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Factors predicting severe childhood obesity in kindergarteners.
MedLine Citation:
PMID:  23147114     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:Severe obesity has increased >300% in US children since 1976, and is associated with multiple cardiovascular risk factors and high adult obesity rates.Objective:The objective of this study was to identify predictors of severe obesity in kindergarteners.Methods:Multivariable logistic regression and recursive partitioning analysis (RPA) were used to identify prenatal/pregnancy, infant, and early childhood predictors of severe kindergarten obesity (body mass index (BMI) 99th percentile) in the Early Childhood Longitudinal Study Birth Cohort, a nationally representative longitudinal study that followed children from birth through kindergarten.Results:For the 6800 children, the severe kindergarten obesity prevalence was 5.7%, with higher adjusted odds for crossing the 85th percentile of BMI at 2 years old (odds ratio (OR), 8.0; 95% confidence interval (CI), 4.1-15.7), preschool age (OR, 7.9; 95% CI, 4.9-12.8) and 9 months old (OR, 1.8; 95% CI, 1.2-2.6); maternal severe obesity (OR, 3.4; 95% CI, 1.9-5.8) and gestational diabetes (OR, 2.9; 95% CI, 1.5-5.5); drinking tea or coffee between meals/before bedtime at 2 years old (OR, 3.3; 95% CI, 1.3-8.5); Latino (OR, 2.3; 95% CI, 1.4-3.7) and multiracial (OR, 2.3; 95% CI, 1.1-4.8) race/ethnicity; and drinking sugary beverages at kindergarten age at least weekly (OR, 2.3; 95% CI, 1.4-3.7). Ever-attending center-based daycare (OR, 0.3; 95% CI, 0.1-0.9), eating fruit at least weekly at kindergarten age (OR, 0.3; 95% CI, 0.1-0.7), and maternal history of a prior newborn birth weight 4000 g (OR, 0.1; 95% CI, 0.02-0.6) were associated with reduced odds of severe obesity. RPA identified low severe obesity prevalence (1.9%) for non-85th BMI-percentile preschool crossers and high severe obesity (56-80%) for predictor clusters which included crossing the 85th BMI percentile at earlier ages, low parental education, specific maternal age cutoffs, preschooler bedtime rules, and outside walking/play frequency for 9-month-olds.Conclusions:Certain parental, prenatal/pregnancy, infant, and early childhood factors, both alone and in combination, are potent predictors of severe obesity in kindergarteners.International Journal of Obesity advance online publication, 13 November 2012; doi:10.1038/ijo.2012.168.
Authors:
G Flores; H Lin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-13
Journal Detail:
Title:  International journal of obesity (2005)     Volume:  -     ISSN:  1476-5497     ISO Abbreviation:  Int J Obes (Lond)     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256108     Medline TA:  Int J Obes (Lond)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA [2] Children's Medical Center, Dallas, TX, USA.
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