The impact of long-term participation in the supplemental nutrition assistance program on child obesity

Participation in the Supplemental Nutrition Assistance Program (SNAP) reached an all-time high of 40.2 million persons in March 2010, which means the program affects a substantial fraction of Americans. A significant body of research has emerged suggesting that participation in SNAP increases the probability of being obese for adult women and has little effect on the probability for adult men. However, studies addressing the effects of participation on children have produced mixed results. This paper examines the effect of long-term SNAP participation on the Body Mass Index (BMI) percentile and probability of being overweight or obese for children ages 5-18 using data from the National Longitudinal Survey of Youth 1979 Children and Young Adults data set. An instrumental variables identification strategy that exploits exogenous variation in state-level program parameters, as well as state and federal expansions of the Earned Income Tax Credit (EITC), is used to address the endogeneity between SNAP participation and obesity. SNAP participation is found to significantly reduce BMI percentile and the probability of being overweight or obese for boys and girls ages 5-11 and boys ages 12-18. For girls ages 12-18, SNAP participation appears to have no significant effect on these outcomes.     

High prevalence of overweight and short stature among Head Start children in Massachusetts.

The Head Start Program measures children''s heights and weights to screen for growth problems such as obesity, wasting, and short stature. At present, little public health use is made of these data. In this paper, the authors present serial cross-sectional nutrition surveillance data from Massachusetts Head Start Programs. Nonrandom samples of local Head Start Programs provided annual screening data from 1988 to 1991 on an average of 2,664 children per year. Height and weight measurements were compared with National Center for Health Statistics (NCHS) reference populations. On average, 87 percent of the children were 36 to 59 months of age and 51 percent were white. From 7.3 to 8.8 percent of children were below the 5th percentile of height for age each year, and from 1.2 to 3.3 percent were underweight, with weight below the 5th percentile for height (P < 0.05 compared with NCHS population). In each year overweight (weight for height above the 95th percentile) was most prevalent, ranging from 9.6 percent to 13.3 percent (P < 0.05 compared with NCHS) and demonstrating a statistically significant upward trend over the 4 years of study (chi-square = 9.21, P < 0.01). The prevalence of overweight and short stature varied by race and ethnicity. A statistically significant upward trend in overweight was seen among Hispanic children (chi-square = 5.99, P < 0.05). Also, children who were 48 months of age or older were more likely than younger children to be overweight (P < 0.05). The prevalence of short stature did not vary significantly by year, sex, or age.(ABSTRACT TRUNCATED AT 250 WORDS)     

CHILE: Outcomes of a group randomized controlled trial of an intervention to prevent obesity in preschool Hispanic and American Indian children

ObjectiveWe examined the outcomes of the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study, a group randomized controlled trial to design, implement, and test the efficacy of a trans-community intervention to prevent obesity in children enrolled in Head Start centers in rural American Indian and Hispanic communities in New Mexico.MethodsCHILE was a 5-year evidence-based intervention that used a socioecological approach to improving dietary intake and increasing physical activity of 1898 children. The intervention included a classroom curriculum, teacher and food service training, family engagement, grocery store participation, and healthcare provider support. Height and weight measurements were obtained four times (fall of 2008, spring and fall of 2009, and spring of 2010), and body mass index (BMI) z-scores in the intervention and comparison groups were compared.ResultsAt baseline, demographic characteristics in the comparison and intervention groups were similar, and 33% of all the children assessed were obese or overweight. At the end of the intervention, there was no significant difference between the two groups in BMI z-scores.ConclusionsObesity prevention research among Hispanic and AI preschool children in rural communities is challenging and complex. Although the CHILE intervention was implemented successfully, changes in overweight and obesity may take longer than 2 years to achieve.     

