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PEDIATRICS Vol. 101 No. 3 Supplement March 1998, pp. 497-504

Overweight Children and Adolescents: Description, Epidemiology, and Demographics

Received Oct 24, 1997; accepted Nov 6, 1997.

Richard P. Troiano and Katherine M. Flegal

From the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.

We describe prevalence and trends in overweight among children and adolescents (6 to 17 years old) in the US population and variation in the prevalence by sex, age, race-ethnicity, income, and educational level. Height and weight were measured in nationally representative surveys conducted between 1963 and 1994: cycles II (1963 to 1965) and III (1966 to 1970) of the National Health Examination Survey (NHES) and the National Health and Nutrition Examination Surveys (NHANES I, 1971 to 1974; NHANES II, 1976 to 1980; and NHANES III, 1988 to 1994). Overweight was defined by the age- and sex-specific 95th percentile of body mass index (BMI) from NHES II and III. BMI values between the 85th and 95th percentiles were considered an area of concern, because at this level there is increased risk for becoming overweight.

Approximately 11% of children and adolescents were overweight in 1988 to 1994, and an additional 14% had a BMI between the 85th and 95th percentiles. The prevalence of overweight did not vary systematically with race-ethnicity, income, or education. Overweight prevalence increased over time, with the largest increase between NHANES II and NHANES III. Examination of the entire BMI distribution showed that the heaviest children were markedly heavier in NHANES III than in NHES, but the rest of the distribution of BMI showed little change.

Data are limited for assessing the causes of the rapid change in the prevalence of overweight. The increased overweight prevalence in US children and adolescents may be one manifestation of a more general set of societal effects. Childhood overweight should be addressed from a public health perspective.

Key words: body weight, body mass index, health surveys, nutrition surveys, child, adolescence, socioeconomic factors.


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Arch Pediatr Adolesc Med, January 1, 2004; 158(1): 27 - 33.
[Abstract] [Full Text] [PDF]

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 Br. J. Sports. Med.Home page
K I Proper, A J van der Beek, V H Hildebrandt, J W R Twisk, and W van Mechelen
Short term effect of feedback on fitness and health measurements on self reported appraisal of the stage of change
Br. J. Sports Med., December 1, 2003; 37(6): 529 - 534.
[Abstract] [Full Text] [PDF]

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 J. Am. Coll. Nutr.Home page
L. J Gillis and O. Bar-Or
Food Away from Home, Sugar-Sweetened Drink Consumption and Juvenile Obesity
J. Am. Coll. Nutr., December 1, 2003; 22(6): 539 - 545.
[Abstract] [Full Text] [PDF]

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 Am J EpidemiolHome page
A. M. Toschke, S. M. Montgomery, U. Pfeiffer, and R. von Kries
Early Intrauterine Exposure to Tobacco-inhaled Products and Obesity
Am. J. Epidemiol., December 1, 2003; 158(11): 1068 - 1074.
[Abstract] [Full Text] [PDF]

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 Arch Pediatr Adolesc MedHome page
S. L. Friedlander, E. K. Larkin, C. L. Rosen, T. M. Palermo, and S. Redline
Decreased Quality of Life Associated With Obesity in School-aged Children
Arch Pediatr Adolesc Med, December 1, 2003; 157(12): 1206 - 1211.
[Abstract] [Full Text] [PDF]

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 Arch. Dis. Child.Home page
Y K Wing, S H Hui, W M Pak, C K Ho, A Cheung, A M Li, and T F Fok
A controlled study of sleep related disordered breathing in obese children
Arch. Dis. Child., December 1, 2003; 88(12): 1043 - 1047.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
B. Caballero, T. Clay, S. M Davis, B. Ethelbah, B. H. Rock, T. Lohman, J. Norman, M. Story, E. J Stone, L. Stephenson, et al.
Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren
Am. J. Clinical Nutrition, November 1, 2003; 78(5): 1030 - 1038.
[Abstract] [Full Text] [PDF]

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 Am. J. Public HealthHome page
E. Goodman, G. B. Slap, and B. Huang
The Public Health Impact of Socioeconomic Status on Adolescent Depression and Obesity
Am J Public Health, November 1, 2003; 93(11): 1844 - 1850.
[Abstract] [Full Text] [PDF]

