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. 2010 Jun 9;26(6):281–289. doi: 10.1016/S1607-551X(10)70041-3

Associations between Substance Use and Body Mass Index: Moderating Effects of Sociodemographic Characteristics Among Taiwanese Adolescents

Tai‐Ling Liu 1, Ju‐Yu Yen 1,2, Chih‐Hung Ko 2,3, Mei‐Feng Huang 4, Peng‐Wei Wang 4, Yi‐Chun Yeh 1, Cheng‐Fang Yen 1,2,✉
PMCID: PMC11916636  PMID: 20538232

Abstract

The aim of this study was to analyze the association between substance use and body mass index (BMI) among adolescents in Southern Taiwan. A total of 10,259 adolescent students aged 11–19 years were selected by stratified random sampling for proportional representation of districts, schools and grades in Southern Taiwan, and completed the questionnaires. The body weight, body height, experience of substance use and sociodemographic characteristics including sex, age, residential background and paternal/maternal educational levels were collected. The association between substance use and BMI, and the moderating effects of sociodemographic characteristics were examined. After adjusting for sociodemographic characteristics, BMI was higher for adolescents who smoke cigarettes or drink alcohol than for those who do not regularly smoke or drink. Chewing betel nuts and using illicit drugs were not significantly associated with BMI. Paternal education level had a moderating effect on the association between smoking and BMI. Smoking, alcohol drinking, and low paternal education level were associated with higher BMI among adolescents. Thus, healthcare professionals should pay more attention to the weight‐related problems among these adolescents.

