In this month’s Pediatrics, Cunningham et al (10.1542/peds.2022-056547) report that in less than a generation, obesity has worsened and gotten more severe among increasingly younger children. More specifically, the risk of obesity increased significantly over time among those children who were already overweight upon kindergarten entry. From the perspective of socioeconomic status (SES), the risk of developing obesity was also most prominent among households of limited financial means.
Obesity risk was also seen to have increased significantly for non-Hispanic Black children (more so than Hispanic children). Additionally, children from low SES households had a higher incidence of obesity as compared to those of higher SES. While this may not be surprising, the rate of increase should be alarming to all.
Major limitations, also discussed in an accompanying commentary by Ogden et al (10.1542/peds.2021-053708), to this study included not having data for children prior to kindergarten and that there are no data for children in cohorts after 2010.
The authors correctly highlight the myriad of interventions (large and small) that have been implemented to address childhood obesity that seemed to not have had a positive impact. Another way to view the results is to speculate at how much worse obesity may have been without interventions.
We are not powerless in effecting meaningful change when it comes to obesity in childhood. As a community, we need to be consistent in monitoring and discussing BMI with families as soon as we begin tracking it at the age of 2. To add more information, the authors highlight other areas in which to target preventative efforts to include addressing maternal obesity which impacts and is associated with their children being predisposed to obesity. 1,2
- Williams S. Overweight at age 21: the association with body mass index in childhood and adolescence and parents' body mass index. A cohort study of New Zealanders born in 1972–1973. International journal of obesity. Feb 2001;25(2):158-163
- Gordon-Larsen P, Adair LS, Suchindran CM. Maternal obesity is associated with younger age at obesity onset in US adolescent offspring followed into adulthood. Obesity (Silver Spring). Nov 2007;15(11):2790-2796