Hip-Hop to Health Jr., an obesity prevention program for minority preschool children: baseline characteristics of participants

BACKGROUND: The prevalence of obesity in the United States is a significant public health problem. Many obesity-related risk factors are more prevalent in minority populations. Given the recalcitrant nature of weight loss interventions for adults, prevention of overweight and obesity has become a high priority. The present study reports baseline data from an obesity prevention intervention developed for minority preschool children. METHODS: Hip-Hop to Health Jr. is a 5-year randomized controlled intervention that targets 3- to 5-year-old minority children enrolled in 24 Head Start programs. Our primary aim is to test the effect of the intervention on change in body mass index. Data were collected on sociodemographic, anthropometric, behavioral, and cognitive variables for the children and parents at baseline. RESULTS: Participants included 416 black children, 337 black parents, 362 Latino children, and 309 Latino parents. Using body mass index for age and sex > or = the 95th percentile as the definition of overweight, 15% of the black children and 28% of the Latino children were overweight. More than 75% of the parents were either overweight or obese. DISCUSSION: The development of interventions to effectively prevent or control obesity early in life is crucial. These data highlight the escalating problem of weight control in minority populations.     

Preschool Enrollment is Associated with Lower Odds of Childhood Obesity Among WIC Participants in LA County

The prevalence of obesity among children in the United States has increased rapidly during the past few decades. Research into social and behavioral determinants of obesity could lead to innovative strategies for prevention. The objective of the present study was to examine the association between childhood obesity and preschool enrollment and number of hours in child care among low-income preschool-aged children who were participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). We conducted a case–control study including 556 3- to 4-year-old children who were either obese (BMI > 95th percentile of reference standard) or normal-weight (BMI 25–75th percentile). The population was largely (96%) Hispanic, an ethnic group that has one of the highest rates of overweight and obesity in adults and children in the US. In multiple logistic regression analysis, controlling for a variety of psychosocial and cognitive home environment variables, key demographics and maternal variables, the odds ratio of being obese was 0.61 for children who attended preschool more than 4 days a week (95% CI: 0.41–0.90). Watching television or videos for an hour or more on a typical day (odds ratio 1.71 (95% CI 1.07–2.75)), and higher maternal BMI (odds ratio 1.08 (95% CI 1.05–1.11)) were independently related to odds of obesity. The impact of preschool attendance and TV viewing are potentially instructive in terms of preventive interventions for children at this age.     

Food security and nutritional outcomes of preschool-age Mexican-American children

OBJECTIVE: To examine the relationship of food insecurity to nutrition of Mexican-American preschoolers. DESIGN: Cross-sectional survey of low-income Mexican-American families with children of preschool age (3 to 6 years). Data included food security using the Radimer/ Cornell scale; acculturation; parental education; monthly income; past experience of food insecurity; and child weight, height, and frequency of consuming 57 foods. Weight-for-height z scores (WHZ), height- for-age z (HAZ) scores, and the percentage of overweight (> or = 85th percentile WHZ) were calculated. SUBJECTS/SETTING: A convenience sample of Mexican-American families (n=211) was recruited through Head Start, Healthy Start, Migrant Education, and the Special Supplemental Nutrition Program for Women, Infants, and Children in Tulare, Fresno, Monterey, and Kern counties in California. Statistical analyses Analysis of variance, t tests, Spearman's correlations, and Mantel Haenszel chi2. RESULTS: Limited education, lack of English proficiency, and low income were negatively correlated with food security (r = -0.31 to -0.44, P<.0001). After controlling for acculturation, children in severely food-insecure households were less likely to meet Food Guide Pyramid guidelines than other children (median number of food groups > or = recommended levels [interquartile range]: 2.0 (2.0) vs 3.0 (2.0), P<.006). Although WHZ (mean +/- SD = 1.28 +/- 1.80) and percent overweight (48%, N=19) tended to peak among children from household level food insecure families, no significant differences were found in weight or height status of children by level of food insecurity. APPLICATIONS/CONCLUSIONS: Dietetics professionals working with low-income Hispanic-American families should screen for different levels of food insecurity to determine needs for nutrition education and other services.     

