Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study

ABSTRACT BACKGROUND: Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING: Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS: The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS: Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prevalences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION: This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity.

摘要

## 研究背景
社会经济地位是公认的肥胖危险因素。本研究旨在评估塞尔维亚成年人群社会经济状况与营养状况之间的关联。

## 研究设计与场景
本研究为横断面研究，数据来源于2013年塞尔维亚全国健康调查。

## 研究方法
研究对象为年龄≥20岁的成年人。由经过培训的工作人员开展面对面访谈及人体测量学指标检测。采用多变量logistic回归分析，探究体重指数（body mass index, BMI）与社会人口学变量之间的关联。

## 研究结果
在12461名男女受试者中，36.4%存在超重情况，22.4%存在肥胖情况。在各项社会人口学特征方面，男女的超重与肥胖患病率均存在显著差异。
在女性群体中，受教育程度与更低的超重及肥胖风险相关：超重风险方面，中等教育水平者的比值比（odds ratio, OR）为0.82，95%置信区间（confidence interval, CI）为0.69~0.98，高等教育水平者OR为0.77，CI为0.62~0.97；肥胖风险方面，中等教育水平者OR为0.68，CI为0.57~0.82，高等教育水平者OR为0.41，CI为0.31~0.54。
与之相反，中等教育水平（OR=1.28；CI=1.08~1.52）与高等教育水平的男性相较于低教育水平男性，超重的患病率更高。
在男性群体中，I级肥胖与最富裕的财富指数组别呈正相关（OR=1.27）；而女性的II级肥胖则呈现相反的关联（OR=0.61）。

## 研究结论
本研究表明，男女之间的营养状况存在显著的社会经济不平等。持续监测与体重相关的社会经济模式具有重要意义，尤其是在进一步探究教育与肥胖之间的关联方面。