title: Socio-economic status as an environmental factor - incidence of underweight, overweight and obesity in adolescents from less-urbanized regions of Poland.
abstract: BACKGROUND
  Under-nutrition, over-nutrition and obesity incidence in relation to environmental diversity and socio-economic influences in adolescents from less urbanized regions of Poland has not been widely studied.
  
  
  OBJECTIVE
  To determine the correlation between socio-economic status and incidence of underweight, overweight and obesity in adolescents located in less-urbanized regions of Poland.
  
  
  METHODS
  The study involved 553 adolescents aged 13-18 living in 2 less-urbanized regions of Poland (small towns and villages in the central and north-eastern regions). The sample was randomly chosen. The distinguishing determinants of socio-economic status (SES) included 6 features. The SES index (SESI) was calculated. Low, average and high SESI adolescents were distinguished. Using logistic regression, the odds ratio (OR) of underweight (BMI<18.5 kg/m(2)), overweight (BMI ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)) incidence was calculated after BMI conversion using the international cut-off by Cole et al. (2000, 2007). The reference group were adolescents with low SESI (OR=1.00).
  
  
  RESULTS
  11% of the adolescents were underweight, 14% were overweight and 3% were obese. The odds ratio of underweight incidence for the average SESI adolescent was 0.33 (95%CI: 0.15, 0.73; p<0.01) and in high SESI adolescents - 1.05 (95%CI: 0.78, 1.42; p>0.05). The odds ratio of overweight incidence in the average SESI adolescent was 1.73 (95%CI: 0.93, 3.19; p>0.05) and in high SESI adolescents - 1.14 (95%CI: 0.83, 1.57; p>0.05). The odds ratio of obesity incidence in the average SESI adolescent was 0.70 (95%CI: 0.21, 2.34; p>0.05) and in high SESI adolescents - 0.76 (95%CI: 0.40, 1.44; p>0.05). Adjustments for gender, age or region of residence did not significantly change the ORs values or their interpretation.
  
  
  CONCLUSIONS
  Underweight incidence in adolescents from less urbanized regions of Poland depended on socio-economic status. An adolescent with average socio-economic status was 3 times less likely to be underweight than an adolescent with low socio-economic status. The correlation between socio-economic status and overweight and obesity was not significant.
authors.affiliation: Chair and Department of Nutrition and Dietetics, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Długosz
authors.affiliation: Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Niedźwiedzka
authors.affiliation: Pharmacy "Marzeń", Bydgoszcz, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Długosz
authors.affiliation: Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland.
authors.forename: Lidia
authors.initials: L
authors.lastname: Wądołowska
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D011044:Poland / Q000453:epidemiology; D012424:Rural Population; D012923:Social Class; D013851:Thinness / Q000453:epidemiology* / Q000209:etiology