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Background  This study examined trends in body mass index (BMI), waist circumference (WC), and childhood overweight and obesity prevalence between 1998–2001 and 2010–2012 according to household income and urbanity among nationally representative Korean children and adolescents aged 10-19.    Methods  The repeated cross-sectional data from Korean National Health and Nutrition Examination Surveys in 1998-2001 and 2010-2012 were used. Gender specific trends in age-adjusted means of WC and BMI by household equivalized income and urbanity were compared between years. The age-standardized prevalence of childhood overweight and obesity was calculated using three international criteria (International Obesity Task Force, World Health Organization, US Centers for Disease Control and Prevention) and a Korean national reference standard.    Results  Among boys, overall BMI and overweight prevalence increased between 1998–2001 and 2010–2012, while overall WC decreased. Clear gender differences were found in the relationship of childhood obesity metrics with household income and urbanity and the time trends of those relationships. Positive relationships between these parameters were found for boys while negative relationships appeared for girls. In addition, compared with the childhood obesity prevalence among boys in rural areas, the prevalence among boys in urban areas were slightly lower in 1998–2001 but became greater in 2010–2012.    Conclusions  This study revealed gender difference in the association of childhood obesity with household income and urbanity and its time trends. The long-term gender-specific monitoring of socioeconomic and urban-rural differences in childhood obesity measures is warranted in South Korea.    Electronic supplementary material  The online version of this article (doi:10.1186/s12889-015-2616-2) contains supplementary material, which is available to authorized users.

Trends in childhood obesity and central adiposity between 1998-2001 and 2010-2012 according to household income and urbanity in Korea