母乳喂养持续时间与学龄前儿童超重和肥胖的关联性分析

目的 分析宝鸡地区母乳喂养持续时间与学龄前儿童超重和肥胖的关系,为预防宝鸡地区儿童超重和肥胖提供科学依据。方法 以2015年8月-2016年12月在宝鸡市妇幼保健院进行预防接种的3 586名3~6岁学龄前儿童作为研究对象。采用问卷调查获得学龄前儿童的母乳喂养情况,测量学龄前儿童的身高和体重,了解学龄前儿童的体格发育情况。通过Logistic回归分析计算母乳喂养持续时间与学龄前儿童超重和肥胖患病风险的OR值和95%的可信区间(CI)。结果 超重和肥胖患病率分别为12.5%和9.8%,母乳喂养持续时间与学龄前儿童超重和肥胖的患病风险呈负相关,母乳喂养≥12个月的学龄前儿童超重和肥胖的患病风险是未经母乳喂养的学龄前儿童的0.58倍。结论 较长时间的母乳喂养是学龄前儿童超重和肥胖的保护因素,应提倡长时间的母乳喂养,预防学龄前儿童超重和肥胖的发生。     

Estimates of overweight and obesity among samples of preschool-aged children in Melbourne and Sydney

Objective: Childhood obesity is a significant and increasing public health issue. We present results from two cross‐sectional surveys from Melbourne and Sydney that sought to estimate the level of overweight and obesity among preschool‐aged children. Methods: In Melbourne, weight and height of 196 children from 12 randomly selected preschools and kindergartens were measured and recorded. In Sydney, data on weight and height of 325 children attending four early childhood centres were extracted from client records. The two studies used the age and gender‐specific body mass index criteria for classifying overweight and obesity. Results: The prevalence of Melbourne preschool‐aged children considered overweight was 15.3% for boys and 17.3% for girls, with a further 7.1% of boys and 8.2% of girls considered obese. In Sydney, the proportion of children considered overweight was 15.3% for boys and 26.3% for girls. An additional 8.7% of boys and 8% of girls were considered obese. Conclusion: There is some evidence that childhood obesity may begin in the preschool years. Intervention programs targeting obesity should be considered for families with preschool‐aged children in urban Australia.     

Socio-economic differences in height and body mass index of children and adults living in urban areas of Karachi, Pakistan

OBJECTIVE: To study the socio-economic differences in height and body mass index (BMI) in urban areas of Karachi. DESIGN: A comparative study was undertaken to compare the heights and BMIs of adults and children belonging to three distinctively different income groups living in urban areas of Karachi. SETTING: Data was collected from families living in small, medium and large houses located in the authorised urban residential areas of Karachi. SUBJECTS: A total of 600 families, 200 from each income group, were included in the study. Anthropometric measurements of 1296 females and 1197 males of different ages were taken. METHODS: All the housewives were interviewed to collect socio-demographic information. Height and weight of all the available family members were measured. In order to determine the socio-economic difference in height status, the mean height in cm of adults was compared. For children (2-17 y) means of height-for-age Z-scores determined on the basis of NCHS reference values were compared. For studying the weight status the BMI of all the respondents was calculated and they were grouped into categories of under-, normal or overweight according to the NCHS recommended cut-off points. For adult men and women BMI values <18.5 kg/m(2) indicated underweight and >25 kg/m(2) indicated overweight. Among children, those having BMI values below the 5th percentile of the NHANES III reference values were categorised as underweight and those above the 95th percentile were termed overweight. RESULTS: Height status improved with income level among adults and children of both sexes. Among males the difference in weight status was significant only among 2 to 18-y-olds (P<0.05 in each case). The rate of overweight among 2 to 18-y-old males was significantly higher (P=0.004) at the middle-income level (15%) as compared to low or high income. The rate of underweight was significantly higher (P=0.025) at the low-income level among 2 to 18-y-old males (31%, 21% and 22% at low-, middle- and high-income levels, respectively). Among females, rates of underweight were not significantly different at any age. Rates of overweight increased significantly (P=0.048) with income level among 41 to 60-y-old women (38%, 53% and 60% at low-, middle- and high-income levels, respectively). CONCLUSION: Chronic undernutrition as indicated by deficit in height decreased with increasing income level. Socio-economic differences in weight status were not uniform among various age-sex groups. The influence of increasing affluence is likely to be seen both in the form of increased obesity among older females and underweight among children. Differing patterns of association between income and weight status among male and female children need to studied further with more accurate birth records, so as to further clarify the situation. In terms of prevention of nutrition-related disorders both problems of under- and over-nutrition need to be addressed.     

