title: Disparities in Early Transitions to Obesity in Contemporary Multi-Ethnic U.S. Populations.
abstract: BACKGROUND
  Few studies have examined weight transitions in contemporary multi-ethnic populations spanning early childhood through adulthood despite the ability of such research to inform obesity prevention, control, and disparities reduction.
  
  
  RESULTS
  We characterized the ages at which African American, Caucasian, and Mexican American populations transitioned to overweight and obesity using contemporary and nationally representative cross-sectional National Health and Nutrition Examination Survey data (n = 21,220; aged 2-80 years). Age-, sex-, and race/ethnic-specific one-year net transition probabilities between body mass index-classified normal weight, overweight, and obesity were estimated using calibrated and validated Markov-type models that accommodated complex sampling. At age two, the obesity prevalence ranged from 7.3% in Caucasian males to 16.1% in Mexican American males. For all populations, estimated one-year overweight to obesity net transition probabilities peaked at age two and were highest for Mexican American males and African American females, for whom a net 12.3% (95% CI: 7.6%-17.0%) and 11.9% (95% CI: 8.5%-15.3%) of the overweight populations transitioned to obesity by age three, respectively. However, extrapolation to the 2010 U.S. population demonstrated that Mexican American males were the only population for whom net increases in obesity peaked during early childhood; age-specific net increases in obesity were approximately constant through the second decade of life for African Americans and Mexican American females and peaked at age 20 for Caucasians.
  
  
  CONCLUSIONS
  African American and Mexican American populations shoulder elevated rates of many obesity-associated chronic diseases and disparities in early transitions to obesity could further increase these inequalities if left unaddressed.
authors.affiliation: Department of Epidemiology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Christy L
authors.initials: CL
authors.lastname: Avery
authors.affiliation: Department of Epidemiology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Katelyn M
authors.initials: KM
authors.lastname: Holliday
authors.affiliation: Department of Biostatistics, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Sujatro
authors.initials: S
authors.lastname: Chakladar
authors.affiliation: Department of Epidemiology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Engeda
authors.affiliation: Department of Epidemiology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Shakia T
authors.initials: ST
authors.lastname: Hardy
authors.affiliation: Epidemiology Branch, Population and Prevention Sciences Program, Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, Maryland, United States of America.
authors.forename: Jared P
authors.initials: JP
authors.lastname: Reis
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, United States of America.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.affiliation: Department of Nutrition, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Shay
authors.affiliation: Department of Medicine Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.affiliation: Department of Epidemiology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.affiliation: Department of Biostatistics, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Dan Yu
authors.initials: DY
authors.lastname: Lin
authors.affiliation: Department of Biostatistics, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Donglin
authors.initials: D
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D014481:United States