Emily V McCormick1, L Miriam Dickinson2, Matthew A Haemer3, Shanna D Knierim4, Simon J Hambidge5, Arthur J Davidson6. 1. Denver Public Health, Denver Health, Denver, Colo. Electronic address: Emily.mccormick@dhha.org. 2. Department of Biostatistics and Informatics and Family Medicine, University of Colorado, Aurora, Colo. 3. Department of Pediatrics, University of Colorado, Aurora, Colo. 4. Division of General Pediatrics, Community Health Services, Denver Health, Denver, Colo. 5. Department of Pediatrics, University of Colorado, Aurora, Colo; Department of Epidemiology, University of Colorado, Aurora, Colo; Division of General Pediatrics, Community Health Services, Denver Health, Denver, Colo. 6. Denver Public Health, Denver Health, Denver, Colo; Department of Biostatistics and Informatics and Family Medicine, University of Colorado, Aurora, Colo; Department of Pediatrics, University of Colorado, Aurora, Colo.
Abstract
OBJECTIVE: To describe childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identify among gender- and race/ethnicity-specific groups any trends for increased risk. METHODS: A retrospective cohort study was conducted among 2- to 12-year-old patients (2006-2013) visiting a safety-net provider. BMI z-score trajectories were calculated overall, for gender- and race/ethnicity-specific groups, and for peak BMI percentile subgroups to describe weight gain longitudinally. RESULTS: From 2006 to 2013, a total of 26,234 eligible children were followed for an average of 3.7 years. At baseline (mean age, 4.2 years), 74% of patients were at a normal weight compared to 65% at most recent observation (mean age, 7.8 years). All gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood. Children consistently under the 50th percentile and those of white race had the most stable BMI z-score trajectories. BMI z-score increased with increasing age in all subgroups. Hispanic boys and black girls had the most significant increase in BMI z-score during this observation period. Children observed in early childhood and whose BMI exceeded the 95th percentile at any time were often already overweight (20%) or obese (36%) by 3 years of age. CONCLUSIONS: The entire population demonstrated an upward trend in BMI z-score trajectory. This trend was most notable among black girls and Hispanic boys. Many obese children were already overweight by age 3, and persistence of obesity after 3 years of age was high, suggesting that intervention before age 3 may be essential to curbing unhealthy weight trajectories.
OBJECTIVE: To describe childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identify among gender- and race/ethnicity-specific groups any trends for increased risk. METHODS: A retrospective cohort study was conducted among 2- to 12-year-old patients (2006-2013) visiting a safety-net provider. BMI z-score trajectories were calculated overall, for gender- and race/ethnicity-specific groups, and for peak BMI percentile subgroups to describe weight gain longitudinally. RESULTS: From 2006 to 2013, a total of 26,234 eligible children were followed for an average of 3.7 years. At baseline (mean age, 4.2 years), 74% of patients were at a normal weight compared to 65% at most recent observation (mean age, 7.8 years). All gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood. Children consistently under the 50th percentile and those of white race had the most stable BMI z-score trajectories. BMI z-score increased with increasing age in all subgroups. Hispanic boys and black girls had the most significant increase in BMI z-score during this observation period. Children observed in early childhood and whose BMI exceeded the 95th percentile at any time were often already overweight (20%) or obese (36%) by 3 years of age. CONCLUSIONS: The entire population demonstrated an upward trend in BMI z-score trajectory. This trend was most notable among black girls and Hispanic boys. Many obesechildren were already overweight by age 3, and persistence of obesity after 3 years of age was high, suggesting that intervention before age 3 may be essential to curbing unhealthy weight trajectories.
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