Prenatal, Perinatal, Early Life, and Sociodemographic Factors Underlying Racial Differences in the Likelihood of High Body Mass Index in Early Childhood

Abstract

Objectives We investigated early childhood disparities in high body mass index (BMI) between Black and White US children. Methods We compared differences in Black and White children’s prevalence of sociodemographic, prenatal, perinatal, and early life risk and protective factors; fit logistic regression models predicting high BMI (≥ 95th percentile) at age 4 to 5 years to 2 nationally representative samples followed from birth; and performed separate and pooled-survey estimations of these models. Results After adjustment for sample design–related variables, models predicting high BMI in the 2 samples were statistically indistinguishable. In the pooled-survey models, Black children’s odds of high BMI were 59% higher than White children’s (odds ratio [OR] = 1.59; 95% confidence interval [CI]= 1.32, 1.92). Sociodemographic predictors reduced the racial disparity to 46% (OR = 1.46; 95% CI = 1.17, 1.81). Prenatal, perinatal, and early life predictors reduced the disparity to nonsignificance (OR = 1.18; 95% CI = 0.93, 1.49). Maternal prepregnancy obesity and short-duration or no breastfeeding were among predictors for which racial differences in children’s exposures most disadvantaged Black children. Conclusions Racial disparities in early childhood high BMI were largely explained by potentially modifiable risk and protective factors.

Epidemiological Paradox or Immigrant Vulnerability? Obesity Among Young Children of Immigrants

“…We test and substantiate the validity of this assumption by conducting diagnostics under a model-fitting framework (see Rendall et al 2013; Weden et al 2012). Our finding of model-fit improvement when adding an intercept shift variable for overall child obesity level differences between the surveys, we argue, is not problematic (for further discussion, see Baker et al 2012: appendix).…”

“…Similarly, using the ECLS-B data, but for non-Hispanic white and black children only, Weden et al (2012) estimated a quadrupling of the child's odds of obesity when the mother was obese relative to normal weight status. Hamilton et al (2011b), analyzing Mexican-origin children at age 9 in the FFCWS, found that having an obese mother quintupled the odds of the child's being obese relative to having a normal-weight mother.…”

“…Second, large total sample sizes of children, such as those found in the NSCH, are needed to identify differences by nativity and parental acculturation, but surveys with measured height and weight often have smaller sample sizes. Third, whereas maternal weight status has been found to be the single strongest predictor of whether the child is obese in studies that have been able to include it among their predictor variables (Hamilton et al 2011b; Li et al 2011; Salsberry and Reagan 2005; Weden et al 2012; Whitaker 2004), this variable is not available in the larger nationally representative data sources that have been used to study the immigrant epidemiological paradox. None among the NSCH, the National Longitudinal Study of Adolescent Health (Add Health), and the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K) includes the height and weight variables needed to calculate maternal body mass index (BMI).…”

Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review

“…For example, African-American children have a prevalence of being overweight when compared to Caucasian children. 50,51 Whitaker and Orzol 52 found that race/ ethnicity and other SES indicators did not explain the higher rates of obesity in Hispanic children when compared to Caucasian or African American children. Other studies reported in the literature have shown similar conflicting results.…”

Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores

“…Childhood weight status often continues into adulthood and is a risk factor for later diabetes, heart disease, and hypertension(Maffeis and Tato 2001, Han, Lawlor and Kimm 2010, Reilly and Kelly 2001, Franks et al 2010.). Furthermore, minority children are disproportionally affected by higher rates of obesity with 35.2% of Non-Hispanic black children classified as overweight and 20.2% classified as obese compared to their white counterparts with 28.5% classified as overweight and 14.1% classified as obese (Ogden et al 2014, Weden, Brownell and Rendall 2012). With a number of factors contributing to the high rates of obesity in African American youth, understanding their current diet quality and contributions to diet quality is of importance.…”