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1968 Through 1988

Fern R. Hauck, MD, MS; Margaret M. Gallaher, MD; Miranda Yang-Oshida, RD, MS, MPH; Mary K. Serdula, MD, MPH

Am J Dis Child. 1992;146(10):1194-1198.

Abstract
• Objective.
—To determine if there were trends in underweight, short stature, and obesity among 1- through 5-yearold Mescalero (NM) Apache Indian children from 1968 through 1988.

Design.
—Cross-sectional review of hospital clinic charts for five cohorts.

Setting.
—General pediatric outpatient clinic at the Mescalero Indian Health Service Hospital. Participants.—Sixty-nine patients aged 1 through 5 years in 1968, 1973, 1978, 1983, or 1988 for whom weight and height were recorded during a well-child visit that occurred in the respective year.

Selection Procedures.
—Approximately half the charts were screened for eligibility through systematic sampling for all years except 1988; for 1988 all available charts were screened for eligibility for the study.

Interventions.
—None.

Measurements and Results.
—We found trends of decreasing prevalence of both underweight (defined as weight-forheight below the fifth percentile) and short stature (defined as height-for-age below the fifth percentile) based on the Centers for Disease Control/World Health Organization growth reference. We found no secular trends in obesity (weight-forheight above the 95th percentile), although the prevalences throughout the 21-year period were as much as two to four times higher than expected when compared with the Centers for Disease Control/World Health Organization reference. There has been an upward shift in both weight-for-height and height-for-age distributions since 1968, indicating that Mescalero children today are, on average, heavier and taller.

Conclusions.
—Underweight and short stature decreased among Mescalero preschool children from 1968 through 1988, suggesting nutritional improvements. However, given the current high prevalence of obesity, it is recommended that surveillance of nutritional status be continued and appropriate interventions be developed to treat and prevent obesity in this population.

(AJDC. 1992;146:1194-1198)

Author Affiliations
From the Division of Nutrition, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, Ga (Drs Hauck, Gallaher, and Serdula), and the Mescalero (NM) Indian Health Service Hospital (Ms Yang-Oshida).

Footnotes
Accepted for publication June 17, 1992.

Presented in part at the Epidemic Intelligence Service Conference, Atlanta, Ga, April 3, 1989; the 117th Annual Meeting of the American Public Health Association, Chicago, Ill, October 25,1989; and the Third Annual Indian Health Service Research Conference, Tucson, Ariz, March 22, 1990.

Reprint requests to Division of Nutrition, Mail Stop K-26, Centers for Disease Control, 1600 Clifton Rd, Atlanta, GA 30333 (Dr Serdula).

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