Trends in Severe Obesity Among Children Aged 2 to 4 Years Enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children From 2000 to 2014
Trends in Severe Obesity Among Children Aged 2 to 4 Years Enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children From 2000 to 2014
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DOI：
10.1001/jamapediatrics.2017.4301
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发表时间：
2018-03-01
期刊：
影响因子：
26.1
通讯作者：
Blanck, Heidi M.
中科院分区：
文献类型：
--
作者：
Pan, Liping;Park, Sohyun;Blanck, Heidi M.
重要性儿童时期的严重肥胖与负面健康后果有关。之前的一项研究调查了1998至2010年间低收入家庭学龄前儿童严重肥胖的趋势。目的研究2000-2014年间2-4岁妇女、婴儿和儿童特别补充营养计划(WIC)注册儿童中按年龄、性别和种族/民族划分的严重肥胖趋势。设计、设置和参与者2000-2014年间来自50个州、哥伦比亚特区和美国5个领地的2260万名注册在WIC的幼儿的连续横断面数据。2017年2月16日至2017年3月9日进行了数据分析。主要结果和衡量严重肥胖的患病率。严重肥胖被定义为性别特定的身体质量指数--2000年疾病控制和预防中心增长图表上第95个百分位数的120%或更多。测量了儿童的体重和身高。排除性别、体重、身高或体重指数缺失或生物学上不可信的儿童。结果2014年重度肥胖率为1.96%。在2000年至2004年期间，患病率总体上从1.80%显著上升到2.11%(调整后的患病率差异，0.26%)，在除亚洲/太平洋岛民以外的所有年龄、性别和种族/民族群体中(调整后的患病率差异，0.05%-0.54%)。最大的相对增长出现在4岁儿童(调整后的患病率[APR]，1.21)、非西班牙裔白人(APR，1.22)和美洲印第安人/阿拉斯加原住民儿童(APR，1.19)。在2004年至2010年期间，男孩、2岁和3岁儿童以及非西班牙裔黑人和亚洲/太平洋岛民儿童的患病率总体上显著下降(apd，-0.05%至-0.18%)。2010至2014年间，患病率总体上从2.12%降至1.96%(apd，-0.14%)，并在所有人口群体中显著下降(apd，跨组-0.04%至-0.30%)。最大的相对下降发生在2岁儿童(APR，0.88)和西班牙裔(APR，0.92)，美洲印第安人/阿拉斯加原住民(APR，0.89)和亚洲/太平洋岛民(APR，0.87)儿童。结论和相关性本研究提供了在WIC注册的幼儿中严重肥胖的最新患病率和趋势，并报告了最近所有亚组中严重肥胖的轻微下降。正在进行的监测可以评估低收入儿童的下降趋势是否会持续到未来。
IMPORTANCE Severe obesity in childhood is associated with negative health consequences. A previous study examined trends in severe obesity among preschool-aged children in low-income families during 1998 to 2010. No recent trends have been reported.OBJECTIVE To examine trends in severe obesity by age, sex, and race/ethnicity among enrollees in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) aged 2 to 4 years during 2000 to 2014.DESIGN, SETTING, AND PARTICIPANTS Serial cross-sectional data from 22.6 million young children enrolled in WIC from 50 states, the District of Columbia, and 5 US territories from 2000 to 2014. Data analysis was conducted from February 16, 2017, to March 9, 2017.MAIN OUTCOMES AND MEASURES Prevalence of severe obesity. Severe obesity was defined as a sex-specific body mass index-for-age 120% or more of the 95th percentile on the 2000 Centers for Disease Control and Prevention growth charts. Childrens weights and heights were measured. Children whose sex, weight, height, or body mass index was missing or biologically implausible were excluded.RESULTS The prevalence of severe obesity was 1.96% in 2014. During 2000 to 2004, the prevalence increased significantly overall from 1.80% to 2.11% (adjusted prevalence difference [APD], 0.26%) and among all the age, sex, and racial/ethnic groups except for Asian/Pacific Islander (APD, 0.05%-0.54% across groups with increases). The largest relative increase occurred in children aged 4 years (adjusted prevalence ratio [APR], 1.21) and non-Hispanic white (APR, 1.22) and American Indian/Alaska Native children (APR, 1.19). During 2004 to 2010, the prevalence decreased significantly overall (APD, -0.05%), among boys, children aged 2 and 3 years, and non-Hispanic black and Asian/Pacific Islander children (APD, -0.05% to -0.18%). During 2010 to 2014, the prevalence decreased significantly overall from 2.12% to 1.96% (APD, -0.14%) and among all demographic groups (APD, -0.04% to -0.30% across groups). The largest relative decrease occurred in children aged 2 years (APR, 0.88) and Hispanic (APR, 0.92), American Indian/Alaska Native (APR, 0.89), and Asian/Pacific Islander (APR, 0.87) children.CONCLUSIONS AND RELEVANCE This study provides updated prevalence and trends of severe obesity among young children enrolled in WIC and reports recent modest declines in severe obesity in all subgroups. Ongoing surveillance can assess whether declines continue into the future among low-income children.