title: Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity.
abstract: Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3-5, 44.2% were 6-11, and 41.6% were 12-17 years old. One-quarter (24.9%) were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%), especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.
authors.affiliation: Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA 94611, USA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Ford
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Gordon
authors.affiliation: Regional Health Education, The Permanente Medical Group, Oakland, CA 94612, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Howell
authors.affiliation: Department of Medicine, Kaiser Permanente Santa Rosa Medical Center, Santa Rosa, CA 95403, USA.
authors.forename: Cheryl E
authors.initials: CE
authors.lastname: Green
authors.affiliation: Department of Pediatrics, Kaiser Permanente San Francisco Medical Center, San Francisco, CA 94115, USA.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Greenspan
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
authors.forename: Malini
authors.initials: M
authors.lastname: Chandra
authors.affiliation: Department of Pediatrics, Kaiser Permanente Stockton Medical Center, Stockton, CA 95210, USA.
authors.forename: R Grant
authors.initials: RG
authors.lastname: Mellor
authors.affiliation: Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA 94611, USA; Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Lo
mesh_terms: D017677:Age Distribution; D002140:California / Q000453:epidemiology; D002648:Child; D019033:Delivery of Health Care, Integrated; D004032:Diet; D005006:Ethnicity; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000517:prevention & control; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D061217:Weight Reduction Programs / Q000379:methods*; D044465:White People