By some measures, the prevalence of pediatric and adolescent obesity appears to have leveled off since 2003, according to an analysis of data from the National Health and Nutrition Examination Survey.
The prevalence of abdominal obesity – as defined by a waist-to-height ratio of 0.5 or higher – reached a peak of 35.5% in 2007-2008, dropping to 32.9% in children and adolescents aged 2-18 years by 2011-2012. When defined as a waist circumference in the 90th percentile or higher, obesity was seen in almost 18% of children and adolescents in 2011-2012 – down from a high of 19.4% in 2007-2008, reported Dr. Bo Xi of Shandong University in Jinan, China, and associates.
The largest decreases from 2003-2004 to 2011-2012 in waist-to-hip ratio were seen among non-Hispanic whites (from 35.3% to 31.4%) and 6- to 11-year-olds (from 33.7% to 30.7%). The largest increase occurred in Mexican Americans, whose prevalence went from 42.5% in 2003-2004 to 46.6% in 2011-2012, the investigators said (Pediatrics 2014;134:e334-9).
Looking at waist circumference, 2- to 5-year-olds had the largest drop in prevalence, from 15.8% in 2003-2004 to 10.9% in 2011-2012. Mexican Americans again had the largest rise, going from 20.1% in 2003-2004 to 24.5% in 2011-2012, Dr. Xi and associates wrote.
"Although the prevalence of abdominal obesity leveled off over the past 9 years among U.S. children and adolescents, it is still high ... suggesting an urgent need for lifestyle modifications," they wrote, and since waist-to-hip ratio may be a better risk indicator for cardiovascular disease than body-mass index or waist circumference, "the message of ‘keep your waist to less than half your height’ is attractive for public health policy."
The study was funded by the Scientific Research Organization Construction Project of Shandong University. The investigators indicated that they had no relevant financial disclosures.