Dynamics of Obesity and Chronic Health Conditions Among Children and Youth | Adolescent Medicine | JAMA Network
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Original Contribution
February 17, 2010

Dynamics of Obesity and Chronic Health Conditions Among Children and Youth

Author Affiliations

Author Affiliations: Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, Massachusetts (Drs Van Cleave and Perrin); Department of Pediatrics, Harvard Medical School, Boston (Drs Van Cleave and Perrin); and Department of Society, Human Development and Health, Harvard School of Public Health, Boston (Dr Gortmaker).

JAMA. 2010;303(7):623-630. doi:10.1001/jama.2010.104

Context Rates of obesity and other childhood chronic conditions have increased over recent decades. Patterns of how conditions change over time have not been widely examined.

Objective To evaluate change in prevalence of obesity and other chronic conditions in US children, including incidence, remission, and prevalence.

Design, Setting, and Participants Prospective study using the National Longitudinal Survey of Youth–Child Cohort (1988-2006) of 3 nationally representative cohorts of children. Children were aged 2 through 8 years at the beginning of each study period, and cohorts were followed up for 6 years, from 1988 to 1994 (cohort 1, n = 2337), 1994 to 2000 (cohort 2, n = 1759), and 2000 to 2006 (n = 905).

Main Outcome Measures Parent report of a child having a health condition that limited activities or schooling or required medicine, special equipment, or specialized health services and that lasted at least 12 months. Obesity was defined as a body mass index at or above the 95th percentile for age. Chronic conditions were grouped into 4 categories: obesity, asthma, other physical conditions, and behavior/learning problems.

Results The end-study prevalence of any chronic health condition was 12.8% (95% confidence interval [CI], 11.2%-14.5%) for cohort 1 in 1994, 25.1% (95% CI, 22.7%-27.6%) for cohort 2 in 2000, and 26.6% (95% CI, 23.5%-29.9%) for cohort 3 in 2006. There was substantial turnover in chronic conditions: 7.4% (95% CI, 6.5%-8.3%) of participants in all cohorts had a chronic condition at the beginning of the study that persisted to the end, 9.3% (95% CI, 8.3%-10.3%) reported conditions at the beginning that resolved within 6 years, and 13.4% (95% CI, 12.3%-14.6%) had new conditions that arose during the 6-year study period. The prevalence of having a chronic condition during any part of the 6-year study period was highest for cohort 3 (51.5%; 95% CI, 47.3%-55.0%), and there were higher rates among male (adjusted odds ratio [AOR], 1.24; 95% CI, 1.07-1.42), Hispanic (AOR, 1.36; 95% CI, 1.11-1.67), and black (AOR, 1.60; 95% CI, 1.35-1.90) youth.

Conclusions Prevalence of chronic conditions among children and youth increased from 1988 to 2006. However, presence of these conditions was dynamic over each 6-year cohort.