title: Abdominal obesity and its association with socioeconomic factors among adolescents from different living environments.
abstract: Socioeconomic status has been associated with obesity in children and adolescents. This association may be dependent according with where adolescents lives.
  
  
  
  The aim of this study was to evaluate the association between different socioeconomic indicators such as parental education and occupation and socioeconomic status with abdominal obesity in adolescents from two observational studies: the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (HELENA-CSS) and the Brazilian Cardiovascular Adolescent Health (BRACAH) study.
  
  
  
  European (n = 3192, aged 12.5-17.5 years, with 53.1% girls from HELENA-CSS) and Brazilian (n = 991, aged 14-18 years, with 54.5% girls from BRACAH study) adolescents from two cross-sectional studies were included in this analysis. Complete data on waist circumference (WC), height, socioeconomic status indicators and several confounders were collected. Socioeconomic indicators were measured using a self-reported questionnaire in order to assess the family social status of the adolescents. Multilevel linear regression models were used to examine associations, and results were adjusted for potential confounders.
  
  
  
  Adjusted results showed inverse associations between mother's and father's education levels (p < 0.001) and father's occupation level (p < 0.001) with waist-to-height ratio (WHtR) and WC in HELENA-CSS girls. Similarly in European girls, socioeconomic indicators by socioeconomic status and maternal occupation level were associated with WHtR. In HELENA-CSS boys, the same significant association was found between WHtR and WC with maternal occupation level. Moreover, in European boys WHtR was also associated with parental education. In Brazilian adolescents, both indicators of abdominal obesity did not remain associated with the independents variables, after adjustment for potential confounders.
  
  
  
  Abdominal obesity was associated with socioeconomic indicators in higher-income countries, but this association was not observed in a lower-middle-income country.
authors.affiliation: Department of Preventive Medicine, School of Medicine, University of São Paulo, YCARE (Youth/Child Cardiovascular Risk and Evironmental) Research Group, São Paulo, Brazil.|Faculty of Health Sciences, University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentário de Aragón (IA2), Zaragoza, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Costa de Oliveira Forkert
authors.affiliation: Department of Preventive Medicine, School of Medicine, University of São Paulo, YCARE (Youth/Child Cardiovascular Risk and Evironmental) Research Group, São Paulo, Brazil.|Faculty of Health Sciences, University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentário de Aragón (IA2), Zaragoza, Spain.
authors.forename: A C F
authors.initials: AC
authors.lastname: de Moraes
authors.affiliation: Department of Preventive Medicine, School of Medicine, University of São Paulo, YCARE (Youth/Child Cardiovascular Risk and Evironmental) Research Group, São Paulo, Brazil.
authors.forename: H B
authors.initials: HB
authors.lastname: Carvalho
authors.affiliation: Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kafatos
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.affiliation: Department of Biosciences, Unit for Preventive Nutrition, Karolinska Institute, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Sjöström
authors.affiliation: ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Technical University of Madrid, Madrid, Spain.|Institut für Ernährungs-und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.
authors.forename: M
authors.initials: M
authors.lastname: González-Gross
authors.affiliation: Unité Inserm U995 and Université Lille Nord de France, Lille, France.|Centre d'Investigation Clinique, CIC-9301-Inserm-CH&U, Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Gottrand
authors.affiliation: CHRU Lille, Faculté Médecine, Université de Lille, Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Beghin
authors.affiliation: Agricultural Research Council, Food and Nutrition Research Centre (CREA-NUT), Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Censi
authors.affiliation: Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kersting
authors.affiliation: Faculty of Health Sciences, University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentário de Aragón (IA2), Zaragoza, Spain.|Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015992:Body Mass Index; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D056128:Obesity, Abdominal / Q000453:epidemiology*; D010290:Parents; D063766:Pediatric Obesity / Q000453:epidemiology*; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Abdominal obesity; adolescents; risk factors; socioeconomic status