Changes in adiposity among children and adolescents in the United States, 1999–2006 to 2011–2018

Abstract

Background Data from the NHANES indicate that BMI has increased in some subgroups of children and adolescents in the United States over the past 20 y; however, BMI is an indirect measure of body fatness. Objectives We assessed changes in DXA-derived measures of adiposity in a nationally representative population of US children and adolescents aged 8–19 y from 1999–2006 to 2011–2018. Methods Using data from the NHANES, we compared the means and distributions of DXA-derived percentage body fat (%BF) and fat mass index (FMI; fat mass/height2 in kg/m2) between 1999–2006 (n = 10,231) and 2011–2018 (n = 6923) among males and females by age group, race and Hispanic origin, and BMI categories. Estimates were standardized by age and race and Hispanic origin. Results From 1999–2006 to 2011–2018, mean %BF increased from 25.6% to 26.3% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P < 0.01) among all males, whereas mean %BF increased from 33.0% to 33.7% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P = 0.01) and mean FMI increased from 7.7 to 8.0 fat mass kg/m2 (change in FMI: 0.3 fat mass kg/m2; 95% CI: 0.0, 0.6 fat mass kg/m2; P = 0.02) among all females. Changes were not consistent across all age, race and Hispanic origin, and BMI categories. Both %BF and FMI increased among Mexican-American children and adolescents, but not other race and Hispanic origin groups. Conclusions Among US children and adolescents, DXA-derived measures of adiposity increased from 1999–2006 to 2011–2018, albeit not consistently in every age, race and Hispanic origin, and BMI subgroup. These data reinforce the need to consider other measures, besides BMI categories, when studying adiposity in children and adolescents.

Household income and maternal education in early childhood and risk of overweight and obesity in late childhood: Findings from seven birth cohort studies in six high-income countries

“…The prevalence of overweight and obesity in children and adolescent increased from the 1970s to 2000 in Western Europe and high income English speaking countries. Since then, the levels have plateaued in northern and western Europe, while in the US there is evidence supporting a continuing increase but at a slower pace than during previous decades [1][2][3]. A majority of studies that focus on the relationship between socioeconomic status (SES) and childhood obesity show that social inequalities, or the SES differences, have continued to increase [4].…”

Visceral adipose tissue and cardiometabolic risk factors in young Hispanic and non-Hispanic girls

“…Hispanic adolescents have higher rates of overweight and obesity than other racial and ethnic subpopulations ( 2 ), tend to gain more body fat during development than NHW and NHB adolescents ( 6 ), and are more prone to abdominal fat deposition ( 16 ). Beyond the cardiovascular risks associated with excess adiposity, individuals of Hispanic ethnicity are at an elevated risk of type 2 diabetes ( 21 ) and non-alcoholic fatty liver disease ( 22 ).…”

“…Direct body composition assessment can provide a more in-depth understanding of the relationship between obesity and cardiometabolic health ( 3 , 5 ). Fat accumulated in the abdominal region has been found to be a better predictor of cardiometabolic health than either BMI or percent body fat among adults ( 6 ). Among children and adolescents, changes in adiposity levels over time may not be fully captured when standard BMI categories are looked at alone which underscores the need to incorporate other body composition measures, such as regional fat depots ( 6 ).…”

“…Fat accumulated in the abdominal region has been found to be a better predictor of cardiometabolic health than either BMI or percent body fat among adults ( 6 ). Among children and adolescents, changes in adiposity levels over time may not be fully captured when standard BMI categories are looked at alone which underscores the need to incorporate other body composition measures, such as regional fat depots ( 6 ). Notably, increases in adiposity have not been found to be the same across racial and ethnic subpopulations with Mexican American adolescents having greater increases in adiposity relative to their non-Hispanic White (NHW) and non-Hispanic Black (NHB) counterparts ( 6 ).…”

Measuring Skin Carotenoids Using Reflection Spectroscopy in a Low-Income School Setting

“…The causes of childhood obesity are multifaceted with poor dietary intake remaining a key contributor. Over the past 20 years, overweight and obesity in children has risen at an alarming rate [1]. Based on serial NHANES surveys from 1999 to 2016, the estimated overall diet quality of US youth showed modest improvement, but more than half of youth still had poor-quality diets [2,3].…”