Abstract
Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3–5, 44.2% were 6–11, and 41.6% were 12–17 years old. One-quarter (24.9%) were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%), especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.
Highlights
The high prevalence of pediatric obesity remains a major healthcare burden and an area of high priority for population management in pediatric care
Newer definitions for higher order obesity delineated by the body mass index (BMI) percentage above the 95th BMI percentile provide additional classification of children with severe obesity [19, 20], where a continued upward trend has been observed nationally [9] and racial/ethnic disparities are evident beginning at an early age [15, 17]
Preschool-aged children who lived in a lower income neighborhood were more likely than those who did not to have severe obesity (39.3% versus 29.7%, p < 0.05 after adjusting for race/ethnicity and gender); living in a lower income neighborhood was not associated with obesity severity among older children
Summary
The high prevalence of pediatric obesity remains a major healthcare burden and an area of high priority for population management in pediatric care. Given the strong tracking effect of childhood obesity into adulthood [1,2,3,4] and the association of pediatric obesity with adverse health consequences [5,6,7], understanding behavioral factors, severity trends, and high-risk subgroups is important from both a public health and clinical perspective. The US Preventive Services Task Force and the American Association of Pediatrics recommend BMI screening for children starting at a very young age, citing evidence for early detection and management of pediatric patients with obesity. In 2013, the American Heart Association [19] recommended the use of new growth charts for children with severe obesity [20], with the goal of optimizing weight classification and BMI tracking above 120% of the 95th BMI percentile [20, 25]. A better understanding of these modifiable behaviors may lead to more targeted screening for specific risk (or protective) factors that can inform the focus of targeted intervention to decrease pediatric obesity
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
