PEDIATRICS Vol. 118 No. 3 September 2006, pp. e594-e601 (doi:10.1542/peds.2005-2801)
ARTICLE |
Identifying Risk for Obesity in Early Childhood
a Division of Community Pediatrics, University of California, San Diego, California;
b Department of Human Development and Family Studies, University of North Carolina, Greensboro, North Carolina
c Statistics and Epidemiology, Research Triangle Institute, Research Triangle Park, North Carolina
d Center for Applied Studies in Education, University of Arkansas, Little Rock, Arkansas
e Institute for Study of Children, Families and Social Issues, Birkbeck University of London, London, United Kingdom
f Department of Sociology and Population Research Center, University of Texas, Austin, Texas
g National Institute of Child Health and Human Development, Bethesda, Maryland
h Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Georgia
i Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
OBJECTIVES. Our aim with this study was to assist clinicians by estimating the predictive value of earlier levels of BMI status on later risk of overweight and obesity during the middle childhood and early adolescent years.
METHODS. We present growth data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, a longitudinal sample of 1042 healthy US children in 10 locations. Born in 1991, their growth reflects the secular trend of increasing overweight/obesity in the population. Height and weight of participating children in the study were measured at 7 time points. We examined odds ratios for overweight and obesity at age 12 years comparing the frequency with which children did versus did not reach specific BMI percentiles in the preschool- and elementary-age periods. To explore the question of whether and when earlier BMI was predictive of weight status at age 12 years, we used logistic regression to obtain the predicted probabilities of being overweight or obese (BMI 
85%) at 12 years old on the basis of earlier BMI.
RESULTS. Persistence of obesity is apparent for both the preschool and elementary school period. Children who were ever overweight (>85th percentile), that is, 1 time at ages 24, 36, or 54 months during the preschool period were >5 times as likely to be overweight at age 12 years than those who were below the 85th percentile for BMI at all 3 of the preschool ages. During the elementary school period, ages 7, 9, and 11 years, the more times a child was overweight, the greater the odds of being overweight at age 12 years relative to a child who was never overweight. Sixty percent of children who were overweight at any time during the preschool period and 80% of children who were overweight at any time during the elementary period were overweight at age 12 years. Follow-up calculations showed that 2 in 5 children whose BMIs were 50th percentile by age 3 years were overweight at age 12 years. No children who were <50th percentile for BMI at all points during elementary school were overweight at age 12 years. Children who have higher range BMIs earlier, but not at the 85th percentile, are also more likely to be overweight at age 12 years. Even at time points before and including age 9 years, children whose BMIs are between the 75th and 85th percentile have an 
40% to 50% chance of being overweight at age 12 years. Children at 54 months old whose BMIs are between the 50th and 75th percentile are 4 times more likely to be overweight at age 12 years than their contemporaries who are <50th percentile, and those whose BMIs are between the 75th and 85th percentile are >6 times more likely to be overweight at age 12 years than those <50th percentile.
CONCLUSIONS. The data from this study indicate that children with BMIs >85th percentile, as well as with BMIs in the high reference range are more likely than children whose BMI is <50th percentile to continue to gain weight and reach overweight status by adolescence. Pediatricians can be confident in counseling parents to begin to address the at-risk child's eating and activity patterns rather than delaying in hopes that overweight and the patterns that support it will resolve themselves in due course. Identifying children at risk for adolescent obesity provides physicians with an opportunity for earlier intervention with the goal of limiting the progression of abnormal weight gain that results in the development of obesity-related morbidity.
Key Words: BMI • childhood obesity • longitudinal growth
Abbreviations: CDC—Centers for Disease Control and Prevention • NICHD—National Institute of Child Health and Human Development • OR—odds ratio • CI—confidence interval
Accepted Feb 10, 2006.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  C. Corvalan, R. Uauy, J. Kain, and R. Martorell Obesity indicators and cardiometabolic status in 4-y-old children Am. J. Clinical Nutrition, January 1, 2010; 91(1): 166 - 174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Resnick, M. Bishop, A. O'Connell, B. Hugo, G. Isern, A. Timm, A. Ozonoff, and A. C. Geller The CHEER Study to Reduce BMI in Elementary School Students: A School-Based, Parent-Directed Study in Framingham, Massachusetts The Journal of School Nursing, October 1, 2009; 25(5): 361 - 372. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Yin, H. Wills, N. Clarke, J. Shacks, C. Bottrell, and M. K. Poulsen Cardiovascular Risk in Preschool Children ICAN: Infant, Child, & Adolescent Nutrition, August 1, 2009; 1(4): 197 - 204. [Abstract] [PDF]
|
|
|
|
 |
|
 L. W. Trapp, A. A. Ryan, A. J. Ariza, C. M. Garcia, and H. J. Binns Primary Care Identification of Infants at High Risk for Overweight and Obesity Clinical Pediatrics, April 1, 2009; 48(3): 313 - 316. [PDF]
|
|
|
|
|
|
U. Ramakrishnan, L. M Neufeld, R. Flores, J. Rivera, and R. Martorell Multiple micronutrient supplementation during early childhood increases child size at 2 y of age only among high compliers Am. J. Clinical Nutrition, April 1, 2009; 89(4): 1125 - 1131. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Francis and E. J. Susman Self-regulation and Rapid Weight Gain in Children From Age 3 to 12 Years Arch Pediatr Adolesc Med, April 1, 2009; 163(4): 297 - 302. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Seeyave, S. Coleman, D. Appugliese, R. F. Corwyn, R. H. Bradley, N. S. Davidson, N. Kaciroti, and J. C. Lumeng Ability to Delay Gratification at Age 4 Years and Risk of Overweight at Age 11 Years Arch Pediatr Adolesc Med, April 1, 2009; 163(4): 303 - 308. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. W. Danner A National Longitudinal Study of the Association Between Hours of TV Viewing and the Trajectory of BMI Growth Among US Children J. Pediatr. Psychol., November 1, 2008; 33(10): 1100 - 1107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Corvalan, R. Uauy, R. Flores, D. Kleinbaum, and R. Martorell Reductions in the Energy Content of Meals Served in the Chilean National Nursery School Council Program Did Not Consistently Decrease Obesity among Beneficiaries J. Nutr., November 1, 2008; 138(11): 2237 - 2243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. McCormick, M. Ramirez, S. Caldwell, A. W. Ripley, and D. Wilkey YMCA Program for Childhood Obesity: A Case Series Clinical Pediatrics, September 1, 2008; 47(7): 693 - 697. [Abstract] [PDF]
|
|
|
|
|
|
J. Kim and K. E. Peterson Association of Infant Child Care With Infant Feeding Practices and Weight Gain Among US Infants Arch Pediatr Adolesc Med, July 1, 2008; 162(7): 627 - 633. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L. Greenstone Preventing Obesity in America: Is It Achievable? American Journal of Lifestyle Medicine, December 1, 2007; 1(6): 430 - 432. [Abstract] [PDF]
|
|
|
|
|
|
C. E. O'Neil and T. A. Nicklas State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health American Journal of Lifestyle Medicine, December 1, 2007; 1(6): 457 - 481. [Abstract] [PDF]
|
|
|
|
 |
|
 A. K. Choudhary, L. F. Donnelly, J. M. Racadio, and J. L. Strife Diseases Associated with Childhood Obesity Am. J. Roentgenol., April 1, 2007; 188(4): 1118 - 1130. [Abstract] [Full Text] [PDF]
|
|
