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Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index

Abstract

Objective

The aims of this study are to describe growth trajectories in the body mass index (BMI) among the major racial and ethnic groups of US children and to identify predictors of children’s BMI trajectories.

Methods

The Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) was used to identify predictors of BMI growth trajectories, including child characteristics, maternal attributes, home practices related to diet and social behaviors, and family sociodemographic factors. Growth models, spanning 48 to 72 months of age, were estimated with hierarchical linear modeling via STATA/Xtmixed methods.

Results

Approximately one-third of 4-year-old females and males were overweight and/or obese. African-American and Latino children displayed higher predicted mean BMI scores and differing mean BMI trajectories, compared with White children, adjusting for time-independent and time-dependent predictors. Several factors were significantly associated with lower mean BMI trajectories, including very low birth weight, higher maternal education level, residing in a two-parent household, and breastfeeding during infancy. Greater consumption of soda and fast food was associated with higher mean BMI growth. Soda consumption was a particularly strong predictor of mean BMI growth trajectory for young Black children. Neither the child’s inactivity linked to television viewing nor fruit nor vegetable consumption was predictive of BMI growth for any racial/ethnic group.

Conclusion

Significant racial and ethnic differences are discernible in BMI trajectories among young children. Raising parents’ and health practitioners’ awareness of how fast food and sweetened-beverage consumption contributes to early obesity and growth in BMI—especially for Blacks and Latinos—could improve the health status of young children.

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Acknowledgments

We would like to thank Anthony Kim and Lynna Chu for their assistance in the preparation of this manuscript. This study was funded by grant R40 MC 21517 from the US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program (PI: Dr. Guerrero). Drs. Fuller and Bridges are supported in part by the University of California’s Institute of Human Development and the McCormick Foundation.

Compliance with Ethical Standards

All authors have approved the manuscript as submitted and with the exception of the funding mentioned in the Acknowledgements section, author Guerrero, author Mao, author Fuller, author Bridges, author Franke, and author Kuo do not have any conflicts of interest to declare for the past three years dating from the month of this submission.

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Correspondence to Alma D. Guerrero.

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Guerrero, A.D., Mao, C., Fuller, B. et al. Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index. J. Racial and Ethnic Health Disparities 3, 129–137 (2016). https://doi.org/10.1007/s40615-015-0122-y

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  • DOI: https://doi.org/10.1007/s40615-015-0122-y

Keywords

  • BMI
  • Early childhood
  • Obesity
  • Ethnic disparities
  • Soda consumption
  • Fast-food