BACKGROUND The high rates of childhood overweight and obesity in the US have generated interest in schools as sites for monitoring BMI information. This study established baseline values for a 5-year longitudinal assessment of BMI of elementary school children and examined variation across the schools, because little is known about factors that affect the distribution of overweight and obesity within school districts. METHODS Height and weight measurements were collected on 2,317 elementary school children in one school district. BMI was calculated using the CDC’s NutStat program. Child characteristics included gender, age, eligibility for free and reduced lunch (proxy for SES), school, grade, and ethnicity/race. Children were grouped into 2 BMI categories, < 85th percentile or ≥ 85th percentile (overweight/obesity). Logistic regression was used to examine potential predictors of overweight/obesity. RESULTS Prevalence of ≥ 85th percentile was 30.9%, 34.4%, 35.3%, 36.4%, 37.1%, and 44.5% for K-5 respectively. Prevalence of ≥ 85th percentile was highest among Hispanic children. Ethnicity was the strongest predictor of inclusion in the ≥ 85th percentile category followed by grade and free and reduced lunch eligibility. CONCLUSION The data are consistent with the prevalence of overweight/obesity among American children and Hispanic children in particular. District prevalence of overweight/obesity is higher than available state statistics. Most of the BMI variation is accounted for by ethnicity, SES, and grade. The grade effect and high prevalence of overweight/obesity provide a rationale for BMI screening retention at the schools.

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