Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population and Study Design
2.2. Procedures
2.2.1. Measurement of Overweight/Obesity (Dependent Variable)
2.2.2. Assessment of the Poverty Rate (Independent Variable)
2.2.3. Socioeconomic Status (Independent Variable)
2.2.4. Covariates
2.2.5. Assessment of Healthy Eating Index (HEI)
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Low SES | Medium SES | High SES | p-Value | |
---|---|---|---|---|---|
Age | Mean (SD) | 8.8 (3.7) | 8.5 (3.7) | 8.3 (3.9) | 0.002 |
Sex | Boys (%) | 981 (50.6) | 786 (51.8) | 520 (51.5) | 0.757 |
Girls (%) | 957 (49.4) | 730 (48.2) | 489 (48.5) | ||
Immigrant status | Native-born (%) | 1793 (92.5) | 1459 (96.2) | 991 (98.2) | <0.001 |
Foreign-born (%) | 145 (7.5) | 57 (3.8) | 18 (1.8) | ||
BMI | Mean (SD) | 19.2 (5.1) | 18.2 (4.3) | 17.8 (3.7) | <0.001 |
Overweight/obesity | No (%) | 1224 (63.2) | 1115 (73.5) | 755 (74.8) | <0.001 |
Yes (%) | 714 (36.8) | 401 (26.5) | 254 (25.2) | ||
Obesity | No (%) | 1642 (84.7) | 1375 (90.7) | 942 (93.4) | <0.001 |
Obesity (%) | 296 (15.3) | 141 (9.3) | 67 (6.6) | ||
HEI (score) | Mean (SD) | 69.1 (9.4) | 70.3 (8.9) | 72.0 (8.3) | <0.001 |
PA category | No exercise (%) | 424 (21.9) | 230 (15.2) | 136 (13.5) | <0.001 |
Occasional physical activity or sport (%) | 508 (26.2) | 378 (24.9) | 210 (20.8) | ||
Physical activity several times a month (%) | 519 (26.8) | 430 (28.4) | 300 (29.7) | ||
Sports or physical training several times a week (%) | 487 (25.1) | 478 (31.5) | 363 (36.0) | ||
ST duration (min) | Mean (SD) | 122.5 (75.3) | 112.5 (69.1) | 102.6 (63.2) | <0.001 |
ST guidelines | Non-meeting (%) | 1101 (56.8) | 853 (56.3) | 539 (53.4) | 0.197 |
Meeting (%) | 837 (43.2) | 663 (43.7) | 470 (46.6) | ||
Sleep duration (hour) | Mean (SD) | 9.4 (1.2) | 9.5 (1.2) | 9.5 (1.2) | 0.006 |
Sleep guidelines | Non-meeting (%) | 665 (34.3) | 516 (34.0) | 336 (33.3) | 0.858 |
Meeting (%) | 1273 (65.7) | 1000 (66.0) | 673 (66.7) | ||
Poverty | Mean (SD) | 22.4 (8.4) | 21.0 (8.0) | 20.3 (8.0) | <0.001 |
Poverty status | Low poverty (%) | 616 (31.8) | 558 (36.8) | 384 (38.1) | <0.001 |
Medium poverty (%) | 569 (29.4) | 498 (32.8) | 345 (34.2) | ||
High poverty (%) | 753 (38.9) | 460 (30.3) | 280 (27.8) |
Variables | Low Poverty | Medium Poverty | High Poverty | p-Values | |
---|---|---|---|---|---|
Age | Mean (SD) | 9.0 (6.0) | 9.0 (7.0) | 9.0 (7.0) | 0.063 |
Sex | Boys (%) | 826 (53.0) | 714 (50.6) | 747 (50.0) | 0.213 |
Girls (%) | 732 (47.0) | 698 (49.4) | 746 (50.0) | ||
SES status | Low SES (%) | 616 (39.5) | 569 (40.3) | 753 (50.4) | <0.001 |
Medium SES (%) | 558 (35.8) | 498 (35.3) | 460 (30.8) | ||
High SES (%) | 384 (24.6) | 345 (24.4) | 280 (18.8) | ||
Immigrant status | Native-born (%) | 1472 (94.5) | 1339 (94.8) | 1432 (95.9) | 0.165 |
Foreign-born (%) | 86 (5.5) | 73 (5.2) | 61 (4.1) | ||
BMI | Mean (SD) | 18.4 (4.3) | 18.4 (5.0) | 18.9 (4.4) | 0.003 |
Overweight/obesity | No (%) | 1132 (72.7) | 1004 (71.1) | 958 (64.2) | <0.001 |
