title: Incidence of obesity among young U.S. children living in low-income families, 2008-2011.
abstract: OBJECTIVE
  To examine the incidence and reverse of obesity among young low-income children and variations across population subgroups.
  
  
  METHODS
  We included 1.2 million participants in federally funded child health and nutrition programs who were 0 to 23 months old in 2008 and were followed up 24 to 35 months later in 2010-2011. Weight and height were measured. Obesity at baseline was defined as gender-specific weight-for-length ≥95th percentile on the 2000 Centers for Disease Control and Prevention growth charts. Obesity at follow-up was defined as gender-specific BMI-for-age ≥95th percentile. We used a multivariable log-binomial model to estimate relative risk of obesity adjusting for gender, baseline age, race/ethnicity, duration of follow-up, and baseline weight-for-length percentile.
  
  
  RESULTS
  The incidence of obesity was 11.0% after the follow-up period. The incidence was significantly higher among boys versus girls and higher among children aged 0 to 11 months at baseline versus those older. Compared with non-Hispanic whites, the risk of obesity was 35% higher among Hispanics and 49% higher among American Indians (AIs)/Alaska Natives (ANs), but 8% lower among non-Hispanic African Americans. Among children who were obese at baseline, 36.5% remained obese and 63.5% were nonobese at follow-up. The proportion of reversing of obesity was significantly lower among Hispanics and AIs/ANs than that among other racial/ethnic groups.
  
  
  CONCLUSIONS
  The high incidence underscores the importance of early-life obesity prevention in multiple settings for low-income children and their families. The variations within population subgroups suggest that culturally appropriate intervention efforts should be focused on Hispanics and AIs/ANs.
authors.affiliation: Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Highway, Mail Stop F-77, Atlanta, GA 30341. Lpan@cdc.gov.
authors.forename: Liping
authors.initials: L
authors.lastname: Pan
authors.forename: Ashleigh L
authors.initials: AL
authors.lastname: May
authors.forename: Holly
authors.initials: H
authors.lastname: Wethington
authors.forename: Karen
authors.initials: K
authors.lastname: Dalenius
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Grummer-Strawn
mesh_terms: D015992:Body Mass Index; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D063105:Food Assistance; D006801:Humans; D015994:Incidence; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015233:Models, Statistical; D015999:Multivariate Analysis; D009765:Obesity / Q000191:economics / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D011203:Poverty; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: childhood obesity; incidence; infancy; population-based studies; preschool age; public health