Assistant Professor, (
Associate Professor, (
J Sch Health. 2019 Apr;89(4):237-245. doi: 10.1111/josh.12741. Epub 2019 Feb 11.
We examined prevalence, incidence, and trajectory of obesity from kindergarten through grade 8 in one of the first states to implement annual surveillance.
Participants included 16,414 children enrolled in kindergarten in Arkansas in 2004 with complete body mass index (BMI) measurements in kindergarten and eighth grade. Repeated measures of weight status were entered in multiple linear and logistic regression models with demographics and family poverty status.
The prevalence of obesity (BMI ≥ 95th percentile) was lowest in kindergarten (14.9%), with subsequent incidence rates consistent at 4%. Prevalence and incidence peaked in eighth grade (24.5% and 4.9%, respectively), with 33.8% of children measuring obese at least once by eighth grade. Kindergarten obesity was a significant predictor of eighth grade obesity (odds ratio, 17.5; 95% confidence interval, 15.8-19.3). We found statistically significant 3-way interactions for sex, race, and time, suggesting unique patterns for Hispanic boys and black girls.
Our study documents unique longitudinal patterns of obesity from kindergarten through eighth grade that expand our understanding of risk. It demonstrates the value of public school health systems that collect routine administrative data about student BMI that is integrated with education records to foster program and policy discussions.
我们研究了在全美最早实施年度监测的阿肯色州，幼儿园至八年级儿童肥胖的流行率、发病率和变化轨迹。
研究对象为 2004 年在阿肯色州上幼儿园的 16414 名儿童，他们在幼儿园和八年级时均完成了完整的体重指数（BMI）测量。使用多元线性和逻辑回归模型，将体重状况的重复测量结果与人口统计学和家庭贫困状况因素相结合。
肥胖（BMI≥第 95 百分位数）的流行率在幼儿园时最低（14.9%），随后的发病率稳定在 4%。肥胖的流行率和发病率在八年级时达到峰值（分别为 24.5%和 4.9%），有 33.8%的儿童在八年级时至少有一次测量结果为肥胖。幼儿园肥胖是八年级肥胖的一个显著预测因素（优势比，17.5；95%置信区间，15.8-19.3）。我们发现性别、种族和时间存在统计学意义上的三向交互作用，表明西班牙裔男孩和黑人女孩存在独特的模式。
我们的研究记录了从幼儿园到八年级肥胖的独特纵向模式，这扩展了我们对风险的理解。它证明了公立学校健康系统的价值，该系统收集关于学生 BMI 的常规行政数据，并将其与教育记录整合，以促进计划和政策讨论。