Yes (%) | 426 (27.3) | 408 (28.9) | 535 (35.8) | ||
Obesity | No (%) | 1404 (90.1) | 1270 (89.9) | 1285 (86.1) | <0.001 |
Yes (%) | 154 (9.9) | 142 (10.1) | 208 (13.9) | ||
HEI (score) | Mean (SD) | 69.6 (8.2) | 71.6 (8.8) | 69.3 (10.0) | <0.001 |
PA category | No exercise (%) | 187 (12.0) | 204 (14.4) | 399 (26.7) | <0.001 |
Occasional physical activity or sport (%) | 386 (24.8) | 452 (32.0) | 258 (17.3) | ||
Physical activity several times a month (%) | 578 (37.1) | 271 (19.2) | 400 (26.8) | ||
Sports or physical training several times a week (%) | 407 (26.1) | 485 (34.3) | 436 (29.2) | ||
PA guidelines | Non-meeting (%) | 1151 (73.9) | 927 (65.7) | 1057 (70.8) | <0.001 |
Meeting (%) | 407 (26.1) | 485 (34.3) | 436 (29.2) | ||
ST duration (min) | Mean (SD) | 94.3 (94.3) | 94.3 (77.1) | 120.0 (102.9) | <0.001 |
ST guidelines | Non-meeting (%) | 850 (54.6) | 780 (55.2) | 863 (57.8) | 0.167 |
Meeting (%) | 708 (45.4) | 632 (44.8) | 630 (42.2) | ||
Sleep duration (hour) | Mean (SD) | 9.0 (1.0) | 9.0 (1.0) | 9.0 (1.0) | 0.343 |
Sleep guidelines | Non-meeting (%) | 506 (32.5) | 488 (34.6) | 523 (35.0) | 0.285 |
Meeting (%) | 1052 (67.5) | 924 (65.4) | 970 (65.0) | ||
Poverty | Mean (SD) | 12.7 (2.6) | 20.9 (3.8) | 31.1 (2.7) | <0.001 |
Outcome (Overweight/Obesity) | |||
---|---|---|---|
Predictors | OR (Univariable) | OR (Multilevel) | |
Specific individual average effects | |||
SES status | Low SES | Reference | Reference |
Medium SES | 0.62 (0.53–0.71, p < 0.001) | 0.63 (0.54–0.73, p < 0.001) | |
High SES | 0.58 (0.49–0.68, p < 0.001) | 0.59 (0.50–0.71, p < 0.001) | |
Immigrant status | Native-born | Reference | Reference |
Foreign-born | 1.26 (0.94–1.66, p = 0.116) | 1.12 (0.83–1.49, p = 0.462) | |
Age | Mean (SD) | 0.96 (0.95–0.98, p < 0.001) | 0.96 (0.94–0.98, p < 0.001) |
Sex | Boys | Reference | Reference |
Girls | 1.00 (0.88–1.13, p = 0.975) | 1.01 (0.88–1.15, p = 0.938) | |
HEI status | Low HEI | Reference | Reference |
Medium HEI | 0.88 (0.75–1.02, p = 0.092) | 0.93 (0.79–1.09, p = 0.369) | |
High HEI | 0.88 (0.76–1.03, p = 0.122) | 0.89 (0.75–1.05, p = 0.161) | |
PA category | No exercise | Reference | Reference |
Occasional physical activity or sport | 0.96 (0.79–1.16, p = 0.658) | 1.13 (0.92–1.39, p = 0.250) | |
Physical activity several times a month | 0.82 (0.68–0.99, p = 0.044) | 1.06 (0.86–1.31, p = 0.586) | |
Sports or physical training several times a week | 0.80 (0.66–0.96, p = 0.019) | 1.04 (0.85–1.28, p = 0.721) | |
ST guidelines | No | Reference | Reference |
Yes | 0.97 (0.85–1.10, p = 0.588) | 0.98 (0.86–1.12, p = 0.803) | |
Sleep guidelines | No | Reference | Reference |
Yes | 0.82 (0.72–0.94, p = 0.004) | 0.91 (0.79–1.05, p = 0.201) | |
Specific contextual average effects | |||
Poverty status | Low poverty | Reference | Reference |
Medium poverty | 1.08 (0.92–1.27, p = 0.347) | 1.10 (0.87–1.39, p = 0.410) | |
High poverty | 1.48 (1.27–1.73, p < 0.001) | 1.48 (1.17–1.86, p = 0.001) | |
