What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Underweight, overweight, or obesity (n=2491). Intervention: Lower education level vs. Higher education level. Primary outcome: Obesity (BMI ≥30.0 kg/m2) versus normal BMI (18.5-24.9 kg/m2) in adult women (OR 2.66, 95% CI 1.01-7.01).

January 1, 2018Open Access

Relationship Between Socioeconomic Status and the Prevalence of Underweight, Overweight or Obesity in a General Japanese Population: NIPPON DATA2010

Key Result

A lower education level was positively associated with obesity in adult women (OR 2.66) but inversely associated with obesity in adult men (OR 0.41) compared to a higher education level.

Study Design

Type

Cross-Sectional (n=2,491)

Multicenter

Yes

Structured PICO

Does lower socioeconomic status increase the prevalence of underweight, overweight, or obesity in a general Japanese population?

Population

2,491 adults (1,081 men and 1,410 women) aged 20 years and older from a general Japanese population (NIPPON DATA2010 cohort).

Intervention

Lower socioeconomic status (lower education level, lower household income, single/living alone, unemployed)

Comparator

Higher socioeconomic status (higher education level, higher household income, married, employed)

Outcome

Prevalence of being underweight (BMI <18.5 kg/m2), overweight (BMI 25.0-29.9 kg/m2), or obese (BMI ≥30.0 kg/m2) versus normal weight (BMI 18.5-24.9 kg/m2)

Socioeconomic status impacts BMI categories differently by gender in Japan, with lower SES associated with obesity in adult women but inversely associated with obesity in adult men.

Main Result

Effect estimate: OR 2.66 (95% CI 1.01-7.01)

Limitations

Cross-sectional study design cannot clarify causal relationships between socioeconomic status and BMI categories.
Influence of age may not be well adjusted due to small numbers in each category.
Household income was used instead of individual income, which may not reflect each individual's income.

Abstract

BACKGROUND: Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20-64 or ≥65 years) in Japan. METHODS: (normal) as the outcome, with SES groups as the main explanatory variables. RESULTS: In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio OR 0.41; 95% confidence interval CI, 0.18-0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07-2.49 for overweight and OR 2.66; 95% CI, 1.01-7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36-17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY). CONCLUSIONS: In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.

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