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Differences in overweight and obesity among Australian schoolchildren of low and middle/high socioeconomic status

MJA 2003; 179 (1): 63

Jennifer A O'Dea

Senior Lecturer, Faculty of Education, University of Sydney, Building A35, Sydney, NSW 2006. j.o'deaATedfac.usyd.edu.au

To the Editor: As part of a large, national nutrition study, height and weight were measured among 4441 students from 38 schools randomly selected from lists of all state and territory schools in Australia in 2000. Public, private and Catholic schools, in both rural and urban areas, were represented.

Schools were categorised as being of low or middle/high socioeconomic status (SES),1 based on direct measurement of parental income. Parental consent was obtained, and the study was approved by the University of Sydney Ethics Committee and all state departments of education.

Overweight and obesity, as defined by an international standard definition,2 were identified in 17.3% and 6.4% of participants, respectively. These characteristics showed a trend towards greater prevalence among students from low-SES backgrounds compared with those from middle/high-SES backgrounds for the total group (19% v 16.8% overweight [P = 0.09]; 8.9% v 5.8% obese [P = 0.02]), females (19.7% v 17.2% overweight [P = 0.2]; 6.9% v 6.2% obese [P = 0.56]), and males (18.5% v 16.3% overweight [P = 0.23]; 9% v 5.5% obese [P = 0.003]), although not all differences were statistically significant.

After controlling for SES differences in age and height, mean body mass index (BMI) was significantly higher among low-SES than middle/high-SES participants for the total group (20.3 kg/m2 [95% CI, 20.1–20.5 kg/m2] v 19.7 kg/m2 [95% CI, 19.6–19.9 kg/m2]; P < 0.001), females (20.4 kg/m2 [95% CI, 20.1–20.7 kg/m2] v 19.8 kg/m2 [95% CI, 19.6–19.9 kg/m2]; P < 0.001), and males (20.2 kg/m2 [95% CI, 20.0–20.5 kg/m2] v 19.6 kg/m2 [95% CI, 19.5–19.8 kg/m2]; P < 0.001). A breakdown of results by SES, sex and school level is shown in the Box.

Low-SES primary school children were also 1–2 cm shorter, on average, than middle/high-SES primary school children (boys: mean 141.5 cm [95% CI, 140.6–142.5 cm] v 143.5 cm [95% CI, 143.0–144.0], P < 0.001; girls: mean 141.0 cm [95% CI, 140.8–142.6 cm] v 143.3 cm [95% CI, 142.5–143.6 cm], P = 0.01).

The average proportions of overweight and obese children and adolescents in the study were similar to those found in other Australian studies.3-5

The results suggest that SES is a factor in the development of overweight and obesity among Australian school children. This may be a relatively recent trend, as these data were obtained in late 2000. Low SES in children may also be associated with nutritional deprivation and height retardation. Further research should clarify these relationships among children from low, middle and high SES backgrounds, as well as examining the combined impact of both SES and ethnicity.

School students classified as overweight or obese* according to socioeconomic status (SES), school level and sex

Males (= 2232)


Females (n = 2209)


Low SES (n = 574)

Middle/high SES (n = 1658)

Low SES (n = 508)

Middle/high SES (n = 1701)


Primary school students (grades 1–6; ages 6–13 years)

Overweight students

19.4% (42/216)

16.2% (110/680)

23.2% (51/220)

17.8% (136/766)

Obese students

  6.9% (15/216)

5.3% (36/680)

  6.4% (14/220)

5.7% (44/766)

High school students (grades 7–12; ages 13–18 years)

Overweight students

17.6% (63/358)

16.4% (160/978)

17.0% (49/288)

16.8% (157/935)

Obese students

10.1% (36/358)

5.6% (55/978)

  7.3% (21/288)

6.5% (61/935)


* Overweight and obesity are classified according to the international standard definition.2

Acknowledgement: This study was supported by a Kellogg Australia Nutrition Research Grant.

  1. Priority Schools Funding Program. Operational guidelines 2003. Sydney: NSW Department of Education and Youth Affairs, 2003.
  2. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240-1243. <PubMed>
  3. O'Dea JA, Caputi P. Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents. Health Educ Res 2001; 16: 521-532. <PubMed>
  4. Magarey AM, Daniels LA, Boulton TJC. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust 2001; 174: 561-564. <eMJA full text><PubMed>
  5. Booth ML, Macaskill P, Lazarus R, Baur LA. Sociodemographic distribution of measures of body fatness among children and adolescents in New South Wales, Australia. Int J Obes Relat Metab Disord 1999; 23: 456-462. <PubMed>

(Received 4 Mar 2003, accepted 17 Apr 2003)

©The Medical Journal of Australia 2003 www.mja.com.au Print ISSN: 0025-729X Online ISSN: 1326-5377

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