title: Prevalence of obesity and extreme obesity in children aged 3-5 years.
abstract: BACKGROUND
  Early childhood adiposity may have significant later health effects. This study examines the prevalence and recognition of obesity and severe obesity among preschool-aged children.
  
  
  METHODS
  The electronic medical record was used to examine body mass index (BMI), height, sex and race/ethnicity in 42,559 children aged 3-5 years between 2007 and 2010. Normal or underweight (BMI < 85th percentile); overweight (BMI 85th-94th percentile); obesity (BMI ≥ 95th percentile); and severe obesity (BMI ≥ 1.2 × 95th percentile) were classified using the 2000 Centers for Disease Control and Prevention growth charts. Provider recognition of elevated BMI was examined for obese children aged 5 years.
  
  
  RESULTS
  Among 42,559 children, 12.4% of boys and 10.0% of girls had BMI ≥ 95th percentile. The prevalence was highest among Hispanics (18.2% boys, 15.2% girls), followed by blacks (12.4% boys, 12.7% girls). A positive trend existed between increasing BMI category and median height percentile, with obesity rates highest in the highest height quintile. The prevalence of severe obesity was 1.6% overall and somewhat higher for boys compared with girls (1.9 vs. 1.4%, P < 0.01). By race/ethnicity, the highest prevalence of severe obesity was seen in Hispanic boys (3.3%). Among those aged 5 years, 77.9% of obese children had provider diagnosis of obesity or elevated BMI, increasing to 89.0% for the subset with severe obesity.
  
  
  CONCLUSIONS
  Obesity and severe obesity are evident as early as age 3-5 years, with race/ethnic trends similar to older children. This study underscores the need for continued recognition and contextualization of early childhood obesity in order to develop effective strategies for early weight management.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Lo
authors.forename: B
authors.initials: B
authors.lastname: Maring
authors.forename: M
authors.initials: M
authors.lastname: Chandra
authors.forename: S R
authors.initials: SR
authors.lastname: Daniels
authors.forename: A
authors.initials: A
authors.lastname: Sinaiko
authors.forename: M F
authors.initials: MF
authors.lastname: Daley
authors.forename: N E
authors.initials: NE
authors.lastname: Sherwood
authors.forename: E O
authors.initials: EO
authors.lastname: Kharbanda
authors.forename: E D
authors.initials: ED
authors.lastname: Parker
authors.forename: K F
authors.initials: KF
authors.lastname: Adams
authors.forename: R J
authors.initials: RJ
authors.lastname: Prineas
authors.forename: D J
authors.initials: DJ
authors.lastname: Magid
authors.forename: P J
authors.initials: PJ
authors.lastname: O'Connor
authors.forename: L C
authors.initials: LC
authors.lastname: Greenspan
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016487:Parenting / Q000208:ethnology; D063766:Pediatric Obesity / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: Children; obesity; preschool; severe obesity