A longitudinal analysis of the effects of socioeconomic factors, foreign media, and attitude toward appearance on general and central adiposity in Chinese adolescents

OBJECTIVE This paper explores the longitudinal effects of socioeconomic factors (i.e., parent education and family income level), foreign media, and attitude toward appearance on general and central adiposity among Chinese adolescents. METHOD A longitudinal analysis was performed using data from the China Seven Cities Study, a health promotion and smoking prevention study conducted in seven cities across Mainland China between 2002 and 2005. Participants included 5,020 middle and high school students and their parents. Explanatory variables included foreign media exposure, attitude toward appearance, parent education, and family income. Three-level, random-effect models were used to predict general adiposity (i.e., body mass index) and central adiposity (i.e., waist circumference). The Generalized Estimating Equation approach was utilized to determine the effect of explanatory variables on overweight status. RESULTS Among girls, foreign media exposure was significantly negatively associated with general adiposity over time (β=-0.06, p=0.01 for middle school girls; β=-0.06, p=0.03 for high school girls). Attitude toward appearance was associated with lesser odds of being overweight, particularly among high school girls (OR=0.86, p<0.01). Among boys, parental education was significantly positively associated with general adiposity (β=0.62, p<0.01 for middle school boys; β=0.37, p=0.02 for high school boys) and associated with greater odds of being overweight (OR=1.55, p<0.01 for middle school boys; OR=1.26, p=0.04 for high school boys). Across all gender and grade levels, family income was significantly negatively associated with central adiposity over time. CONCLUSION Interventions addressing Chinese adolescent overweight/obesity should consider these factors as potential focus areas.