Keywords: adolescents, body mass index, substance use

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References

  • 1. Bauman A, Phongsavan P. Epidemiology of substance use in adolescence: prevalence, trends and policy implication. Drug Alcohol Depend. 1999; 55: 187–207. [DOI] [PubMed] [Google Scholar]
  • 2. Chong MY, Chan KW, Cheng AT. Substance use disorders among adolescents in Taiwan: prevalence, sociode‐mographic correlates and psychiatric co‐morbidity. Psychol Med. 1999; 29: 1387–1396. [DOI] [PubMed] [Google Scholar]
  • 3. Gau SS, Chong MY, Yang P, et al. Psychiatric and psychosocial predictors of substance use disorders among adolescents: longitudinal study. Br J Psychiatry. 2007; 190: 42–48. [DOI] [PubMed] [Google Scholar]
  • 4. Chen WJ, Fu TC, Ting TT, et al. Use of ecstasy and other psychoactive substances among school‐attending adolescents in Taiwan: national surveys 2004‐2006. BMC Public Health. 2009; 9: 27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5. DuRant RH, Smith JA, Kreiter SR, et al. The relationship between early age of onset of initial substance use and engaging in multiple health risk behaviors among young adolescents. Arch Pediatr Adolesc Med. 1999; 153: 286–291. [DOI] [PubMed] [Google Scholar]
  • 6. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006; 1: 11–25. [DOI] [PubMed] [Google Scholar]
  • 7. Yen CF, Hsiao RC, Yen JY, et al. Body weight statuses and their socio‐demographic correlates among adolescents in southern Taiwan: results using two sets of cutoff references. J Adolesc Health. 2010; 46: 62–69. [DOI] [PubMed] [Google Scholar]
  • 8. Falkner NH, Neumark‐Sztainer D, Story M, et al. Social, educational, and psychological correlates of weight status in adolescents. Obes Res. 2001; 9: 32–42. [DOI] [PubMed] [Google Scholar]
  • 9. Herva A, Laitinen J, Miettunen J, et al. Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. Int J Obes (Lond). 2006; 30: 520–527. [DOI] [PubMed] [Google Scholar]
  • 10. Neumark‐Sztainer D, Story M, Faibisch L. Perceived stigmatization among overweight African‐American and Caucasian adolescent girls. J Adolesc Health. 1998; 23: 264–270. [DOI] [PubMed] [Google Scholar]
  • 11. Wannamethee SG, Shaper AG, Whincup PH. Alcohol and adiposity: effects of quantity and type of drink and time relation with meals. Int J Obes (Lond). 2005; 29: 1436–1444. [DOI] [PubMed] [Google Scholar]
  • 12. Fonseca H, Matos MG, Guerra A, et al. Are overweight and obese adolescents different from their peers?. Int J Pediatr Obes. 2009; 4: 166–174. [DOI] [PubMed] [Google Scholar]
  • 13. Nelson MC, Lust K, Story M, et al. Alcohol use, eating patterns, and weight behaviors in a university population. Am J Health Behav. 2009; 33: 227–237. [DOI] [PubMed] [Google Scholar]
  • 14. Canoy D, Wareham N, Luben R, et al. Cigarette smoking and fat distribution in 21,828 British men and women: a population‐based study. Obes Res. 2005; 13: 1466–1475. [DOI] [PubMed] [Google Scholar]
  • 15. Chiolero A, Jacot‐Sadowski I, Faeh D, et al. Association of cigarettes smoked daily with obesity in a general adult population. Obesity (Silver Spring). 2007; 15: 1311–1318. [DOI] [PubMed] [Google Scholar]
  • 16. Saarni SE, Pietilainen K, Kantonen S, et al. Association of smoking in adolescence with abdominal obesity in adulthood: a followup study of 5 birth cohorts of Finnish twins. Am J Public Health. 2009; 99: 348–354. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17. Rodondi N, Pletcher MJ, Liu K, et al. Marijuana use, diet, body mass index, and cardiovascular risk factors (from the CARDIA study). Am J Cardiol. 2006; 98: 478–484. [DOI] [PubMed] [Google Scholar]
  • 18. Santolaria‐Fernandez FJ, Gomez‐Sirvent JL, GonzalezReimers CE, et al. Nutritional assessment of drug addicts. Drug Alcohol Depend. 1995; 38: 11–18. [DOI] [PubMed] [Google Scholar]
  • 19. Strickland SS, Duffield AE. Anthropometric status and resting metabolic rate in users of the areca nut and smokers of tobacco in rural Sarawak. Ann Hum Biol. 1997; 24: 453–474. [DOI] [PubMed] [Google Scholar]
  • 20. Mannan N, Boucher BJ, Evans SJ. Increased waist size and weight in relation to consumption of Areca catechu (betel‐nut): A risk factor for increased glycaemia in Asians in east London. Br J Nutr. 2000; 83: 267–275. [DOI] [PubMed] [Google Scholar]
  • 21. Kautiainen S, Koivisto AM, Koivusilta L, et al. Socio‐demographic factors and a secular trend of adolescent overweight in Finland. Int J Pediatr Obes. 2009; 4: 360–370. [DOI] [PubMed] [Google Scholar]
