1. The current prevalence of obesity among all children aged 2 to 19 years was 17.0% in the period between 2013 and 2014, with a 5.8% prevalence of extreme obesity.
2. Since 1988, rates of obesity in children 2 to 5 years old increased until 2004 and then decreased.
Evidence Rating Level: 2 (Good)
Study Rundown: Obesity during childhood predisposes to obesity in adulthood and is associated with increased morbidity and mortality. Several previous studies have shown that the prevalence of childhood obesity steadily increased between the 1970s and 1990s, while appearing to moderate in the early 2000s. This study sought to estimate the prevalence of childhood obesity in 2013-2014 and analyze how the rates have changed by age group over the past 30 years.
In a sample of 40 780 children between the ages of 2 and 19 included in the National Health and Nutrition Examination Survey (NHANES), the study calculated that obesity was prevalent in 17.0% of children, and extreme obesity (i.e., BMI > 120% of the age-and-sex-specific 95th percentile) was prevalent in 5.8%. For children between 2 and 5 years of age, obesity increased between 1988 and 2004, but then decreased significantly over the past decade. Older children, between 6 and 11 years of age, had increasing rates of obesity from 1988 to 2004, but then stabilized, while adolescents had a continual increase in obesity over all time periods.
Relevant Reading: Prevention of pediatric overweight and obesity
In-Depth [retrospective cohort]: This study utilized information from the National Health and Nutrition Examination Survey (NHANES), which has been continuously collecting information between 1999 and 2014. Prior to 1999, data was generated during only specific time periods, including 1988 through 1994. Over the entire period, height and weight information was gathered from 40 780 children. Data from 6878 children between 2011 and 2014 were used to determine that the prevalence rates of obesity (17.0%; 95%CI 15.5–18.6%), and extreme obesity (5.8%; 95%CI 4.9–6.8%). Among children between 2 and 5 years of age, the prevalence of obesity was 7.2%, 13.9%, and 9.4% in the time periods 1988-1994, 2003-2004, and 2013-2014, respectively (p = 0.03 between 2003 and 2014). In children between 6 and 11 years of age, rates of obesity were 11.3%, 19.6%, and 17.4% in the same time periods (p = 0.44 between 2003 and 2014). In adolescents between 12 and 19 years of age, the prevalence rates of obesity were 10.5% in 1988-1994 and 20.5% in 2013-2014 (p < 0.001). Over the entire time period, rates of extreme obesity were significantly higher in children aged 6-11 years (p = 0.02) and adolescents aged 12-19 years (p < 0.001).
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