Preschool Obesity Rates Inch Lower for First Time in Decades

Jenni Laidman

August 07, 2013

US health officials hope that small but significant declines in obesity rates among preschoolers in 18 states and the Virgin Islands mark a tipping point in the breathtaking 4-decade climb in childhood obesity rates.

"This is the first time in a generation we're seeing [obesity trends] go in the right direction in 2- to 4-year-olds," said Thomas Frieden, MD, MPH, director of the US Centers for Disease Control and Prevention (CDC), in a press briefing August 6. The briefing was held in conjunction with the early release of the CDC Morbidity and Mortality Weekly Report announcing the first signs that fat may be on the mat.

The analysis of 2008–2011 data from 40 states, the District of Columbia, the Virgin Islands, and Puerto Rico uncovered modest but statistically significant reductions in the obesity rate of low-income preschoolers in 18 states and the Virgin Islands.

Sheer Size of Study Helped Uncover Favorable Trend

In the Virgin Islands, which had the largest decline, obesity prevalence fell by 2.6%, to 11%, from 2008 to 2011 (adjusted odds ratio, 0.92). All state data were adjusted for age, sex, and race/ethnicity. Obesity in the study was defined as children with age- and sex-specific body mass index (BMI) in the 95th percentile or higher on the 2002 CDC growth charts.

Five states recorded obesity declines of 1 percentage point or more, including Florida, Georgia, Missouri, New Jersey, and South Dakota. Other states reporting declining obesity rates are California, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, New Hampshire, New Mexico, New York, and Washington.

No change in obesity rates in the latest analysis was reported by 21 states/territories. And just 3 states — Colorado, Pennsylvania, and Tennessee — reported increases. There were 10 states that were not included in the analysis due to data reporting issues.

CDC epidemiologist Ashleigh May, PhD, an author of the report, said during the press briefing that even if all 10 excluded states had reported significant increases in obesity, bringing the total number of states reporting an obesity increase to 13, they would have not overwhelmed progress reported elsewhere.

And even 13 states with increasing obesity would be an improvement over earlier years. The last previous state-by-state report of preschool obesity rates, covering 2003–2008, included 24 states reporting increasing obesity and only 9 showing a decrease; 11 were unchanged.

"We are still seeing progress," Dr. May said. Further, a secondary analysis that adjusted for socioeconomic status failed to alter the study results, she added.

The sheer size of the study — 11.6 million low-income children ages 2 years to 4 years — helped uncover the thin but statistically significant trend. "What we're seeing is a data system that's unusual," Dr. Frieden said. "It's millions and millions of kids, and generally, when you have that many kids in a data system, you can pick up small changes."

The data were collected from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), representing about half of all low-income children, as well as from the Early and Periodic Screening, Diagnosis program and the Maternal and Child Health Bureau Title V program.

MMWR Morb Mortal Wkly Rep. Published online August 6, 2013. Full text


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