Prevalence of marked overweight and obesity in a multiethnic pediatric population: Findings from the Child and Adolescent trial for Cardiovascular Health (CATCH) study

Objective Determine the prevalence of marked overweight and obesity among c hildren in the Child and Adolescent Trial for Cardiovascular Health (CATCH) , identify high risk groups, and compare findings to other recent studies. Design Cohort study. Subjects/setting Five thousand one hundred-six school children who were par ticipants in CATCH at baseline (age approximately 9 years) during 1991 and 4,019 of those children who had follow-up data from 1994 (age approximately 11 years) available. Methods Body mass index (BMI), triceps and subscapular skinfolds, subscapul ar to triceps skinfold (S/T) ratio, and an estimate of body fat distributio n from skinfolds was calculated. Findings were compared to population-based reference data from the First National Health and Nutrition Examination Su rvey, 1971 to 1973 (NHANES I), to data from the Bogalusa Heart Study, and t o data from the Third National Health and Nutrition Examination Survey, 198 8 to 1994 (NHANES III). Results Children in CATCH were markedly heavier and fatter than the NHANES I population and more comparable to the NHANES III population, especially t hose in the upper percentiles. The prevalence of obesity based on BMI and t riceps skinfolds >95th percentile among CATCH children was higher in boys t han in girls at both baseline (boys 9.1%, girls 8.6%) and follow-up (boys 1 1.7%, girls 7.2%). It was higher among African-Americans and Hispanics than whites for both sexes. S/T ratios did not differ appreciably from those ob served in the NHANES I reference population, suggesting that body fat distr ibution was more stable over time than BMI and skinfolds. Applications Our findings support other recent reports that American childr en, especially African-American and Hispanic children, are becoming heavier and fatter. Preventive measures are warranted, especially for high-risk yo uth.