New York City Department of Health and Mental Hygiene, Office of School Health, New York, New York, United States of America.
Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America.
PLoS One. 2024 May 15;19(5):e0302099. doi: 10.1371/journal.pone.0302099. eCollection 2024.
Recent national trends in the United States indicate a significant increase in childhood obesity, a major public health concern with documented physical and mental comorbidities and sociodemographic disparities. We aimed to estimate the prevalence of obesity and severe obesity among youth in New York City (NYC) before the COVID-19 pandemic and examine time trends overall and by key characteristics. We included all valid height and weight measurements of kindergarten through 8th grade public school students aged 5 to 15 from school years 2011-12 through 2019-20 (N = 1,370,890 unique students; 5,254,058 observations). Obesity and severe obesity were determined using age- and sex-specific body mass index percentiles based on the Centers for Disease Control and Prevention growth charts. Analyses were performed using multivariate logistic regression models with repeated cross-sectional observations weighted to represent the student population for each year and clustered by student and school. Among youth attending public elementary and middle schools in NYC, we estimate that 20.9% and 6.4% had obesity and severe obesity, respectively, in 2019-20. While consistent declines in prevalence were observed overall from 2011-12 to 2019-20 (2.8% relative decrease in obesity and 0.2% in severe obesity, p<0.001), increasing trends were observed among Black, Hispanic, and foreign-born students, suggesting widening disparities. Extending previous work reporting prevalence estimates in this population, nearly all groups experienced significant increases in obesity and severe obesity from 2016-17 to 2019-20 (relative change = 3.5% and 6.7%, respectively, overall; p<0.001). Yet, some of the largest increases in obesity were observed among those already bearing the greatest burden, such as Black and Hispanic students and youth living in poverty. These findings highlight the need for greater implementation of equity-centered obesity prevention efforts. Future research should consider the influence of the COVID-19 pandemic and changes in clinical guidance on childhood obesity and severe obesity in NYC.
美国最近的全国性趋势表明,儿童肥胖率显著上升,这是一个主要的公共卫生关注点,有记录表明其与身体和精神共病以及社会人口统计学差异有关。我们旨在估计新冠疫情大流行前纽约市(NYC)青年肥胖和重度肥胖的流行率,并总体和按关键特征检查时间趋势。我们纳入了 2011-12 学年至 2019-20 学年期间,幼儿园至 8 年级公立学校学生的所有有效身高和体重测量值,这些学生年龄为 5 至 15 岁(共 1370890 名独特学生;5254058 次观察)。肥胖和重度肥胖是根据疾病控制与预防中心生长图表的年龄和性别特异性体重指数百分位数来确定的。分析使用多元逻辑回归模型进行,使用重复横截面观察进行加权,以代表每年的学生人群,并按学生和学校进行聚类。在参加 NYC 公立小学和中学的年轻人中,我们估计 2019-20 年分别有 20.9%和 6.4%的人患有肥胖症和重度肥胖症。虽然从 2011-12 年到 2019-20 年总体上观察到患病率持续下降(肥胖症相对下降 2.8%,重度肥胖症相对下降 0.2%,p<0.001),但在黑人、西班牙裔和外国出生的学生中观察到上升趋势,表明差距在扩大。扩展了先前报告该人群患病率估计的工作,从 2016-17 年到 2019-20 年,几乎所有群体的肥胖症和重度肥胖症都显著增加(总体而言,相对变化分别为 3.5%和 6.7%,p<0.001)。然而,在那些已经承受最大负担的人中,如黑人、西班牙裔和生活贫困的年轻人中,肥胖症的增长幅度最大。这些发现强调了需要更大力实施以公平为中心的肥胖预防工作。未来的研究应考虑新冠疫情大流行和对纽约市儿童肥胖症和重度肥胖症的临床指导变化的影响。