and physical activity levels by school SEC Adolescents enrolled in medium- and high-SEC schools were more likely to eat at school compared with those enrolled in low-SEC schools (ORmedium/low = 3.77, 95% 95% acceleratedbootstrap confidence interval (CI) = 2.44–5.90 and ORhigh/low = 17.23, 95% CI = 10.66– 28.43, respectively)
Summary
The main objective of this study was to investigate the interaction effect of school socioeconomic composition (SEC) and adolescent socioeconomic status (SES) in the prevalence of overweight and obesity among a representative sample of French adolescents of the third most populous département of France. These habits are in part shaped by the provisions and types of facilities available in peoples’ living environments, for example the presence of fast-food restaurants, parks, cycling paths and sport facilities [7,8,9]. Disadvantaged areas are subject to higher prevalence of overweight and obesity due to an unfavourable environment for adopting a healthy diet and a physically active lifestyle [11,12,13] Among adolescents, those living in a neighbourhood and attending a school with lower socioeconomic composition (SEC) are at greater risk of overweight and obesity [10, 14, 15]. Neighbourhood SEC was found to be more influential than household socioeconomic status (SES) [10]
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