Ethnic differences in the prevalence of overweight among young children in Hawaii.
OBJECTIVE
To compare the prevalence of overweight among young children of different ethnic backgrounds and describe the age pattern of overweight in early childhood.


METHODS
Cross-sectional study of 21,911 children, 12 to 59 months old, participating in the Hawaii Special Supplemental Nutrition Program for Women, Infants, and Children in 1997-1998. They were grouped in eight ethnic categories. For 1-year-olds we defined overweight as weight-for-age at the 95th percentile or more and underweight as weight-for-age at less than the 10th percentile. For 2- to 4-year-olds overweight was defined as body mass index (BMI) at the 95th percentile or more, underweight as BMI less than 10th percentile, tall stature as height-for-age at the 95th percentile or more, and short stature as height-for-age at less than the 10th percentile. The National Center for Health Statistics 2000 growth charts were the reference values. The analysis included bivariate and multivariate methods.


RESULTS
Large differences were found among ethnic groups. Among 1-year-olds, Samoans were the heaviest (17.5% overweight) and Filipinos the lightest (30.2% underweight). Among 2- to 4-year-olds, Samoans were the heaviest (27.0% overweight) and the tallest (16.9% tall), whereas Asians were the lightest (12.2% underweight), and Filipinos the shortest (19.0% short). Hawaiians and Asians also had a high percentage of short children (13.6% and 12.2%, respectively). Prevalence of overweight in all 2- to 4-year-olds was more than the expected 5%, especially for Samoans, Filipinos, Hawaiians, and Asians. At age 2 to 4 years, overweight was almost twice as prevalent as at age 1. Multivariate analysis showed that ethnicity (Samoan) had the strongest independent association with weight-for-age percentile, BMI, and overweight in the two age groups, followed by birth weight.


CONCLUSIONS
This is the first study of overweight among children of Asian and Pacific Island backgrounds in Hawaii. It identified important characteristics of growth and will be helpful in the design of appropriate activities to prevent overweight.
Baruffi
Gigliola
G
Department of Public Health Sciences and Epidemiology, John A. Burns School of Medicine, University of Hawaii, 1960 East West Rd, Biomed C-103, Honolulu, HI 96822-2319, USA. gigliola@hawaii.edu
Hardy
Charles J
CJ
Waslien
Carol I
CI
Uyehara
Sue J
SJ
Krupitsky
Dmitry
D
D000069:Acculturation; D017677:Age Distribution; D000704:Analysis of Variance; D044466:Asian People; D001827:Body Height / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight; D015362:Child Nutrition Disorders / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000145:classification / Q000208:ethnology / Q000706:statistics & numerical data; D005260:Female; D006254:Hawaii / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D007223:Infant; D008297:Male; D044468:Native Hawaiian or Pacific Islander; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class