title: Growth Trajectories of Refugee and Nonrefugee Children in the United States.
abstract: Limited data examine longitudinal nutrition outcomes of refugee children after United States resettlement. Among refugee children, our aims were to (1) assess the changes in weight-based nutritional status between baseline (0-3 months) and 10-24 months after arrival and (2) compare the BMI (BMIz) or weight-for-length z score (WFLz) trajectories to nonrefugee children for up to 36 months after arrival.
  
  
  
  We conducted a retrospective study of refugees aged 0-16 years from Washington and Pennsylvania and compared them with an age and sex-matched nonrefugee low-income sample from Washington. Data included anthropometric measurements from the initial screening medical visit and subsequent primary care visits. Multilevel linear mixed-effects regression models evaluated the change in BMIz or WFLz trajectory.
  
  
  
  The study included 512 refugee and 1175 nonrefugee children. The unadjusted prevalence of overweight/obesity increased from 8.9% to 20% (P < .001) for 2- to 16-year-old refugees from baseline to 10-24 months. Refugees (2-16 years old) had a steeper increase in their BMIz per 12 months compared with nonrefugees (coefficient 0.18 vs 0.03; P < .001). Refugees <2 years old had a less steep increase in their WFLz per 12 months compared with nonrefugees (coefficient 0.12 vs 0.36, P = .002).
  
  
  
  Older refugee children exhibited a higher risk of obesity than nonrefugees, whereas refugees <2 years old exhibited a slower increase in their risk of obesity than nonrefugee children. All age groups experienced increasing obesity prevalence. Targeted and culturally tailored obesity prevention interventions may mitigate health and nutrition inequities among refugee children.
authors.affiliation: Departments of Pediatrics and eedh@uw.edu.|Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dawson-Hahn
authors.affiliation: Departments of Pediatrics and.|Global Health, University of Washington, Seattle, Washington.
authors.forename: Suzinne
authors.initials: S
authors.lastname: Pak-Gorstein
authors.affiliation: Refugee Health Program, Washington State Department of Health, Shoreline, Washington.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Matheson
authors.affiliation: Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington.
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.affiliation: PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Katherine
authors.initials: K
authors.lastname: Yun
authors.affiliation: Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and.
authors.forename: Kevin
authors.initials: K
authors.lastname: Scott
authors.affiliation: Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and.
authors.forename: Colleen
authors.initials: C
authors.lastname: Payton
authors.affiliation: Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stein
authors.affiliation: Refugee Screening Clinic, Seattle-King County Public Health, Seattle, Washington.
authors.forename: Annette
authors.initials: A
authors.lastname: Holland
authors.affiliation: Departments of Pediatrics and.
authors.forename: H Mollie
authors.initials: HM
authors.lastname: Grow
authors.affiliation: Departments of Pediatrics and.|Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Mendoza
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000886:Anthropometry; D001827:Body Height / Q000208:ethnology; D015992:Body Mass Index; D016022:Case-Control Studies; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status / Q000208:ethnology; D050177:Overweight / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012016:Reference Values; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D035862:Vulnerable Populations / Q000208:ethnology* / Q000706:statistics & numerical data