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Factors predicting severe childhood obesity in kindergarteners

A Corrigendum to this article was published on 07 May 2013

Abstract

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.

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Correspondence to G Flores.

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The authors declare no conflict of interest.

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Author contributions

Dr Flores had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Flores and Lin were responsible for the study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, and statistical analysis. Administrative, technical or material support, and study supervision were provided by Flores.

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Flores, G., Lin, H. Factors predicting severe childhood obesity in kindergarteners. Int J Obes 37, 31–39 (2013). https://doi.org/10.1038/ijo.2012.168

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  • DOI: https://doi.org/10.1038/ijo.2012.168

Keywords

  • overweight
  • children
  • early childhood
  • recursive partitioning analysis

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