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 PediatricsHome page
J. C. Lumeng, K. Gannon, H. J. Cabral, D. A. Frank, and B. Zuckerman
Association Between Clinically Meaningful Behavior Problems and Overweight in Children
Pediatrics, November 1, 2003; 112(5): 1138 - 1145.
[Abstract] [Full Text] [PDF]

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 Am J EpidemiolHome page
F. D. Gilliland, K. Berhane, T. Islam, R. McConnell, W. J. Gauderman, S. S. Gilliland, E. Avol, and J. M. Peters
Obesity and the Risk of Newly Diagnosed Asthma in School-age Children
Am. J. Epidemiol., September 1, 2003; 158(5): 406 - 415.
[Abstract] [Full Text] [PDF]

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 Arch Pediatr Adolesc MedHome page
J. Giammattei, G. Blix, H. H. Marshak, A. O. Wollitzer, and D. J. Pettitt
Television Watching and Soft Drink Consumption: Associations With Obesity in 11- to 13-Year-Old Schoolchildren
Arch Pediatr Adolesc Med, September 1, 2003; 157(9): 882 - 886.
[Abstract] [Full Text] [PDF]

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 Arch Pediatr Adolesc MedHome page
K. R. Evenson, S. L. Huston, B. J. McMillen, P. Bors, and D. S. Ward
Statewide Prevalence and Correlates of Walking and Bicycling to School
Arch Pediatr Adolesc Med, September 1, 2003; 157(9): 887 - 892.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
B. Caballero, J. H Himes, T. Lohman, S. M Davis, J. Stevens, M. Evans, S. Going, and J. Pablo
Body composition and overweight prevalence in 1704 schoolchildren from 7 American Indian communities
Am. J. Clinical Nutrition, August 1, 2003; 78(2): 308 - 312.
[Abstract] [Full Text] [PDF]

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 Arch Pediatr Adolesc MedHome page
P. K. Newby, K. E. Peterson, C. S. Berkey, J. Leppert, W. C. Willett, and G. A. Colditz
Dietary Composition and Weight Change Among Low-Income Preschool Children
Arch Pediatr Adolesc Med, August 1, 2003; 157(8): 759 - 764.
[Abstract] [Full Text] [PDF]

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 Arch Pediatr Adolesc MedHome page
S. Cook, M. Weitzman, P. Auinger, M. Nguyen, and W. H. Dietz
Prevalence of a Metabolic Syndrome Phenotype in Adolescents: Findings From the Third National Health and Nutrition Examination Survey, 1988-1994
Arch Pediatr Adolesc Med, August 1, 2003; 157(8): 821 - 827.
[Abstract] [Full Text] [PDF]

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 Am. J. Public HealthHome page
S. A. French, M. Story, J. A. Fulkerson, and A. F. Gerlach
Food Environment in Secondary Schools: A La Carte, Vending Machines, and Food Policies and Practices
Am J Public Health, July 1, 2003; 93(7): 1161 - 1168.
[Abstract] [Full Text] [PDF]

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 Am. J. Public HealthHome page
M. Y. Kubik, L. A. Lytle, P. J. Hannan, C. L. Perry, and M. Story
The Association of the School Food Environment With Dietary Behaviors of Young Adolescents
Am J Public Health, July 1, 2003; 93(7): 1168 - 1173.
[Abstract] [Full Text] [PDF]

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 Clin. Chem.Home page
P. Allard, E. E. Delvin, G. Paradis, J. A. Hanley, J. O'Loughlin, C. Lavallee, E. Levy, and M. Lambert
Distribution of Fasting Plasma Insulin, Free Fatty Acids, and Glucose Concentrations and of Homeostasis Model Assessment of Insulin Resistance in a Representative Sample of Quebec Children and Adolescents
Clin. Chem., April 1, 2003; 49(4): 644 - 649.
[Abstract] [Full Text] [PDF]

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 PediatricsHome page
K. K. Davison, E. J. Susman, and L. L. Birch
Percent Body Fat at Age 5 Predicts Earlier Pubertal Development Among Girls at Age 9
Pediatrics, April 1, 2003; 111(4): 815 - 821.
[Abstract] [Full Text] [PDF]

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 PediatricsHome page
C. S. Berkey, H. R. H. Rockett, M. W. Gillman, and G. A. Colditz
One-Year Changes in Activity and in Inactivity Among 10- to 15-Year-Old Boys and Girls: Relationship to Change in Body Mass Index
Pediatrics, April 1, 2003; 111(4): 836 - 843.
[Abstract] [Full Text] [PDF]