Incidence of Obesity Among Young US Children Living in Low-Income Families, 2008–2011

Abstract

OBJECTIVE To examine the incidence and reverse of obesity among young low-income children and variations across population subgroups. METHODS We included 1.2 million participants in federally funded child health and nutrition programs who were 0 to 23 months old in 2008 and were followed up 24 to 35 months later in 2010–2011. Weight and height were measured. Obesity at baseline was defined as gender-specific weight-for-length ≥95th percentile on the 2000 Centers for Disease Control and Prevention growth charts. Obesity at follow-up was defined as gender-specific BMI-for-age ≥95th percentile. We used a multivariable log-binomial model to estimate relative risk of obesity adjusting for gender, baseline age, race/ethnicity, duration of follow-up, and baseline weight-for-length percentile. RESULTS The incidence of obesity was 11.0% after the follow-up period. The incidence was significantly higher among boys versus girls and higher among children aged 0 to 11 months at baseline versus those older. Compared with non-Hispanic whites, the risk of obesity was 35% higher among Hispanics and 49% higher among American Indians (AIs)/Alaska Natives (ANs), but 8% lower among non-Hispanic African Americans. Among children who were obese at baseline, 36.5% remained obese and 63.5% were nonobese at follow-up. The proportion of reversing of obesity was significantly lower among Hispanics and AIs/ANs than that among other racial/ethnic groups. CONCLUSIONS The high incidence underscores the importance of early-life obesity prevention in multiple settings for low-income children and their families. The variations within population subgroups suggest that culturally appropriate intervention efforts should be focused on Hispanics and AIs/ANs.

Observed self-regulation is associated with weight in low-income toddlers

“…The one study (Graziano et al, 2010) that examined both emotional and behavioral SR in relation to weight in children under age 3 years used non-food tasks and was based on a small sample of toddlers (n=57) at low socioeconomic risk. Yet, nearly half (49%) of infants and toddlers in the United States are low-income (Addy, Engelhardt, & Skinner, 2013) and low-income children are up to twice as likely to be obese (Pan, May, Wethington, Dalenius, & Grummer-Strawn, 2013). It is vital to identify malleable mechanisms associated with obesity that emerge during this developmental period in order to effectively intervene with this high-risk group.…”

CHILE: Outcomes of a group randomized controlled trial of an intervention to prevent obesity in preschool Hispanic and American Indian children

“…National data on AI children remain limited, but the 2010 Pediatric Nutrition Surveillance System of the CDC observed an obesity/overweight rate of 41.2% and an obesity rate of 21.1% among AI or Alaska Native (AN) children aged 2 to 4 years (Dalenius et al, 2011). Compared with non-Hispanic white children, the risk of obesity was 35% higher in Hispanic children and 49% higher in AI/AN children (Pan et al, 2013). …”

Using Electronic Health Records to Examine Disease Risk in Small Populations: Obesity Among American Indian Children, Wisconsin, 2007–2012

“…Although comparison rates are available for non-Hispanic white children in NHANES, American Indian children are typically included only in the “All Race” category in NHANES reports from 1999 through 2012 (23,24). Data from the 2011 Pediatric Nutrition Surveillance Survey (PedNSS) reported national rates of overweight of 20.1% and obesity rates of 20.8% for American Indian/Alaska Native children older than 2 years of age (6). However, these data were collected primarily from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) records (87.0% of records), which included only low-income children aged 5 years or younger and therefore excluded older children and children from higher-income families.…”