State-level estimates of childhood obesity prevalence in the United States corrected for report bias
State-level estimates of childhood obesity prevalence in the United States corrected for report bias
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DOI：
10.1038/ijo.2016.130
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发表时间：
2016-10-01
影响因子：
4.9
通讯作者：
Gortmaker, S. L.
中科院分区：
文献类型：
--
作者：
Long, M. W.;Ward, Z. J.;Gortmaker, S. L.
背景/目的：各州特定的肥胖率数据对于公共卫生努力解决儿童肥胖症流行至关重要。然而，很少有州实施客观测量的身体质量指数(BMI)监测计划。这项研究报告了按年龄和性别校正父母报告的儿童身高和体重偏差的州特定儿童肥胖率。SUBJECTS/方法：作为儿童肥胖干预成本效益研究(CHOICES)的一部分，我们使用2010年美国人口普查和美国社区调查(ACS)、2003-2004年和2007-2008年全国儿童健康调查(NSCH)(n=133 213)和2005-2010国家健康和营养检查调查(NHANES)(n=9377；2-17岁)的数据，对2005-2010年期间各州的儿童肥胖率进行了估计。使用NHANES测量的身高和体重数据，使用非参数统计匹配算法纠正NSCH中父母报告的偏差。根据五个州(AR、FL、MA、PA和TN)的监测数据验证了模型估计的有效性。结果：父母报告的身高和体重导致2-5岁男性儿童肥胖的最大高估(NSCH：42.36%对NHANES：11.44%)。对这一群体(12.81%)以及所有年龄和性别类别的选择模型估计与NHANES没有统计学差异。我们模拟的肥胖患病率与五个验证州的测量数据非常接近，平均差异为0.64个百分点(范围为0.23-1.39)，相关系数高(r=0.96，P=0.009)。各州儿童肥胖率的估计范围在11.0%到20.4%之间。结论：NSCH对儿童肥胖率的未经校正的估计与测量的国家数据有很大差异，从2-5岁男性高估278%到14-17岁女性低估44%。这项研究证明了选择匹配方法的有效性，以纠正父母报告的BMI数据的偏差，并强调了公开发布2011年至2012年NSCH最新数据的必要性。
BACKGROUND/OBJECTIVES: State-specific obesity prevalence data are critical to public health efforts to address the childhood obesity epidemic. However, few states administer objectively measured body mass index (BMI) surveillance programs. This study reports state-specific childhood obesity prevalence by age and sex correcting for parent-reported child height and weight bias.SUBJECTS/METHODS: As part of the Childhood Obesity Intervention Cost Effectiveness Study (CHOICES), we developed childhood obesity prevalence estimates for states for the period 2005-2010 using data from the 2010 US Census and American Community Survey (ACS), 2003-2004 and 2007-2008 National Survey of Children's Health (NSCH) (n = 133 213), and 2005-2010 National Health and Nutrition Examination Surveys (NHANES) (n = 9377; ages 2-17). Measured height and weight data from NHANES were used to correct parent-report bias in NSCH using a non-parametric statistical matching algorithm. Model estimates were validated against surveillance data from five states (AR, FL, MA, PA and TN) that conduct censuses of children across a range of grades.RESULTS: Parent-reported height and weight resulted in the largest overestimation of childhood obesity in males ages 2-5 years (NSCH: 42.36% vs NHANES: 11.44%). The CHOICES model estimates for this group (12.81%) and for all age and sex categories were not statistically different from NHANES. Our modeled obesity prevalence aligned closely with measured data from five validation states, with a 0.64 percentage point mean difference (range: 0.23-1.39) and a high correlation coefficient (r = 0.96, P = 0.009). Estimated state-specific childhood obesity prevalence ranged from 11.0 to 20.4%.CONCLUSION: Uncorrected estimates of childhood obesity prevalence from NSCH vary widely from measured national data, from a 278% overestimate among males aged 2-5 years to a 44% underestimate among females aged 14-17 years. This study demonstrates the validity of the CHOICES matching methods to correct the bias of parent-reported BMI data and highlights the need for public release of more recent data from the 2011 to 2012 NSCH.