Researchers know that by the time U.S. children reach adolescence, there are disparities in the prevalence of obesity among racial and ethnic groups, according to background information in the article. However, little is known about the age at which these differences begin to appear. Their origins may lie in the preschool years because eating and exercise habits develop early and because a mother's obesity before and immediately after birth may influence her child's risk.
Robert C. Whitaker, M.D., M.P.H., and Sean M. Orzol, M.P.H., of Mathematica Policy Research, Inc., Princeton, N.J., studied 2,452 children born in 75 U.S. hospitals between 1998 and 2000. Mothers were surveyed in the hospital after giving birth and again one and three years later, answering questions about their ethnic background, education level, income and access to food. The three-year survey was an in-home interview, during which researchers also measured the height and weight of the children. Body mass index (BMI) was calculated by dividing the children's weight in kilograms by the square of their height in meters. Children who had BMIs at the 95th percentile or higher for their age and sex were considered obese.
About 19 percent of the children were white, 52.2 percent were black, 25.4 percent were Hispanic and 3.1 percent were another race or ethnicity. At the three-year interview, 18.4 percent of all the children were obese, including 25.8 percent of Hispanic children, 16.2 percent of black children and 14.8 percent of white children; Hispanic children had significantly higher odds of being obese than black or white children. Hispanic children continued to have higher odds when the researchers adjusted for three socioeconomic factors that have been linked to childhood obesity: mothers' education level, household income and food security, or access to food.
"This disparity in obesity between Hispanic and non-Hispanic children seems to develop early in life, so future research into modifiable determinants of this disparity should focus on the period from conception to school entry," the authors conclude. "This research might benefit from more emphasis on qualitative studies across racial/ethnic groups of those cultural factors that can influence energy balance, such as how young children are nourished or spend their time."
(Arch Pediatr Adolesc Med. 2006;160:578-584. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This study was supported by a grant from the Economic Research Service, U.S. Department of Agriculture; grants from the National Institutes of Health; and a consortium of private foundations.
Editorial: Research, Interventions Needed to Help Latino Children
Studies that look more closely at the ethnic and cultural backgrounds of Latino children would help researchers understand more about the risk factors for obesity in this group, writes Elena Fuentes-Afflick, M.D., M.P.H., San Francisco General Hospital, in an accompanying editorial.
"There may be cultural differences in the 'ideal' body image for children and adults and these differences could contribute to the high rates of obesity among Latino children," she writes. "For Latino immigrants, who may have experienced hunger as children or witnessed the adverse effects of malnutrition, the ideal image of a healthy baby or child may be an 'overweight' image by current body mass standards."
"The research community must investigate the underlying risk factors and develop effective interventions to improve health and well-being for Latino children and their families," Dr. Fuentes-Afflick concludes.
(Arch Pediatr Adolesc Med. 2006;160:656-657. Available pre-embargo to the media at www.jamamedia.org.)
Media Advisory: To contact editorialist Elena Fuentes-Afflick, M.D., M.P.H., call Phyllis Brown at 415-476-2557.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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