Oregon Research Institute, PO Box 1715, Franklin Blvd., Eugene, OR 97403, USA.
J Sch Health. 2013 Mar;83(3):157-63. doi: 10.1111/josh.12011.
The high rates of childhood overweight and obesity in the United States have generated interest in schools as sites for monitoring body mass index (BMI) information. This study established baseline values for a 5-year longitudinal assessment of BMI of elementary school children and examined variation across the schools, because little is known about factors that affect the distribution of overweight and obesity within school districts.
Height and weight measurements were collected on 2317 elementary school children in 1 school district. BMI was calculated using the Centers for Disease Control and Prevention's NutStat program. Child characteristics included gender, age, eligibility for free and reduced lunch (proxy for socioeconomic status [SES]), school, grade, and ethnicity/race. Children were grouped into 2 BMI categories, <85th percentile or ≥85th percentile (overweight/obesity). Logistic regression was used to examine potential predictors of overweight/obesity.
Prevalence of ≥85th percentile was 30.9%, 34.4%, 35.3%, 36.4%, 37.1%, and 44.5% for K-5, respectively. Prevalence of ≥85th percentile was highest among Hispanic children. Ethnicity was the strongest predictor of inclusion in the ≥85th percentile category followed by grade and free and reduced lunch eligibility.
The data are consistent with the prevalence of overweight/obesity among American children and Hispanic children in particular. District prevalence of overweight/obesity is higher than available state statistics. Most of the BMI variation is accounted for by ethnicity, SES, and grade. The grade effect and high prevalence of overweight/obesity provide a rationale for BMI screening retention at the schools.
美国儿童超重和肥胖率居高不下，这使得人们对学校作为监测体重指数（BMI）信息的场所产生了兴趣。本研究建立了对小学儿童进行为期 5 年 BMI 纵向评估的基线值，并研究了学校之间的差异，因为人们对影响学区内超重和肥胖分布的因素知之甚少。
在一个学区内，对 2317 名小学生进行了身高和体重测量。使用疾病控制与预防中心的 NutStat 程序计算 BMI。儿童特征包括性别、年龄、是否有资格享受免费和降价午餐（代表社会经济地位 [SES]）、学校、年级和种族/民族。儿童分为 2 个 BMI 类别，<85 百分位或≥85 百分位（超重/肥胖）。使用逻辑回归检查超重/肥胖的潜在预测因素。
K-5 年级的≥85 百分位的患病率分别为 30.9%、34.4%、35.3%、36.4%、37.1%和 44.5%。≥85 百分位的患病率在西班牙裔儿童中最高。种族是被归入≥85 百分位类别的最强预测因素，其次是年级和是否有资格享受免费和降价午餐。
数据与美国儿童，特别是西班牙裔儿童超重/肥胖的流行情况一致。该地区的超重/肥胖率高于现有的州统计数据。大多数 BMI 变化归因于种族、SES 和年级。年级效应和超重/肥胖的高患病率为在学校进行 BMI 筛查保留提供了依据。
