Rural Canadian adolescents are more likely to be obese compared with urban adolescents.

OBJECTIVE: Few studies have examined variations in overweight and obesity by geographic location in youth. The purpose of this study was to investigate the association between urban/rural geographic status and being overweight or obese among Canadian adolescents.

METHODS: The study involved an analysis of a representative sample of 4851 Canadian adolescents in grades 6 to 10 from the 2001-02 Health Behaviour in School-aged Children Survey. Self-reports of participants' demographics, physical activity, screen time, diet, and body mass index (BMI) were assessed. Adiposity status was determined using the international BMI thresholds for children and youth. Urban/rural status was coded on a five-point scale based on the geographic location of the participants' schools. Logistic regression with generalized estimating equations to adjust for clustering was used to examine the association between urban/rural status and overweight/obesity.

RESULTS: The population was 53.3% female with a mean age of 13.9 years (standard deviation, SD=1.5). Approximately 22.2% were living in rural areas while 14.4% were living in large metropolitan (metro) areas. After adjusting for age, sex, socioeconomic status, and Region of Canada, there was a trend for increasing overweight (p=0.001) and obesity (p=0.03) among adolescents as the level of "rurality" increased (relative odds for most urban to most rural regions for overweight or obese: 1.00, 0.98, 1.18, 1.57, 1.36; obesity: 1.00, 1.06, 1.39, 1.58, 1.56). Conclusion. This study provides new information about patterns of overweight/obesity among Canadian adolescents by urban-rural geographic status. These findings suggest that obesity prevention interventions should be particularly aggressive in rural areas.