Prevalence of Overweight and At Risk of Overweight in Fourth-Grade Children across Five School-Based Studies Conducted during Four School Years.

Abstract

PURPOSE/OBJECTIVES: This article discusses differences by ethnicity (Black, White), gender, and time (season/year) in body mass index (BMI)-for-age percentiles, and prevalence of overweight and at risk of overweight, in fourth-grade children across five studies conducted during four school years. These five studies concerned either the accuracy of children's dietary recalls or children's social desirability, so weight and height measurements were secondary rather than primary aims. METHODS: Across five studies, 1,696 fourth-grade children (54% Black, 46% White; 51% girls) from a total of 14 public elementary schools in one school district were measured. Each child's BMI-for-age percentile was determined using the Centers for Disease Control and Prevention's gender-specific BMI-for-age growth charts. RESULTS: Across all five studies, 20 children (1.2%) were underweight (<5(th) percentile), 989 children (58.3%) were at a healthy weight (≥5(th) and <85(th) percentiles), 281 children (16.6%) were at risk of overweight (≥85(th) and <95(th) percentiles), and 406 children (23.9%) were overweight (≥95(th) percentile). The mean gender-specific BMI-for-age percentile across all children was high (70.1%) and greater for Black children (72.0%) than White children (67.8%) (p=0.02; analysis of covariance). A higher percentage of Black children (26.5%) compared to White children (21.0%) were overweight (p=0.01; chi-square). No differences were found by gender or time in the prevalence of children who were overweight; likewise, no differences were found by ethnicity, gender, or time in the prevalence of children who were at risk of overweight. APPLICATIONS TO CHILD NUTRITION PROFESSIONALS: Schools provide an excellent venue for measuring children's weight and height annually to determine BMI-for-age percentiles. This information can be used to track changes over time, and linked to computerized administrative records of children's daily participation in school meals from one school year to the next to increase knowledge of a relationship between childhood obesity and daily participation in school meals.