POOR (%) | Low poverty vs. Medium poverty | 30.3 | |
POOR (%) | Low poverty vs. High poverty | 2.1 | |
Country variance | 0.018 (0.014–0.022) | ||
ICC (%) | 0.53 | ||
MOR | 1.14 (1.12–1.15) | ||
Model performance metrics | |||
BIC | 5524.4 | ||
Nakagawa’s R2 | 0.041 |
Outcome (Obesity) | |||
---|---|---|---|
Predictors | OR (Univariable) | OR (Multilevel) | |
Specific individual average effects | |||
SES status | Low SES | Reference | Reference |
Medium SES | 0.57 (0.46–0.70, p < 0.001) | 0.56 (0.45–0.70, p < 0.001) | |
High SES | 0.39 (0.30–0.52, p < 0.001) | 0.37 (0.28–0.50, p < 0.001) | |
Immigrant status | Native-born | Reference | Reference |
Foreign-born | 1.58 (1.07–2.26, p = 0.016) | 1.29 (0.88–1.91, p = 0.194) | |
Age | Mean (SD) | 0.85 (0.83–0.87, p < 0.001) | 0.85 (0.82–0.87, p < 0.001) |
Sex | Boys | Reference | Reference |
Girls | 0.95 (0.79–1.14, p = 0.588) | 0.99 (0.82–1.20, p = 0.931) | |
HEI status | Low HEI | Reference | Reference |
Medium HEI | 0.78 (0.62–0.98, p = 0.033) | 0.76 (0.60–0.96, p = 0.022) | |
High HEI | 0.96 (0.77–1.20, p = 0.747) | 0.81 (0.64–1.03, p = 0.091) | |
PA category | No exercise | Reference | Reference |
Occasional physical activity or sport | 0.75 (0.58–0.97, p = 0.028) | 0.92 (0.70–1.22, p = 0.564) | |
Physical activity several times a month | 0.50 (0.38–0.65, p < 0.001) | 0.85 (0.63–1.15, p = 0.293) | |
Sports or physical training several times a week | 0.49 (0.38–0.64, p < 0.001) | 0.95 (0.71–1.28, p = 0.749) | |
ST guidelines | No | Reference | Reference |
Yes | 0.93 (0.77–1.13, p = 0.477) | 0.93 (0.76–1.13, p = 0.443) | |
Sleep guidelines | No | Reference | Reference |
Yes | 0.57 (0.47–0.69, p < 0.001) | 0.86 (0.70–1.06, p = 0.168) | |
Specific contextual average effects | |||
Poverty status | Low poverty | Reference | Reference |
Medium poverty | 1.02 (0.80–1.30, p = 0.876) | 0.98 (0.71–1.35, p = 0.891) | |
High poverty | 1.48 (1.18–1.84, p = 0.001) | 1.40 (1.02–1.94, p = 0.039) | |
POOR (%) | Low poverty vs. Medium poverty | 45.9 | |
POOR (%) | Low poverty vs. High poverty | 6.0 | |
Country variance | 0.024 (0.019–0.029) | ||
ICC (%) | 0.61 | ||
MOR | 1.16 (1.14–1.18) | ||
Model performance metrics | |||
BIC | 3026.4 | ||
Nakagawa’s R2 | 0.164 |
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Gallego, A.; Olivares-Arancibia, J.; Yáñez-Sepúlveda, R.; Gutiérrez-Espinoza, H.; López-Gil, J.F. Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents. Children 2024, 11, 1020. https://doi.org/10.3390/children11081020
Gallego A, Olivares-Arancibia J, Yáñez-Sepúlveda R, Gutiérrez-Espinoza H, López-Gil JF. Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents. Children. 2024; 11(8):1020. https://doi.org/10.3390/children11081020
Chicago/Turabian StyleGallego, Alejandra, Jorge Olivares-Arancibia, Rodrigo Yáñez-Sepúlveda, Héctor Gutiérrez-Espinoza, and José Francisco López-Gil. 2024. "Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents" Children 11, no. 8: 1020. https://doi.org/10.3390/children11081020