Childhood obesity among primary school children is increasing and starting at earlier ages, according to a new study.
“With more children experiencing severe obesity in the recent cohort, we can expect higher risks of … co-morbidities in today’s high-schoolers and future adults,” authors wrote in “Changes in the Incidence of Childhood Obesity,” (Cunningham SA, et al. Pediatrics. July 5, 2022).
Researchers followed two nationally representative groups of children from kindergarten through fifth grade. One group entered kindergarten in 1998 and the other in 2010.
About 15.3% of the children had obesity when they entered kindergarten in 2010 compared to 12% in the earlier cohort, and a higher proportion of the recent group had severe obesity, the study found.
Among children who did not have obesity when they entered kindergarten, 16.2% of the later cohort had obesity by the end of fifth grade compared to 15.5% of the earlier group. This difference was driven largely by those who were overweight in kindergarten and progressed. There was no change in the risk of developing obesity among those with a normal body mass index (BMI) in kindergarten.
The risk of developing obesity was greater among boys than girls in both groups. Authors also noted differences by race. The risk of new onset obesity by fifth grade was 29% higher for Black students in the recent group compared to the earlier group, the only racial group to see an increase.
Looking at socioeconomic data, the greatest risk of developing obesity was among the lowest and highest groups while staying steady for those in the middle. Authors said the finding is “a reminder that children of all walks of life are at risk for obesity.”
They expressed concern about the impact of rising obesity on rates of diabetes and cardiovascular issues and a wider array of health issues for those with severe obesity. Authors also called for more research on biological factors such as maternal obesity in addition to social determinants and interventions for young children.
“We speculate that prevention programs need to look beyond simple solutions to obesity, including addressing the substantial changes in physical activity and in food environments that have progressed in recent decades, as well as the epigenetic and neuro-psycho-behavioral pathways to obesity,” they wrote. “Ongoing surveillance is required to monitor changes in health at population levels.”
Authors of a related commentary noted Hispanic children have higher obesity rates by age 2 years compared to children of other races.
“This finding supports the American Academy of Pediatrics recommendation of a life-course approach to identify children ‘early on the path to obesity’ for primary prevention of obesity,” they wrote.