A community-based obesity prevention program for minority children: rationale and study design for Hip-Hop to Health Jr

BACKGROUND; The increasing prevalence of overweight among children in the United States presents a national health priority. Higher rates of overweight/obesity among minority women place their children at increased risk. Although increased rates of overweight are observed in 4- to 5-year-old children, they are not observed in 2- to 3-year-old children. Therefore, early prevention efforts incorporating families are critical. METHODS: The primary aim of Hip-Hop to Health Jr. is to alter the trajectory toward overweight/obesity among preschool African-American and Latino children. This 5-year randomized intervention is conducted in 24 Head Start programs, where each site is randomized to either a 14-week dietary/physical activity intervention or a general health intervention. RESULTS: This paper presents the rationale and design of the study. Efficacy of the intervention will be determined by weight change for the children and parent/caretaker. Secondary measures include reductions in dietary fat and increases in fiber, fruit/vegetable intake, and physical activity. Baseline data will be presented in future papers. CONCLUSIONS: The problem of overweight/obesity is epidemic in the United States. Behaviors related to diet and physical activity are established early in life and modeled by family members. Early intervention efforts addressing the child and family are needed to prevent obesity later in life. This paper describes a comprehensive, family-oriented obesity prevention program for minority preschool children.     

Dietary intake in Head Start vs non-Head Start preschool-aged children: results from the 1999-2004 National Health and Nutrition Examination Survey

Objective

To determine whether dietary intakes of children enrolled in Head Start programs differ from those of children not attending preschool or children in non–Head Start programs.

Design

Using data from the 1999-2004 National Health and Nutrition Examination Survey, low-income, 3- to 5-year-old children were categorized into one of four preschool groups: Head Start (n=184), non–Head Start (n=189), past preschool (n=193), and no preschool (n=384). Total nutrient intakes were calculated using 24-hour parental recalls.

Statistical analyses performed

Mean macronutrient and micronutrient intakes were compared across groups and the percentage of children not meeting Recommended Dietary Allowances (RDAs) were calculated. Multivariate logistic regression was used to evaluate the relationship between preschool group and likelihood of not meeting dietary guidelines.

Results

Many children did not meet the RDA for folate (20.5%), vitamin A (39.7%), vitamin E (79.7%), calcium (40.2%), iron (28.8%), and potassium (90.8%). Compared with the other preschool groups, Head Start children had lower mean protein, saturated fat, riboflavin, calcium, and phosphorous intakes. The greatest differences in intake were observed between Head Start participants and no-preschool children. Multivariate analyses demonstrated an association between Head Start and inadequate intake of protein, thiamin, riboflavin, niacin, calcium, and selenium.

Conclusions

Compared with other low-income children, those in Head Start programs appear to be at greater risk for not meeting the RDA for several key vitamins and minerals. These differences in diet quality may present an opportunity for Head Start programs to enhance nutrition in this student population.     

