Characteristics of obese children aged 1-4 years at a referral clinic
ABSTRACT To describe characteristics and indicators of nutritional status of young, obese children.
Medical records of 135 children aged 1-4 years seen in an urban referral setting between January 2000 and June 2006 were reviewed. Characteristics associated with severe obesity [percent ideal body weight (%IBW) > or = 160%] were determined. Relationships between %IBW, weight-for-height Z score (WHZ), body mass index (BMI) and BMI Z score (BMIZ) were evaluated. Receiver operating characteristic analyses evaluated BMI values classifying severe and moderate (140-159% IBW) obesity.
Children were: 41% male, 71% Hispanic, 76% Medicaid/uninsured, 64% ever breastfed, had median BMI of 25.0 kg/m2 and median %IBW of 159. Fifty-two percent of mothers had BMI > or = 30 kg/m2. Severely obese children more frequently had an obese mother, birthweight > or = 4 kg, were older, male, never breastfed and reported higher juice intake. WHZ and BMIZ were lowest at 4 years; BMI and %IBW were lowest at 1 year. %IBW and BMI were highly correlated. BMI > or = 22.2 kg/ m2 indicated moderate obesity (sensitivity = 0.90, specificity = 0.93), and BMI > or = 25.0 kg/m2 indicated severe obesity (sensitivity = 0.97, specificity = 0.92).
Few current health behaviors and many family or past risk factors were associated with degree of obesity. %IBW and BMI may be the most useful nutritional status measures to track progress in young, obese children.
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ABSTRACT: The epidemic of overweight/obesity among U.S. children has led to an alarming increase in health-related consequences, including early-onset diabetes and cardiovascular disease. Recent research has identified the independent contribution of several maternal and child factors to the development of childhood overweight/obesity. Few studies, however, have examined risk profiles of childhood obesity. This study used classification and regression tree (CART) analysis to examine the combined effect of maternal and child factors in generating risk profiles for overweight/obesity among preschoolers. Data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) study were used. The sample was comprised of preschool children. CART and logistic regression models were built and compared. Children who were overweight/obese at two years of age had an increased risk of being overweight/obese at four years of age. Children born to overweight/obese mothers were more likely to be overweight/obese by age four, even if their BMI at two years of age was normal. Children with high birth weight (> or = 4000 g.) were also more likely to be overweight/obese at age four years if they were born to mothers with a normal pregravid BMI, but were of a lower socioeconomic status. Among preschoolers whose mothers were black or white and who had a high pregravid BMI, breastfeeding duration and parity played an important role in determining their risk of being overweight/obese. Classification tree analysis confirms and extends current knowledge of preschool overweight/obesity by providing preliminary risk profiles that are structured within the context of prenatal and postnatal maternal and child characteristics.Early human development 09/2010; 86(9):563-8. DOI:10.1016/j.earlhumdev.2010.07.006 · 1.93 Impact Factor
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