Rich and Fat

The Centers for Disease Control and Prevention have issued a report finding that the obesity rate among American pre-schoolers has declined since 2008:

In recent years there have been small but significant decreases in childhood obesity. The finding that 19 states/territories experienced a decrease in obesity among low-income preschoolers, a vulnerable population, adds to recent findings from local data of low-income preschoolers (10,11) and studies observing decreases among children with higher socioeconomic status (SES) (12). The specific factors that might have contributed to the differential changes in obesity prevalence by state could not be readily identified. States likely differ by cultural and other factors that affect diet, activity, and weight as well as the implementation of policy and environmental interventions used to improve nutrition and physical activity. For example, reductions in obesity prevalence might reflect a combination of contributing factors, such as local and state initiatives that focus on the implementation of nutrition and physical activity standards for early care and education (ECE) programs (13) and efforts to improve healthier food options and physical activity offerings in communities (14). Federal policy changes such as the alignment of the WIC package of nutritious foods with the Dietary Guidelines for Americans (15) might have led to improved diets among low-income preschool children and their families. Population-level changes in behavior such as increases in breastfeeding (16) also might have contributed to declines in obesity.

The children included in the report are limited to those from low income families who participated in federal nutrition programs, it only included states who consistently reported PedNSS (Pediatric Nutrition Surveillance Program) data, and the families of those participating in such programs were demographically somewhat different from those prior to 2008. Specifically, the children tended to be older, a smaller proportion were non-Hispanic whites, and a larger proportion were non-Hispanic blacks. No mention is made of the relative proportions of Hispanic kids between the pre-2008 and later cohorts.

I find this report interesting and suggestive but certainly not dispositive. I’m skeptical of their explanations for the differences and can’t help but wonder if demographics and changes in the perception as well as the actuality of income and economic conditions aren’t more important than the factors they suggest. We have good reason to believe, for example, that racial and ethnic differences in obesity persist after controlling for differences in family income, that there are differences in obesity rates among whites, blacks, and Hispanics, and that income is negatively correlated with obesity in white adults, weakly correlated with obesity in Hispanic and black female adults, and positively correlated with obesity in black male adults.

I can’t help but wonder if changes in behavior unrelated to education or other government programs aren’t more important in whatever change has occurred. Has uncertainty about the future made people more cautious about spending money than they were prior to the recession? Have the reported demographic changes also had some effect?

7 comments… add one
  • TastyBits Link

    I think some of the differences are due to body type and attitudes. Many black and hispanic women are curvier, and there is a more accepting attitude of larger women. I suspect that in the non-white, upper income population this is slowly changing.

    Among the higher economic groups, people select thinner mates, and their breeding produces thinner offspring. Being large is less acceptable, and therefore, there are less large people.

    I think most white women could stand to eat a few Snickers bars.

  • PD Shaw Link

    I’m a little surprised that they are using BMI, which I didn’t think was very accurate for young children. (A quick google suggests BMI has been supplanting older weight-to-height ratios)

    Tough age to be making this type of assessment. Kids seem to put on a big weight before the shoot up like bean poles — its never quite smooth. Parents tend towards being concerned in the early years with the kids getting enough food to grow and learning to eat. A big toddler is a healthy toddler. In my experience, physicians are more concerned about drastic changes or conditions above/below the 5th and 95th percentiles as potential indicators of other health issues.

    I’m skeptical about the utility of obesity at 2-4 yrs, though the report does say there is a correlation with obesity later in life. Not that there probably aren’t issues with kids drinking BigGulps and being tied down on strollers all of the time.

    BTW/ If obesity begins at age 2, is this evidence of nature or nurture?

  • PD Shaw Link

    A little research confirms my suspicions. This is the statement from the report Dave links that contradicts my expectations:

    “Overweight or obese preschoolers are five times as likely as to become overweight or obese adults as their non-obese peers.”

    This statement is sourced to a 1997 report from the New Engaland Journal of Medicine entitled “Predicting obesity in young adulthood from childhood and parental obesity.”

    Here is the conclusion from that 1997 report:

    “Obese children under three years of age without obese parents are at low risk for obesity in adulthood, but among older children, obesity is an increasingly important predictor of adult obesity, regardless of whether the parents are obese. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age.”

    This study finds parental obesity the key to how early one can identify potential problems in their children. This caught my eye: “We caution against interventions to treat overweight children under three years of age who do not have obese parents. Physicians should avoid labeling these children as being at risk for later obesity, because few of them will become obese adults.”

  • PD Shaw Link

    A link to the study (pdf)

    Kind of interesting. So basically, they found the child’s weight before age three to be completely uninformative. They _might_ find the parent’s weight interesting at that age, particularly if there are two obese parents. From age three to before ten, they think looking at both the child and the parents’ weight can be informative. Once the child hits ten, the child’s age is really the only thing informative.

  • michael reynolds Link

    I suspect we’re going to see a wider trend eventually. Kids seem thinner to me. Nutritional education, food fashion, surgery, it’s adding up.

  • steve Link

    This correlates with what I have been seeing clinically. We used to see 6- 8 y/os well over 100 lbs on a regular basis. Some of these kids were so fat that taking care of them was pretty risky. Kids of that size have become uncommon again. Still a lot of fatties, but fewer and the ones we have are not as massively obese.


  • steve Link

    OT- Spencer England looked at part-time workers, private vs government. The increase in part-timers is nearly all in the govt sector.

Leave a Comment