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      Vital signs: obesity among low-income, preschool-aged children--United States, 2008-2011.

      MMWR. Morbidity and mortality weekly report

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          Abstract

          The prevalence of obesity among U.S. preschoolers has doubled in recent decades. Childhood obesity increases the risk for adult obesity and is associated with negative health consequences. Trends in the state-specific prevalence of obesity among low-income U.S. preschool children have not been examined since 2008. State-specific obesity prevalence surveillance helps determine the need for and impact of state and local obesity prevention strategies.

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          Recommended community strategies and measurements to prevent obesity in the United States.

          Approximately two thirds of U.S. adults and one fifth of U.S. children are obese or overweight. During 1980--2004, obesity prevalence among U.S. adults doubled, and recent data indicate an estimated 33% of U.S. adults are overweight (body mass index [BMI] 25.0-29.9), 34% are obese (BMI >or=30.0), including nearly 6% who are extremely obese (BMI >or=40.0). The prevalence of being overweight among children and adolescents increased substantially during 1999-2004, and approximately 17% of U.S. children and adolescents are overweight (defined as at or above the 95% percentile of the sex-specific BMI for age growth charts). Being either obese or overweight increases the risk for many chronic diseases (e.g., heart disease, type 2 diabetes, certain cancers, and stroke). Reversing the U.S. obesity epidemic requires a comprehensive and coordinated approach that uses policy and environmental change to transform communities into places that support and promote healthy lifestyle choices for all U.S. residents. Environmental factors (including lack of access to full-service grocery stores, increasing costs of healthy foods and the lower cost of unhealthy foods, and lack of access to safe places to play and exercise) all contribute to the increase in obesity rates by inhibiting or preventing healthy eating and active living behaviors. Recommended strategies and appropriate measurements are needed to assess the effectiveness of community initiatives to create environments that promote good nutrition and physical activity. To help communities in this effort, CDC initiated the Common Community Measures for Obesity Prevention Project (the Measures Project). The objective of the Measures Project was to identify and recommend a set of strategies and associated measurements that communities and local governments can use to plan and monitor environmental and policy-level changes for obesity prevention. This report describes the expert panel process that was used to identify 24 recommended strategies for obesity prevention and a suggested measurement for each strategy that communities can use to assess performance and track progress over time. The 24 strategies are divided into six categories: 1) strategies to promote the availability of affordable healthy food and beverages), 2) strategies to support healthy food and beverage choices, 3) a strategy to encourage breastfeeding, 4) strategies to encourage physical activity or limit sedentary activity among children and youth, 5) strategies to create safe communities that support physical activity, and 6) a strategy to encourage communities to organize for change.
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            Changes in state-specific childhood obesity and overweight prevalence in the United States from 2003 to 2007.

            To examine changes in state-specific obesity and overweight prevalence among US children and adolescents between 2003 and 2007. Temporal cross-sectional analysis of the 2003 and 2007 National Survey of Children's Health data. The 50 states and the District of Columbia. A total of 46 707 and 44 101 children aged 10 to 17 years in 2003 and 2007, respectively. Prevalence and odds of obesity and overweight, differentials in which were examined by bivariate and logistic regression analyses. In 2007, 16.4% of US children were obese and 31.6% were overweight. The prevalence of obesity varied substantially across the states, with Mississippi having the highest prevalence (21.9%) and Oregon the lowest prevalence (9.6%). Overweight prevalence varied from a low of 23.1% for children in Utah to a high of 44.5% for children in Mississippi. Between 2003 and 2007, obesity prevalence increased by 10% for all US children and by 18% for female children, declined by 32% for children in Oregon, and doubled among female children in Arizona and Kansas. Children in Illinois, Tennessee, Kentucky, West Virginia, Georgia, and Kansas had more than twice the adjusted odds of being obese than children in Oregon. Individual, household, and neighborhood social and built environmental characteristics accounted for 45% and 42% of the state variance in childhood obesity and overweight, respectively. Substantial geographic disparities in childhood obesity and overweight exist, with an apparent shift toward higher prevalence in 2007 for several states. Marked geographic disparities indicate the potential for considerable reduction in US childhood obesity.
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              Decreasing prevalence of obesity among young children in Massachusetts from 2004 to 2008.

              To examine whether the obesity prevalence is increasing, level, or decreasing among young US children (aged <6 years) in the past decade; and to compare regional data to those of 2 national databases. We analyzed data from 108 762 well-child visits (36 827 children) at a multisite pediatric practice in eastern Massachusetts during 1999-2008. By using the Centers for Disease Control and Prevention 2000 gender-specific growth charts, we defined obesity as weight-for-length ≥95th percentile for children aged <24 months and BMI ≥95th percentile for children aged 24 to <72 months. By using multivariable logistic regression, we estimated gender-specific obesity trends in 2 separate periods, 1999-2003 and 2004-2008, adjusting for age group, race/ethnicity, health insurance, and practice site. From 1999 to 2003, the obesity prevalence was fairly stable among both boys and girls. From 2004 to 2008, the obesity prevalence substantially decreased among both boys and girls. The decline in obesity prevalence during 2004-2008 was more pronounced among children insured by non-Medicaid health plans than among those insured by Medicaid. Among children aged <6 years at this multisite pediatric practice, obesity prevalence decreased during 2004-2008, which is in line with national data showing no increase in prevalence during this time period. The smaller decrease among Medicaid-insured children may portend widening of socioeconomic disparities in childhood obesity.
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