Korean J Health Promot KJHP Korean Journal of Health Promotion 2234-2141 2093-5676 Korean Society for Health Promotion and Disease Prevention 10.15384/kjhp.2018.18.1.23 Original Article The Distribution of Weight Status according to Familial Socioeconomic Status in Korean Adolescents: The Twelfth Korea Youth Risk Behavior Web-based Survey, 2016 Jang Jinyoung Cho Young Gyu Kang Jae-Heon Park Hyun Ah Kim Kyoungwoo Hur Yang-Im Park Ki Byeong Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. Corresponding author: Young Gyu Cho, MD. Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 04551, Korea. Tel: +82-2-2270-0097, Fax: +82-2-2272-0908, jacobel@hanmail.net 03 2018 31 03 2018 18 1 23 31 26 12 2017 19 02 2018 Copyright © 2018 Korean Society for Health Promotion and Disease Prevention 2018 Korean Society for Health Promotion and Disease Prevention This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents.

 Methods

This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level.

 Results

In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04).

 Conclusions

This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.

 Obesity Thinness Social class Adolescent Shrewsbury V Wardle J Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990–2005 Obesity (Silver Spring) 2008 16 2 275 284 Lim SM Kim CH Cho HJ Park HS Relationship between overweight and socioeconomic factors in Korean adolescents: using data from the 2007 Korean Youth's Risk Behavior Web-based Study Korean J Fam Med 2010 31 9 703 710 Noh JW Kim YE Park J Oh IH Kwon YD Impact of parental socioeconomic status on childhood and adolescent overweight and underweight in Korea J Epidemiol 2014 24 3 221 229 Chung A Backholer K Wong E Palermo C Keating C Peeters A Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review Obes Rev 2016 17 3 276 295 Mak KK Tan SH Underweight problems in Asian children and adolescents Eur J Pediatr 2012 171 5 779 785 Kim KE Kim SH Park S Khang YH Park MJ Changes in prevalence of obesity and underweight among Korean children and adolescents: 1998-2008 Korean J Obes 2012 21 4 228 235 Wang Y Monteiro C Popkin BM Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia Am J Clin Nutr 2002 75 6 971 977 Ministry of Education, Ministry of Health and Welfare Korea Centers for Disease Control and Prevention The Twelfth Korea Youth Risk Behavior Web-Based Survey, 2016 Cheongju Korean Centers for Disease Control and Prevention 2016 Korea Centers for Disease Control and Prevention (KCDC) 2007 Korean children and adolescents national growth chart: commentary [Internet] Cheongju KCDC 2008 Accessed 2017 Dec 7 Available from: http://cdc.go.kr/CDC/mobile/info/CdcKrInfo0201.jsp?menuIds=HOME001-MNU1154-MNU0004-MNU1889&fid=28&q_type=&q_vaue=&cid=1235&pageNum=1 Barriuso L Miqueleiz E Albaladejo R Villanueva R Santos JM Regidor E Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013 BMC Pediatr 2015 15 129 Armstrong J Dorosty AR Reilly JJ Emmett PM Child Health Information Team Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study Arch Dis Child 2003 88 8 671 675 Stamatakis E Wardle J Cole TJ Childhood obesity and overweight prevalence trends in England: evidence for growing scoioeconomic disparities Int J Obes (Lond) 2010 34 1 41 47 White J Rehkopf D Mortensen LH Trends in socioeconomic inequalities in body mass index, underweight and obesity among English children, 2007-2008 to 2011-2012 PLoS One 2016 11 1 e0147614 Ueda P Kondo N Fujiwara T The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan Int J Obes (Lond) 2015 39 9 1414 1420 Kim HR Hwang NM Shim JE Kim EJN Analysis on breastfeeding and nutritional health among children and adolescents and counter policies in Korea Seoul Korean Institute for Health and Social Affairs 2008 Park JA Lee SH Kim JS Body-figure preferences in male and female adolescents Korean J Health Promot Dis Prev 2005 5 3 190 196 Moon SS Lee YS Comparison of dietary habits, exercise, recognized body shapes and weight control between obesity and underweight of adolescents Korean J Hum Ecol 2009 18 3 1337 1348 Hanson MD Chen E Socioeconomic status and health behaviors in adolescence: a review of the literature J Behav Med 2007 30 3 263 285 Currie CE Elton RA Todd J Platt S Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in School-aged Children Survey Health Educ Res 1997 12 3 385 397 Goodman E Adler NE Daniels SR Morrison JA Slap GB Dolan LM Impact of objective and subjective social status on obesity in a biracial cohort of adolescents Obes Res 2003 11 8 1018 1026 Oh IH Cho Y Park SY Oh C Choi BK Choi JM Relationship between socioeconomic variables and obesity in Korean adolescents J Epidemiol 2011 21 4 263 270 Ministry of Health and Welfare, Korea Health Promotion Foundation The fourth health plan 2016–2020 Sejong Ministry of health and Welfare 2015 Backholer K Beauchamp A Ball K Turrell G Martin J Woods J A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight Am J Public Health 2014 104 10 e43 e50 Kim JY Son SJ Lee JE Kim JH Jung IK The effects of body image satisfaction on obesity stress, weight control attitudes, and eating disorders among female junior high school students J Korean Home Econ Assoc 2009 47 4 49 59 Kim HR Cho JH Kim SW Kang YH Study on the development of prevention strategies for obesity in children and adolescents Sejong Korean Institute for Health and Social Affairs 2014 General characteristics of the study subjects

Values are expressed as mean±standard error or % (standard error).

aBy t-test or chi-square test.

bDo not have their father or mother.

 Distribution of weight status according to familial socioeconomic status in boys

Values are expressed as % (standard error).

aBy chi-square test.

bDo not have their father or mother.

 Distribution of weight status according to familial socioeconomic status in girls

Values are expressed as % (standard error).

aBy chi-square test.

bDo not have their father or mother.

 OR (95% CI)<sup>a</sup> of familial socioeconomic status on weight status by multinomial logistic regression analyses in boys

Abbreviations: OR, odds ratio; CI, confidence interval.

aAdjusted by age, current smoking status, current alcohol intake, physical activity, breakfast skipping, fast food consumption, soft drinks consumption, perceived stress, depressive mood, living with family, and residential district.

bP<0.05 by multinomial logistic regression analysis.

cDo not have their father or mother.

 OR (95% CI)<sup>a</sup> of familial socioeconomic status on weight status by multinomial logistic regression analyses in girls

Abbreviations: OR, odds ratio; CI, confidence interval.

aAdjusted by age, current smoking status, current alcohol intake, physical activity, breakfast skipping, fast food consumption, soft drinks consumption, perceived stress, depressive mood, living with family, and residential district

bP<0.05 by multinomial logistic regression analysis.

cDo not have their father or mother.