Lo J C, Maring B, Chandra M, Daniels S R, Sinaiko A, Daley M F, Sherwood N E, Kharbanda E O, Parker E D, Adams K F, Prineas R J, Magid D J, O'Connor P J, Greenspan L C
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.
Pediatr Obes. 2014 Jun;9(3):167-75. doi: 10.1111/j.2047-6310.2013.00154.x. Epub 2013 May 15.
Early childhood adiposity may have significant later health effects. This study examines the prevalence and recognition of obesity and severe obesity among preschool-aged children.
The electronic medical record was used to examine body mass index (BMI), height, sex and race/ethnicity in 42,559 children aged 3-5 years between 2007 and 2010. Normal or underweight (BMI < 85th percentile); overweight (BMI 85th-94th percentile); obesity (BMI ≥ 95th percentile); and severe obesity (BMI ≥ 1.2 × 95th percentile) were classified using the 2000 Centers for Disease Control and Prevention growth charts. Provider recognition of elevated BMI was examined for obese children aged 5 years.
Among 42,559 children, 12.4% of boys and 10.0% of girls had BMI ≥ 95th percentile. The prevalence was highest among Hispanics (18.2% boys, 15.2% girls), followed by blacks (12.4% boys, 12.7% girls). A positive trend existed between increasing BMI category and median height percentile, with obesity rates highest in the highest height quintile. The prevalence of severe obesity was 1.6% overall and somewhat higher for boys compared with girls (1.9 vs. 1.4%, P < 0.01). By race/ethnicity, the highest prevalence of severe obesity was seen in Hispanic boys (3.3%). Among those aged 5 years, 77.9% of obese children had provider diagnosis of obesity or elevated BMI, increasing to 89.0% for the subset with severe obesity.
Obesity and severe obesity are evident as early as age 3-5 years, with race/ethnic trends similar to older children. This study underscores the need for continued recognition and contextualization of early childhood obesity in order to develop effective strategies for early weight management.
儿童早期肥胖可能对日后健康产生重大影响。本研究调查了学龄前儿童肥胖和重度肥胖的患病率及识别情况。
利用电子病历检查了2007年至2010年间42559名3至5岁儿童的体重指数（BMI）、身高、性别和种族/族裔。根据2000年美国疾病控制与预防中心的生长图表将其分类为正常或体重不足（BMI＜第85百分位数）、超重（BMI第85至94百分位数）、肥胖（BMI≥第95百分位数）以及重度肥胖（BMI≥1.2×第95百分位数）。对5岁肥胖儿童的医疗服务提供者对BMI升高的识别情况进行了调查。
在42559名儿童中，12.4%的男孩和10.0%的女孩BMI≥第95百分位数。西班牙裔儿童的患病率最高（男孩为18.2%，女孩为15.2%），其次是黑人（男孩为12.4%，女孩为12.7%）。BMI类别增加与身高百分位数中位数之间存在正相关趋势，身高最高五分位数的肥胖率最高。重度肥胖的总体患病率为1.6%，男孩略高于女孩（1.9%对1.4%，P＜0.01）。按种族/族裔划分，西班牙裔男孩的重度肥胖患病率最高（3.3%）。在5岁儿童中，77.9%的肥胖儿童被医疗服务提供者诊断为肥胖或BMI升高，重度肥胖儿童亚组这一比例增至89.0%。
肥胖和重度肥胖在3至5岁时就很明显，种族/族裔趋势与大龄儿童相似。本研究强调需要持续认识和了解儿童早期肥胖情况，以便制定有效的早期体重管理策略。
