Original Paper

Journal of Community Health

, Volume 37, Issue 1, pp 242-252

First online:

State Disparities in Time Trends of Adolescent Body Mass Index Percentile and Weight-Related Behaviors in the United States

  • Daniel R. TaberAffiliated withDepartment of Epidemiology, Gillings School of Global Public Health, University of North CarolinaHealth Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago Email author 
  • , June StevensAffiliated withDepartment of Nutrition (Chair) and Epidemiology, Gillings School of Global Public Health, University of North Carolina
  • , Charles PooleAffiliated withDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina
  • , Matthew L. MaciejewskiAffiliated withDepartment of Medicine, Duke University School of MedicineCenter for Health Services Research in Primary Care, Durham VA Medical Center
  • , Kelly R. EvensonAffiliated withDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina
  • , Dianne S. WardAffiliated withDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Evidence is conflicting as to whether youth obesity prevalence has reached a plateau in the United States overall. Trends vary by state, and experts recommend exploring whether trends in weight-related behaviors are associated with changes in weight status trends. Thus, our objective was to estimate between-state variation in time trends of adolescent body mass index (BMI) percentile and weight-related behaviors from 2001 to 2007. A time series design combined cross-sectional Youth Risk Behavior Survey data from 272,044 adolescents in 29 states from 2001 to 2007. Self-reported height, weight, sports participation, physical education, television viewing, and daily consumption of 100% fruit juice, milk, and fruits and vegetables were collected. Linear mixed models estimated state variance in time trends of behaviors and BMI percentile. Across states, BMI percentile trends were consistent despite differences in behavioral trends. Boys experienced a modest linear increase in BMI percentile (ß = 0.18, 95% CI: 0.07, 0.30); girls experienced a non-linear increase, as the rate of increase declined over time from 1.02 units in 2001–2002 (95% CI: 0.68, 1.36) to 0.23 units in 2006–2007 (95% CI: −0.09, 0.56). States in which BMI percentile decreased experienced a greater decrease in TV viewing than states where BMI percentile increased. Otherwise, states with disparate BMI percentile trends did not differ with respect to behaviors. Future research should explore the role of other behaviors (e.g., soda consumption), measurement units (e.g., portion size), and societal trends (e.g., urban sprawl) on state and national adiposity trends.

Keywords

Adiposity Adolescents Weight-related behaviors Time trends Mixed models