Objective The aims of this study are to describe growth trajectories in the body mass index (BMI) among the major racial and ethnic groups of US children and to identify predictors of children's BMI trajectories. Methods The Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) was used to identify predictors of BMI growth trajectories, including child characteristics, maternal attributes, home practices related to diet and social behaviors, and family sociodemographic factors. Growth models, spanning 48 to 72 months of age, were estimated with hierarchical linear modeling via STATA/Xtmixed methods. Results Approximately one-third of 4-year-old females and males were overweight and/or obese. African-American and Latino children displayed higher predicted mean BMI scores and differing mean BMI trajectories, compared with White children, adjusting for time-independent and time-dependent predictors. Several factors were significantly associated with lower mean BMI trajectories, including very low birth weight, higher maternal education level, residing in a two-parent household, and breastfeeding during infancy. Greater consumption of soda and fast food was associated with higher mean BMI growth. Soda consumption was a particularly strong predictor of mean BMI growth trajectory for young Black children. Neither the child's inactivity linked to television viewing nor fruit nor vegetable consumption was predictive of BMI growth for any racial/ethnic group. Conclusion Significant racial and ethnic differences are discernible in BMI trajectories among young children. Raising parents’ and health practitioners’ awareness of how fast food and sweetened-beverage consumption contributes to early obesity and growth in BMI—especially for Blacks and Latinos—could improve the health status of young children.
Racial/ethnic and linguistic disparities exist in provider elicitation of developmental concerns. Addressing lack of insurance, medical homes, and specific medical-home components might reduce disparities.
Background The prevalence of childhood obesity among racial and ethnic minority groups is high. Multiple factors affect the development of childhood obesity including dietary practices. Objective To examine the racial and ethnic differences in reported dietary practices among the largest minority groups of California children. Methods Data from the 2007 and 2009 California Health Interview Survey were analyzed using multivariate regression with survey weights to examine how race, ethnicity, socio-demographics, and child factors were associated with specific dietary practices. Results The sample included 15,902 children ages 2-11. In multivariate regressions, substantial differences in fruit juice, fruit, vegetable, sugar-sweetened beverages, sweets, and fast food consumption were found among the major racial and ethnic groups of children. Asians regardless of interview language were more likely than Whites to have low vegetable intake (Asians English interview OR, 1.20; 95% CI, 1.01-1.43; Asians non-English-interview OR, 2.09; 95% CI, 1.23-3.57) and low fruit (Asians English interview OR, 1.69; 95% CI, 1.41-2.03; Asians non-English interview OR, 3.04; 95% CI, 2.00-4.62) consumption. Latinos regardless of interview language were also more likely than Whites to have high fruit juice (Latinos English interview OR, 1.54; 95% CI and 1.28-1.84; Latinos non-English interview OR, 1.29; 95% 1.02-1.62) and fast food (Latinos English interview OR 1.74; 95% CI, 1.46-2.08 2.16; Latinos non-English interview OR 1.48; 95% CI, 1.16-1.91) consumption; but Latinos were less likely than Whites to consume sweets (Latinos English interview OR, 0.81; 95% CI, 0.66-0.99; Latinos non-English interview OR, 0.56; 95% CI 1.16-1.91). Conclusions Significant racial and ethnic differences exist in the dietary practices of California children. Increased fruit and vegetable consumption appears to be associated with parental education but not income. Our findings suggest that anticipatory guidance and dietary counseling might benefit from tailoring to specific ethnic groups to potentially address disparities in overweight and obesity.
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