Association between fruit juice consumption and self‐reported body mass index among adult Canadians

Background: The prevalence of obesity and being overweight is rising among adult Canadians and diet is recognised as one of the main causes of obesity. The consumption of fruit and vegetables is shown to be protective against obesity and being overweight but little is known about the association of fruit juice consumption and obesity and being overweight. The present study aimed to investigate the association between fruit juice consumption and self‐reported body mass index (BMI) among adult Canadians. Methods: This analysis is based on the Canadian Community Health Survey, Cycle 3.1. A regression method was used to assess the association of fruit juice consumption with self‐reported BMI in 18–64‐year‐old Canadians who had been adjusted for sex, age, total household income, education, self‐rated health, and daily energy expenditure. Because the analysis is based on a cross‐sectional dataset, it does not imply a cause and effect relationship. Results: Almost 38.6% of adult Canadians reported a fruit juice intake of 0.5–1.4 times per day and 18.2% consumed fruit juice more than 1.5 times per day. Participants with normal weight were likely to consume more fruit juice than obese individuals. Regression analysis showed a negative association between fruit juice consumption and BMI after adjusting for age, sex, education, marital status, income, total fruit and vegetable intake, daily energy expenditure, and self‐rated health. On average, for each daily serving of fruit juice, a ?0.22 unit (95% confidence interval = ?0.33 to ?0.11) decrease in BMI was observed. Conclusions: The results obtained showed a moderate negative association between fruit juice intake and BMI, which may suggest that a moderate daily consumption of fruit juice is associated with normal weight status.     

A shift from underweight to overweight and obesity in Asian children and adolescents with congenital heart disease

Background: In Western countries, obesity is a common problem in children with congenital heart disease (CHD). However, this problem may have racial difference, and little is known about the shift of this trend as patients grow up. The present study sought to investigate the prevalence and trends of being underweight, overweight and obesity in an Asian CHD cohort using a 5‐year citywide school survey database. Methods: Patient group consisted of 705 first grade elementary school students (children) and 219 first grade senior high school students (adolescents), while 18753 healthy children and 15014 healthy adolescents served as controls. Body mass index (BMI) percentile was calculated to define underweight (BMI < 15^th percentile) and overweight (BMI 85^th–95^th percentile)/obesity (BMI ≥ 95^th percentile). Results: In CHD children, the prevalence of underweight and overweight/obesity was 21.0% (control 16%, P < 0.001) and 14.5% (control 19.8%, P < 0.001), respectively. Children with moderate to severe CHD, especially cyanotic CHD, were more underweight and less overweight/obese than children with non‐cyanotic CHD. The prevalence of underweight (23.3%) and overweight/obesity (26.5%) in CHD adolescents became close to that in controls. From childhood to adolescence, different shifts in BMI distribution were noted; controls became more underweight and overweight/obese for males and more underweight and less overweight/obese for females, while CHD patients became more overweight/obese for both genders, including cyanotic CHD. Conclusions: In this Asian CHD cohort, we demonstrates a shift of BMI distribution from more underweight and less overweight/obese compared with healthy children, to a pattern similar to that in healthy adolescents.     

Body mass index and dietary intake among Head Start children and caregivers

Background

The US Head Start program serves low-income preschoolers and their caregivers and provides an opportunity for assessment and intervention on obesity. We sought to determine the prevalence of obesity among children and their caregivers and to identify variables that are associated with child body mass index (BMI) z scores and caregiver BMI.

Design/setting

Cross-sectional data on diet and BMI from 770 caregiver–child dyads recruited from 57 Head Start centers in Alabama and Texas.

Methods

Height and weight of each caregiver and child were measured using standardized protocols. Dietary intakes of caregiver–child dyads were collected using three 24-hour dietary recalls and Block food frequency questionnaires. Data were collected between September 2004 and November 2005. The larger Food Pyramid categories were divided into 17 food consumption groups and tested for their association with child BMI z scores. Analysis of variance was used to test if food groups were significantly associated with child BMI z score.

