title: High prevalence of overweight and obesity among a representative sample of Puerto Rican children.
abstract: BACKGROUND
  The prevalence of childhood overweight and obesity has become a public health problem worldwide. The objectives of the study were: 1) to establish the BMI prevalence in 12-year olds residing in Puerto Rico, and 2) to determine BMI differences by sex, public-private school type, and geographic regions.
  
  
  METHODS
  Data was obtained from an island-wide probabilistic stratified sample of 1,582 twelve-year-olds (53% girls and 47% boys). The BMI was determined using the National Health and Nutrition Examination Survey procedures. Children were categorized as underweight, healthy weight, overweight or obese using the Center for Disease Control and Prevention's age and gender specific growth charts. A logistic regression model was used to estimate BMI category prevalence. Odds ratios were calculated using a multinomial regression.
  
  
  RESULTS
  In this study, 18.8% of the children were overweight and 24.3% were obese. A higher prevalence of obesity was observed in boys as compared to girls, 28.2% vs. 20.2%, respectively. The estimated prevalence of overweight and obesity in children from public schools was lower than for those from private schools. After adjusting for type of school and region, boys had a significantly higher risk of being obese (64%) as compared to girls. In public schools, boys had a lower prevalence of being overweight while girls had a higher prevalence compared to children attending private schools. Girls attending private schools had a higher obesity prevalence (27.8%) compared to girls from public schools (19.8%). The prevalence of underweight (2.7%) is slightly lower than in the United States.
  
  
  CONCLUSIONS
  The prevalence of overweight and obesity of 12-year-olds residing in PR was 18.8% and 24.3%, respectively; higher than in the U.S. (by groups). Boys were at higher risk of obesity than girls. There is an urgent need to implement public health policies/programs to reduce the prevalence of overweight and obesity in children in PR.
authors.affiliation: School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico. augusto.elias@upr.edu.
authors.forename: Augusto R
authors.initials: AR
authors.lastname: Elías-Boneta
authors.affiliation: School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico. toromilagros@gmail.com.
authors.forename: Milagros J
authors.initials: MJ
authors.lastname: Toro
authors.affiliation: School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico. omar.garcia@upr.edu.
authors.forename: Omar
authors.initials: O
authors.lastname: Garcia
authors.affiliation: School of Public Health, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico. roxana.torres@upr.edu.
authors.forename: Roxana
authors.initials: R
authors.lastname: Torres
authors.affiliation: School of Public Health, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico. cristina.palacios@upr.edu.
authors.forename: Cristina
authors.initials: C
authors.lastname: Palacios
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D011634:Public Health; D011647:Puerto Rico / Q000453:epidemiology; D012574:Schools / Q000706:statistics & numerical data; D013851:Thinness / Q000453:epidemiology; D014481:United States