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.

A systematic review of the association between consumption of sugar‐containing beverages and excess weight gain among children under age 12

“…Of these, 4 out of 7 studies (57 percent) demonstrated a statistically significant positive association between change in SCB consumption and change in adiposity . Out of the 24 studies that did not conduct a change‐over‐change analysis, 15 demonstrated (63 percent) a statistically significant positive association between change in SCB consumption and change in adiposity .…”

“…Of these, 4 out of 7 studies (57 percent) demonstrated a statistically significant positive association between change in SCB consumption and change in adiposity (46,47,54,61). Out of the 24 studies that did not conduct a change-over-change analysis, 15 demonstrated (63 percent) a statistically significant positive association between change in SCB consumption and change in adiposity (12,48,50,52,53,60,62,63,(66)(67)(68)71,72,77,78). Table 2B summarizes the frequency of the included studies with a positive association between SCB consumption and total adiposity, considering risk of bias assessment and study design features that could potentially be biasing or confounding the results.…”

“…Subgroup Analyses that Demonstrated a Statistically Significant Positive Association Between Sugar-Containing-Beverage or Fruit Juice Consumption and Total Adiposity (With or Without Controlling for Total Energy Intake) in Children Under Age 5Risk of biasLow risk of bias 5 out of 5 studies (100%)(47,48,55,59,68,77) Moderate or high risk of bias 3 out of 6 studies (50%)(49,56,57) …”

Novel genetic risk factors for asthma in African American children: Precision Medicine and the SAGE II Study

“…The disparity in asthma prevalence is mirrored in obesity, in which African American children have higher prevalence of obesity than European Americans (Guerrero et al 2016). Previous studies report overlapping risk factors between asthma and obesity.…”

Does breast-feeding reduce offspring junk food consumption during childhood? Examinations by socio-economic status and race/ethnicity

“…Highly educated mothers may be (i) more likely to search out information on the health aspects of infant feeding choices and (ii) better able to afford feeding supplies (18,20,23) milk while at work more challenging, especially when their occupations are hazardous (20,24) . Whatever the reasons for the disparities in breastfeeding, race/ethnicity and SES may be worth considering when examining associations between breast-feeding and child health outcomes, particularly since such outcomes, including obesity and diet, also vary by race/ethnicity and SES (25)(26)(27) . A handful of scholars have employed this line of reasoning by examining whether the influence of breast-feeding on overweight/obesity varies as a function of race/ethnicity and/or SES (28)(29)(30)(31)(32) .…”