Results

The prevalence of obesity among children was 18.4%, 24.3%, and 37.3% among black, Hispanic, and white children, respectively (P<0.0001), whereas it was 58.3%, 41.4%, and 41.6% among black, Hispanic, and white caregivers, respectively (P<0.0001). Child BMI z scores and caregiver BMIs were correlated (r=0.16, P<0.0001). In multivariable models, children were 1.90 (95% confidence interval 1.31-2.74) times more likely to have BMI ≥95th percentile if their caregiver was obese. Five variables (fruits, unsweetened beverages, low-fat dairy, race, and caregiver's BMI) were significantly associated with child BMI z scores. Fruits were inversely related, whereas unsweetened beverages, low-fat dairy, and caregiver's BMI were positively associated with child BMI z score (P<0.03). Compared to whites, black and Hispanic children had lower BMI z scores (P<0.05).

Conclusions

The high prevalence of obesity in this population together with the observed inverse association between fruit consumption and BMI, if replicated in other studies, suggests that interventions that promote fruit consumption could have beneficial effects on child BMI.     

Health status and school achievement of children from Head Start and Free School Lunch Programs.

School health records of 332 children through the eighth grade were examined in a retrospective comparative analysis of physical health status and school achievement of children from Head Start and Free School Lunch Programs. The objective was to determine if nutrition early in the lives of children as a part of a comprehensive health and education program such as Head Start produces greater or different benefits for disadvantaged children than nutrition intervention later through free lunches when the child enters school. Cross-sectional longitudinal, and case-study approaches were used in the analysis. A group of no-food-program disadvantaged children and a group of advantaged children served as comparisons. Results showed that advantaged children performed better on all parameters of school achievement and health status compared with the disadvantaged children, regardless of the form of intervention. Measures of school achievement of Head Start and Free Lunch children did not differ from those of the disadvantaged comparison group, but there were significant differences in measures of health status between the disadvantaged groups. Fewer boys from Project Head Start fell below the 25th percentile for height compared with boys in the Free Lunch Program. Head Start children also scored higher in physical fitness and had fewer reported absences from school due to illness.     

Factors related to obesity in preschool children

The purpose of this research was to examine the following variables for their relationship to the prevalence of preschool obesity: familial aggregation of obesity, infant feeding practices, socioeconomic status, and parents' attitudes toward the use of food for non-nutritive purposes. Parents completed a biographical data form. Height, weight, and skinfold measurements were obtained from 94 preschool children and their biological parents. Both parents answered a Child Feeding Opinion Questionnaire. Anthropometric measurements were evaluated using percentile rankings from NHANES. On the assumption that subjects over the 75th percentile for triceps skinfold were overweight and those above the 90th percentile were obese, 23.4% and 7.5% of the children, 9.6% and 5.3% of the mothers, and 29.8% and 10.6% of the fathers were overweight or obese, respectively. Most parent-child anthropometric correlations were statistically significant. No statistically significant relationships were found between infant feeding practices and childhood obesity. Mothers' educational level varied inversely with the children's weight for height. Mothers and fathers opposed the use of food for reward, punishment, soothing, or affection. The parents' child feeding attitudes had no obvious relationship with the children's anthropometric measurements.     

Effect of poverty on urban preschool children’s understanding of conventional time concepts

The purpose of the present study was to compare the understanding of conventional time concepts by urban preschool children reared in poverty with that of their peers not raised in poverty. The questionnaire used in this study was based on the original work of Ames. Thirty‐six children ranging in age from three to five years of age participated in the study. Twelve attended a Head Start program for homeless children, 12 lived in low‐income housing and attended a neighborhood Head Start program, and 12 attended one of three university daycare centers. Each child was interviewed using a questionnaire containing age, calendar, clock, experiential and conceptual time‐related questions. The results of this study revealed that homeless children and children living in poverty who attended Head Start programs possessed less conventional time knowledge than their peers who attended university daycare centers, as well as those children who participated in the original Ames study. These results have important implications for educational practices.     

