Abstract
BackgroundAbdominal obesity has become an important public health issue in China. Socioeconomic disparities are thought to be closely related to the prevalence of abdominal obesity. Exploring socioeconomic disparities in abdominal obesity over the life course in China could inform the design of new interventions to prevent and control abdominal obesity.MethodsThe China Health and Nutrition Survey (CHNS) was a prospective household-based study involving seven rounds of surveys between 1993 and 2011. Twenty three thousand, two hundred and forty-three individuals were followed up over an 18-year period. The mixed effects models with random intercepts were used to assess the effects on abdominal obesity. Six key socioeconomic indicators, with age and age-squared added to the models, were used to identify socioeconomic disparities in abdominal obesity over the adult life course.ResultsPrevalence of abdominal obesity increased non-linearly with age over the adult life course. Abdominal obesity was more prevalent in younger than older birth cohorts. Positive period effects on the prevalence of abdominal obesity were substantial from 1993 to 2011, and were stronger among males than females. Prevalence of abdominal obesity was higher among ethnic Han Chinese and among the married [coefficient (95% confidence intervals): 0.03(0.003, 0.057) and 0.035(0.022, 0.047), respectively], and was lower among males [coefficient (95% confidence intervals): − 0.065(− 0.075,-0.055)]. A higher-level of urbanization and higher household income increased the probability of abdominal obesity [coefficient (95% confidence intervals): 0.160(0.130, 0.191), 3.47E− 4 (2.23E− 4, 4.70E− 4), respectively], while individuals with more education were less likely to experience abdominal obesity [coefficient (95% confidence intervals): − 0.222 (− 0.289, − 0.155)] across adulthood.ConclusionsIn China, abdominal obesity increased substantially in more recent cohorts. And people with lower educational attainment, with higher household income, or living in more urbanized communities may be the disadvantaged population of abdominal obesity over the adult life course. Effective interventions targeting the vulnerable population need to be developed.
Highlights
Abdominal obesity has become an important public health issue in China
Socioeconomic disparities are thought to be closely related to the distribution of abdominal obesity [5, 6], abdominal obesity may tend to be more prevalent among the adult population with low socioeconomic status
Curvilinear age effects on the prevalence of abdominal obesity were observed confirming non-linear increase with age [coefficient (95% confidence intervals): 2.60(2.46, 2.74) for age and − 0.018 (− 0.019, − 0.017) for age-squared; all P < 0.001] over the adult life course (Table 2, Model 1, Additional file 1: Table S1)
Summary
Socioeconomic disparities are thought to be closely related to the prevalence of abdominal obesity. Exploring socioeconomic disparities in abdominal obesity over the life course in China could inform the design of new interventions to prevent and control abdominal obesity. Some studies based on cross-sectional surveys have examined socioeconomic disparities in abdominal obesity [7, 8], they could not observe the long-term changes of the variables because some socioeconomic determinants are likely to change with age and period [9, 10]. Waist-to-height ratio (WHtR) is regarded as a superior indicator of abdominal obesity [12], and has been shown to be a better predictor of metabolic syndrome [2], adverse cardiovascular events and mortality [3] than waist circumference (WC) or body mass index (BMI) in the general population [13, 14]. In studies that use WHtR as an indicator, abdominal obesity is generally defined as WHtR of over 0.5 [12, 13]
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