  • 22. Grant BF, Goldstein RB, Chou SP, et al. Socio‐demographic and psychopathologic predictors of first incidence of DSM‐IV substance use, mood and anxiety disorders: results from the Wave 2 National Epi‐demiologic Survey on Alcohol and Related Conditions. Mol Psychiatry. 2008; 14: 1051–1066. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23. Yen CF, Ko CH, Yen JY, et al. The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia among Taiwanese adolescents. Sleep. 2008; 31: 1515–1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24. Ministry of the Interior . Taiwan‐Fukien Demographic Fact Book, Republic of China. Taipei: Executive Yuan, Taiwan. 2002. [In Chinese]. [Google Scholar]
  • 25. Yen CF, Yang YH, Ko CH, et al. Substance initiation sequences among Taiwanese adolescents using metham‐phetamine. Psychiatry Clin Neurosci. 2005; 59: 683–689. [DOI] [PubMed] [Google Scholar]
  • 26. Danielzik S, Czerwinski‐Mast M, Langnase K, et al. Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5‐7 y‐old children: baseline data of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord. 2004; 28: 1494–1502. [DOI] [PubMed] [Google Scholar]
  • 27. Lamerz A, Kuepper‐Nybelen J, Wehle C, et al. Social class, parental education, and obesity prevalence in a study of six‐year‐old children in Germany. Int J Obes (Lond). 2005; 29: 373–380. [DOI] [PubMed] [Google Scholar]
  • 28. Baron RM, Kenny DA. The moderator‐mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51: 1173–1182. [DOI] [PubMed] [Google Scholar]
  • 29. Thiele TE, Navarro M, Sparta DR, et al. Alcoholism and obesity: overlapping neuropeptide pathways?. Neuropeptides. 2003; 37: 321–337. [DOI] [PubMed] [Google Scholar]
  • 30. Koval JJ, Pederson LL, Zhang X, et al. Can young adult smoking status be predicted from concern about body weight and self‐reported BMI among adolescents? Results from a ten‐year cohort study. Nicotine Tob Res. 2008; 10: 1449–1455. [DOI] [PubMed] [Google Scholar]
  • 31. Kaufman AR, Augustson EM. Predictors of regular cigarette smoking among adolescent females: does body image matter?. Nicotine Tob Res. 2008; 10: 1301–1309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32. Chen PS, Yang YK, Yeh TL, et al. Correlation between body mass index and striatal dopamine transporter availability in healthy volunteers‐a SPECT study. Neuroimage. 2008; 40: 275–279. [DOI] [PubMed] [Google Scholar]
  • 33. Yang YK, Yao WJ, Yeh TL, et al. Decreased dopamine transporter availability in male smokers‐Adual isotope SPECT study. Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32: 274–279. [DOI] [PubMed] [Google Scholar]
  • 34. Escobedo LG, Marcus SE, Holtzman D, et al. Sports participation, age at smoking initiation, and the risk of smoking among US high school students. JAMA. 1993; 269: 1391–1395. [PubMed] [Google Scholar]
  • 35. Jessor R. Risk behavior in adolescence: a psychosocial framework for understanding and action. J Adolesc Health. 1991; 2: 597–605. [DOI] [PubMed] [Google Scholar]
  • 36. Barry D, Petry NM. Associations between body mass index and substance use disorders differ by gender: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Addict Behav. 2009; 34: 51–60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37. Chang WC, Hsiao CF, Chang HY, et al. Betel nut chewing and other risk factors associated with obesity among Taiwanese male adults. Int J Obes (Lond). 2006; 30: 359–363. [DOI] [PubMed] [Google Scholar]
  • 38. Ko YC, Chiang TA, Chang SJ, et al. Prevalence of betel quid chewing habit in Taiwan and related sociodemo‐graphic factors. J Oral Pathol Med. 1992; 21: 261–264. [DOI] [PubMed] [Google Scholar]
  • 39. Hirschler V, Buzzano K, Erviti A, et al. Overweight and lifestyle behaviors of low socioeconomic elementary school children in Buenos Aires. BMC Pediatr. 2009; 9: 17. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40. Lasserre AM, Chiolero A, Cachat F, et al. Overweight in Swiss children and associations with children's and parents' characteristics. Obesity (Silver Spring). 2007; 15: 2912–2919. [DOI] [PubMed] [Google Scholar]
  • 41. Jaser SS, Holl MG, Jefferson V, et al. Correlates of depressive symptoms in urban youth at risk for type 2 diabetes mellitus. J Sch Health. 2009; 79: 286–292. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42. Brener ND, McManus T, Galuska DA, et al. Reliability and validity of self‐reported height and weight among high school students. J Adolesc Health. 2003; 32: 281–287. [DOI] [PubMed] [Google Scholar]
  • 43. Goodman E, Hinden BR, Khandelwal S. Accuracy of teen and parental reports of obesity and body mass index. Pediatrics. 2000; 106: 52–58. [DOI] [PubMed] [Google Scholar]

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