城区学龄前儿童肥胖与血压的关系

  目的  调查青岛市城区学龄前儿童血压现状，明确学龄前儿童肥胖与血压的关系。  方法  采用整群方便抽样，抽取青岛市城区13家中等规模幼儿园，测量大、中、小班儿童身高、体重、腰围、臀围和血压，评价体质指数（body mass index，BMI）、腰臀比、腰围身高比，分析儿童肥胖与血压间的关系。  结果  青岛市城区学龄前儿童收缩压（systoblic blood pressure，SBP）和舒张压（diastolic blood pressure，DBP）均值分别为（95.52±7.66）mmHg和（62.78±6.52）mmHg；调查儿童中高血压检出率为13.50%；儿童SBP和DBP与BMI、腰围、臀围和腰围身高比均呈正相关；BMI和年龄与血压存在线性回归关系；超重组和肥胖组儿童高血压患病风险分别为正常体重组的5.191和2.824倍。  结论  青岛市城区学龄前儿童高血压发病率较高，超重和肥胖是其血压升高的危险因素，因此在防控学龄前儿童肥胖的同时，学龄前儿童血压监测与高血压早期干预应尽快提上工作日程。     

Obesity and socioeconomic status in children of Tijuana

BACKGROUND: Although obesity has been associated with socioeconomic status among Hispanics living in the United States, little is known about whether a similar association exists among Hispanics living in Mexico, particularly among those living along the U.S.-Mexico border. OBJECTIVE: To determine the prevalence of obesity and its association with socioeconomic status in Mexican schoolchildren attending public and private schools in Tijuana, Baja California. METHODS: Anthropometric measurements and socioeconomic status were assessed in a cross-sectional study of 1172 school children, aged 6 to 13 years from 55 schools in Tijuana in 2001-2002. Underweight (body mass index [BMI] for age 5th percentile or lower), risk of overweight (BMI at 85th percentile or higher), and overweight (BMI greater than 95th percentile) were assessed using charts published by the Centers for Disease Control and Prevention. RESULTS: Abnormalities in weight were found in 46.3% of 587 boys and 43.7% of 585 girls in the study. Undernutrition was found in 3.7% of the boys and 3.8% of the girls. The general prevalence of overweight was 23.2% for boys and 21.7% for girls. Children living in low-income neighborhoods had the thickest biceps skinfolds (p<0.01), while children living in moderate-income neighborhoods and attending public schools had the thickest triceps skinfolds (p<0.001). Although boys living in high socioeconomic status neighborhoods were at decreased risk for being overweight, boys and girls attending private schools had a 75% increased risk (odds ratio, 1.75; confidence interval, 1.22-2.52) of being overweight than children attending public schools. CONCLUSIONS: Adiposity varies by type of school and neighborhood socioeconomic status. The biphasic curve in risk for being overweight associated with neighborhood socioeconomic status suggests that Mexican children living along the U.S. border may be experiencing a nutrition transition with respect to an increased risk of obesity and related chronic disease.     

Perception of overweight is associated with poor academic performance in US adolescents

BACKGROUND: To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement. METHODS: We performed a cross‐sectional study of 14–17‐year‐olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self‐reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status. RESULTS: Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60‐0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and physical activity (OR 0.83, 95% CI: 0.74–0.94, p = .003). Statistically significant results also were seen with medically defined obese participants. Youth who perceived themselves as overweight were less likely to report higher grades (OR 0.82, 95% CI: 0.73–0.92, p = .001) in unadjusted analysis and after adjustment for the same variables (OR 0.79, 95% CI: 0.68–0.91, p = .002). The perception of overweight was a more significant determinant of academic performance (OR 0.81, 95% CI: 0.69–0.95, p = .012) compared to medically defined obesity (OR 0.90, 95% CI: 0.77–1.05, p = .174). CONCLUSIONS: Perceived overweight status is negatively associated with academic performance, regardless of actual weight status. These findings suggest that perception of overweight may be a mechanism for prior results indicating a negative association of obesity and academic achievements, and have implications for the academic health of these adolescents.