title: Severe obesity among children in New York City public elementary and middle schools, school years 2006-07 through 2010-11.
abstract: BACKGROUND
  Although studies have shown that childhood obesity overall is on the decline among New York City (NYC) public school children, the prevalence of severe childhood obesity has not been studied.
  
  
  METHODS
  We used height and weight measurements of 947,765 NYC public school students aged 5 to 14 years in kindergarten through 8th grade (K-8), from school years 2006-07 through 2010-11. We used age- and sex-specific body mass index (BMI) percentiles according to Centers for Disease Control and Prevention growth charts to define childhood obesity (BMI ≥ 95th percentile) and severe childhood obesity (BMI ≥120% of 95th percentile) and to identify biologically implausible values (BIV). Multivariable logistic models tested for trends in obesity and severe obesity prevalence. To evaluate misclassification, we recalculated prevalence estimates for the most recent school year (2010-11) including the student records identified as BIV who were also declared severely obese (BMI ≥ 120% of 95th percentile). We refer to this subgroup of BIVs as "high BIV."
  
  
  RESULTS
  Severe obesity among NYC public school students in grades K-8 decreased 9.5% from the 2006-07 school year (6.3%) to the 2010-11 school year (5.7%), and obesity decreased 5.5% (from 21.9% to 20.7%). The prevalence of severe obesity and obesity was highest among minority, poor, and male children. Severe obesity declined in prevalence among every subgroup, with the greatest effect among white students and wealthy students. Severe obesity prevalence increased with age, and obesity prevalence peaked among those aged 7 to 10 years. For the 2010-11 school year, including high BIVs increased severe obesity prevalence from 5.7% to 6.6% and increased obesity prevalence from 20.7% to 21.5%.
  
  
  CONCLUSIONS
  Among all subgroups of NYC public school children in grades K-8, the reduction in severe obesity was greater than the reduction in overall obesity. Efforts to decrease obesity in NYC have affected the severely obese; however, monitoring of this specific subgroup should continue because of differences in trends and greater health risks.
authors.affiliation: New York City Department of Health and Mental Hygiene, Division of Epidemiology, 42-09 28th Street, Long Island City, NY 11101. E-mail: sday@health.nyc.gov.
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Day
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Konty
authors.affiliation: New York City Department of Health and Mental Hygiene, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Maya
authors.initials: M
authors.lastname: Leventer-Roberts
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Cathy
authors.initials: C
authors.lastname: Nonas
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Tiffany G
authors.initials: TG
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009519:New York City / Q000453:epidemiology; D009767:Obesity, Morbid / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D010809:Physical Fitness / Q000502:physiology; D012015:Reference Standards; D012574:Schools / Q000706:statistics & numerical data* / Q000639:trends; D012737:Sex Factors; D012923:Social Class; D013334:Students / Q000706:statistics & numerical data*