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Sarah E. Anderson, PhD; Robert C. Whitaker, MD, MPH

Arch Pediatr Adolesc Med. 2009;163(4):344-348.

Objective  To estimate the prevalence of obesity in 5 major racial/ethnic groups in 4-year-old US children.

Design  Cross-sectional secondary data analysis.

Setting  Nationally representative sample of US children born in 2001.

Participants  Height and weight were measured in 2005 in approximately 8550 children who participated in the Early Childhood Longitudinal Study, Birth Cohort.

Main Exposure  Racial/ethnic group.

Outcome Measure  Prevalence of obesity, defined as body mass index at or above the 95th percentile for age of the sex-specific Centers for Disease Control and Prevention growth charts.

Results  Obesity prevalence among 4-year-old US children (mean age, 52.3 months) was 18.4% (95% confidence interval [CI], 17.1%-19.8%). Obesity prevalence differed by racial/ethnic group (P < .001): American Indian/Native Alaskan, 31.2% (95% CI, 24.6%-37.8%); Hispanic, 22.0% (95% CI, 19.5%-24.5%); non-Hispanic black, 20.8% (95% CI, 17.8%-23.7%); non-Hispanic white, 15.9% (95% CI, 14.3%-17.5%); and Asian, 12.8% (95% CI, 10.0%-15.6%). All pairwise differences in obesity prevalence between racial/ethnic groups were statistically significant after a Bonferroni adjustment (P < .005) except for those between Hispanic and non-Hispanic black children and between non-Hispanic white and Asian children.

Conclusions  Racial/ethnic disparities in obesity are apparent in 4-year-old US children. The highest prevalence is in American Indian/Native Alaskan children, in whom obesity is twice as common as in non-Hispanic white or Asian children.

Author Affiliations: Division of Epidemiology, The Ohio State University College of Public Health, Columbus (Dr Anderson); and Departments of Public Health and Pediatrics, Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania (Dr Whitaker).

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