Open Access Research article

Adiposity among children in Norway by urbanity and maternal education: a nationally representative study

Anna Biehl12*, Ragnhild Hovengen1, Else-Karin Grøholt1, Jøran Hjelmesæth2, Bjørn Heine Strand1 and Haakon E Meyer13

Author Affiliations

1 Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403 Oslo, Norway

2 The Morbid Obesity Centre, Vestfold Hospital Trust, P.O. Box 2168, 3103 Tønsberg, Norway

3 Department of Community Medicine, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, 0318 Oslo, Norway

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BMC Public Health 2013, 13:842  doi:10.1186/1471-2458-13-842

Published: 12 September 2013



International research has demonstrated that rural residency is a risk factor for childhood adiposity. The main aim of this study was to investigate the urban-rural gradient in overweight and obesity and whether the association differed by maternal education.


Height, weight and waist circumference (WC) were measured in a nationally representative sample of 3166 Norwegian eight-year-olds in 2010. Anthropometric measures were stratified by area of residence (urbanity) and maternal education. Risk estimates for overweight (including obesity) and waist-to-height ratio ≥0.5 were calculated by log-binomial regression.


Mean BMI and WC and risk estimates of overweight (including obesity) and waist-to-height ratio ≥0.5 were associated with both urbanity and maternal education. These associations were robust after mutual adjustment for each other. Furthermore, there was an indication of interaction between urbanity and maternal education, as trends of mean BMI and WC increased from urban to rural residence among children of low-educated mothers (p = 0.01 for both BMI and WC), whereas corresponding trends for children from higher educational background were non-significant (p > 0.30). However, formal tests of the interaction term urbanity by maternal education were non-significant (p-value for interaction was 0.29 for BMI and 0.31 for WC).


In this nationally representative study, children living rurally and children of low-educated mothers had higher mean BMI and waist circumference than children living in more urban areas and children of higher educated mothers.

Epidemiology; Anthropometry; Waist circumference; Overweight; Obesity; Child; Socioeconomic position; Rural; Urbanity; Public health