title: Socio-economic influences on anthropometric status in urban South African adolescents: sex differences in the Birth to Twenty Plus cohort.
abstract: OBJECTIVE
  To investigate the associations of household and neighbourhood socio-economic position (SEP) with indicators of both under- and overnutrition in adolescents and to explore sex differences.
  
  
  METHODS
  Analysis of anthropometric, household and neighbourhood SEP data from the Birth to Twenty Plus cohort born in 1990. Anthropometric outcomes were BMI (thinness, overweight and obesity) and percentage body fat (%BF; low, high). Associations between these and the household wealth index, caregiver education and neighbourhood SEP tertile measures were examined using binary logistic regression.
  
  
  METHODS
  Johannesburg-Soweto, South Africa.
  
  
  METHODS
  Adolescents aged 17-19 years (n 2019; 48·2% men).
  
  
  RESULTS
  Women had a significantly higher combined prevalence of overweight/obesity (26·2%) than men (8·2%) whereas men had a significantly higher prevalence of thinness than women (22·2% v. 10·6%, respectively). Having a low neighbourhood social support index was associated with higher odds of high %BF in women (OR=1·59; 95% CI 1·03, 2·44). A low household wealth index was associated with lower odds of both overweight (OR=0·31; 95% CI 0·12, 0·76) and high %BF in men (OR=0·28; 95% CI 0·10, 0·78). A low or middle household wealth index was associated with higher odds of being thin in men (OR=1·90; 95% CI 1·09, 3·31 and OR=1·80; 95% CI 1·03, 3·15, respectively). For women, a low household wealth index was associated with lower odds of being thin (OR=0·49; 95% CI 0·25, 0·96).
  
  
  CONCLUSIONS
  The study highlights that even within a relatively small urban area the nutrition transition manifests itself differently in men and women and across SEP indicators. Understanding the challenges for different sexes at different ages is vital in helping to plan public health services.
authors.affiliation: 1Centre for Global Health and Human Development,School of Sport,Exercise and Health Sciences,Loughborough University,Loughborough,Leicestershire,LE11 3TU,UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Pradeilles
authors.affiliation: 1Centre for Global Health and Human Development,School of Sport,Exercise and Health Sciences,Loughborough University,Loughborough,Leicestershire,LE11 3TU,UK.
authors.forename: Paula L
authors.initials: PL
authors.lastname: Griffiths
authors.affiliation: 2MRC/Wits Developmental Pathways for Health Research Unit,University of the Witwatersrand,Johannesburg,South Africa.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
authors.affiliation: 2MRC/Wits Developmental Pathways for Health Research Unit,University of the Witwatersrand,Johannesburg,South Africa.
authors.forename: Alison B
authors.initials: AB
authors.lastname: Feeley
authors.affiliation: 1Centre for Global Health and Human Development,School of Sport,Exercise and Health Sciences,Loughborough University,Loughborough,Leicestershire,LE11 3TU,UK.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Rousham
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D050177:Overweight / Q000209:etiology; D015995:Prevalence; D012111:Residence Characteristics; D012737:Sex Factors; D012923:Social Class; D012944:Social Support; D013019:South Africa / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology*; D014505:Urban Population; D055815:Young Adult
keywords: Adolescents; Anthropometric status; Household; Neighbourhood; Socio-economic; South Africa; Urban