Obesity Holds Steady for Poor Preschoolers

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CDC Officials Say Efforts to Improve Nutrition and Increase Exercise May Be Paying Off

By Salynn Boyles
WebMD Health News

Reviewed By Louise Chang, MD

July 23, 2008 -- One in seven low-income, preschool-aged children in the U.S. is obese, government figures reveal, but experts express optimism that the pediatric obesity epidemic may be stabilizing.

Between 2003 and 2008, the obesity rate among poor 2- to 4-year-olds rose by just one-tenth of 1%, from 14.5% to 14.6%, according to a newly released report from the CDC.

The figure suggests a slowing in a decade-long increase in obesity among low-income preschoolers.

The CDC's Pediatric Nutrition Surveillance System (PedNSS) monitors the nutritional status of nearly 8 million children under age 5 enrolled in federally funded food assistance programs.

It is the only surveillance program in the U.S. that tracks weight trends among preschoolers from year to year, says CDC nutrition branch chief Laurence Grummer-Strawn, PhD.

"There is some reason for optimism in this report that the rise in pediatric obesity may be slowing, but rates continue to be much higher than they should be," he tells WebMD.

Rates Mostly Steady Since 2003

The prevalence of obesity among low-income preschoolers has remained constant or declined since 2003 in about half of the states contributing data to PedNSS.

Obesity rates continued to be highest among Hispanics, American Indians, and Alaska Natives.

The 2008 figures revealed that:

• 21.2% of American Indian and Alaska Native low-income preschoolers were obese. These were the only two ethnic groups that saw increases in obesity between 2003 and 2008.
• 18.5% of Hispanic preschoolers were obese, which was similar to 2003 figures.
• Among ethnic groups, obesity rates were lowest among white preschoolers (12.6%), Asians or Pacific Islanders (12.3%), and African-Americans (11.8%).
• Just two states -- Colorado and Hawaii -- reported obesity rates under 10%.
• The state with the highest obesity rates among low-income preschoolers was Virginia (19%), followed by New Jersey (17.9%) and California (17.3%).

Studies suggest that children from low-income families are at greater risk for obesity than those whose families are better off economically. But national figures show that the difference is not that great.

Grummer-Strawn says the 14.6% obesity rate reported among low-income preschoolers is slightly higher, but still in line, with national figures for all children under 5.

More Evidence of Obesity Stabilization

The new report is not the first to suggest that obesity rates may be stabilizing among children in the U.S.

A national health survey that included children between the ages of 2 and 19 showed no significant increase in obesity prevalence between 1999 and 2006.

The survey showed that the obesity rate among children between the ages of 2 and 5 was 12.4% between 2003 and 2006.

CDC officials say the figures may indicate that greater efforts to improve nutrition and increase activity among low-income children may be paying off.

Grummer-Strawn cites upcoming changes in the Department of Agriculture's Women, Infants and Children (WIC) program as a good example.

As of Oct. 1, WIC will issue fewer vouchers for foods like whole-fat milk, high-sugar juices, eggs, and cheese and more vouchers for fruits and vegetables, he says.

In a news release, CDC epidemiologist Andrea Sharma, PhD, who was the lead author of the report, said efforts to limit the consumption of high-fat and high-sugar foods and to increase the consumption of fruits and vegetables are critical to reversing the pediatric obesity epidemic.

"To reduce childhood obesity, it is important that we create environmental and policy changes that promote physical activity and good nutrition," she notes.

SOURCES: Morbidity and Mortality Weekly Report, July 24, 2009; vol 58. William H. Dietz, MD, director, CDC Division of Nutrition, Physical Activity and Obesity. NHANES 1999-2006. Andrea Sharma, PhD, MPH, epidemiologist, CDC.

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