Incidence of childhood obesity in the United States.
Incidence of childhood obesity in the United States.
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DOI：
10.1056/nejmoa1309753
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发表时间：
2014-01-30
期刊：
影响因子：
--
通讯作者：
Narayan KM
中科院分区：
文献类型：
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作者：
Cunningham SA;Kramer MR;Narayan KM
尽管有记录表明美国儿童肥胖症患病率有所增加，但对其发病率却知之甚少。我们在此报告全国小学生肥胖发生率。我们评估了 1998-1999 年幼儿园班级早期儿童纵向研究的数据，该研究是一个由 1998 年在美国幼儿园的 7738 名参与者组成的代表性前瞻性队列。 1998 年至 2007 年间，体重和身高被测量了七次。在 7738 名参与者中，6807 人在基线时不肥胖；这些参与者被跟踪了 50,396 人年。我们使用疾病控制和预防中心的标准阈值来定义“超重”和“肥胖”类别。我们根据性别、社会经济地位、种族或族裔群体、出生体重和幼儿园体重，估计了肥胖的年发病率、9年的累积发病率以及总体发病密度（每人年病例数）。进入幼儿园时（平均年龄5.6岁），12.4%的儿童肥胖，另有14.9%的儿童超重；在八年级（平均年龄 14.1 岁），20.8% 肥胖，17.0% 超重。肥胖症的年发生率从幼儿园期间的 5.4% 下降到五年级至八年级期间的 1.7%。超重的 5 岁儿童肥胖的可能性是正常体重儿童的四倍（9 年累积发病率，分别为 31.8% 和 7.9%），分别为每 1000 人年 91.5 例和 17.2 例。在 5 岁至 14 岁之间肥胖的儿童中，近一半的人体重超标，75% 的基线体重指数超过第 70 个百分位。 5 岁至 14 岁之间的肥胖事件更有可能发生在较年轻的年龄，主要是在进入幼儿园时超重的儿童中。
Although the increased prevalence of childhood obesity in the United States has been documented, little is known about its incidence. We report here on the national incidence of obesity among elementary-school children. We evaluated data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999, a representative prospective cohort of 7738 participants who were in kindergarten in 1998 in the United States. Weight and height were measured seven times between 1998 and 2007. Of the 7738 participants, 6807 were not obese at baseline; these participants were followed for 50,396 person-years. We used standard thresholds from the Centers for Disease Control and Prevention to define “overweight” and “obese” categories. We estimated the annual incidence of obesity, the cumulative incidence over 9 years, and the incidence density (cases per person-years) overall and according to sex, socioeconomic status, race or ethnic group, birth weight, and kindergarten weight. When the children entered kindergarten (mean age, 5.6 years), 12.4% were obese and another 14.9% were overweight; in eighth grade (mean age, 14.1 years), 20.8% were obese and 17.0% were overweight. The annual incidence of obesity decreased from 5.4% during kindergarten to 1.7% between fifth and eighth grade. Overweight 5-year-olds were four times as likely as normal-weight children to become obese (9-year cumulative incidence, 31.8% vs. 7.9%), with rates of 91.5 versus 17.2 per 1000 person-years. Among children who became obese between the ages of 5 and 14 years, nearly half had been overweight and 75% had been above the 70th percentile for body-mass index at baseline. Incident obesity between the ages of 5 and 14 years was more likely to have occurred at younger ages, primarily among children who had entered kindergarten overweight.