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Comment & Response
November 5, 2019

Trends in Obesity Among Low-Income Young Children—Reply

Author Affiliations
  • 1Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
JAMA. 2019;322(17):1714-1715. doi:10.1001/jama.2019.14247

In Reply We agree with Drs Stefan and Schulze that there are limitations of BMI as a surrogate of adiposity in our study of the prevalence of obesity among children aged 2 through 4 years enrolled in WIC.1

The association between height and excess weight (relative to the sex-, age-, and height-specific median weight of a reference population) among children has been known for more than 75 years.2 However, we believe that the reported correlation of r = 0.47 may overstate the magnitude of the association between BMI and height. Based on our analyses of other data,3 this may be the unadjusted correlation between height and BMI over a wide range of ages or among children between the ages of 8 and 10 years. One method to control for this association is to transform BMI and height into z scores that account for sex and age differences.