1. Sixty-five percent of studied fifth-graders who were obese in the fifth grade remained obese in the tenth grade.
2. Obese fifth-graders who came from homes of lower household education and those who perceived themselves as heavier than their ideal body weight were more likely to remain obese in the tenth grade.
Evidence Rating Level: 1 (Excellent)
Study Rundown: As the prevalence of obesity has increased, it is important to delineate epidemiological trends in weight gain to target intervention efforts. In this study, children were examined in the fifth grade, and again in the tenth grade, to identify patterns of weight change and its associated predictors. Nearly half of studied fifth-graders were already overweight or obese. Of those obese in the tenth grade, the significant majority was already obese by the fifth grade. Overweight fifth-graders were more likely to become obese by tenth grade if they had an obese parent or if they watched more television than normal weight peers. Obese fifth-graders were more likely to remain obese if they came from a lower education household or if they perceived themselves as much higher than their ideal body weight. Despite also collecting anthropometric measurements, this study is limited by self-reported behavioral measures. It suggests, however, that obesity efforts may benefit from targeting the pre-adolescence age group given the rate of overweight and obese children in the fifth grade and the sustained weight seen by tenth grade.
Relevant Reading: Clinical Practice: Overweight Children and Adolescents
In-Depth [prospective cohort study]: Participants included 3961 students and 1 parent each from public schools in Birmingham, AL, Houston, TX, and Los Angeles, CA. Participants were surveyed when children were in the fifth grade and then again in the tenth grade. Weight, height, and BMI were calculated at both time points. Children were categorized as underweight (<5th percentile), normal weight (≥5th to < 85th percentile), overweight (≥85th to <95th percentile, and obese (≥ 95th percentile) through standardized gender-specific growth charts. Forty-five percent of fifth-graders and 38% of tenth-graders were classified as overweight or obese. Of obese tenth-graders, 83% were obese in the fifth grade and 13% were overweight. Having an obese parent (P < 0.001) and watching more television weekly compared to normal weight children (P = 0.02) were associated with overweight fifth-graders becoming obese by the tenth grade. Of obese fifth-graders, those who came from homes of lower educational background (P = 0.006) and those who perceived themselves as a higher body weight than ideal (P = 0.01) were more likely to remain obese by the tenth grade.
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