TY - JOUR
T1 - Understanding childhood obesity in the US
T2 - the NIH environmental influences on child health outcomes (ECHO) program
AU - Tylavsky, Frances A.
AU - Ferrara, Assiamira
AU - Catellier, Diane J.
AU - Oken, Emily
AU - Li, Xiuhong
AU - Law, Andrew
AU - Dabelea, Dana
AU - Rundle, Andrew
AU - Gilbert-Diamond, Diane
AU - Hivert, Marie France
AU - Breton, Carrie V.
AU - Cassidy-Bushrow, Andrea E.
AU - Mueller, Noel T.
AU - Hunt, Kelly J.
AU - Arteaga, S. Sonia
AU - Lombo, Tania
AU - Mahabir, Somdat
AU - Ruden, Doug
AU - Sauder, Katherine
AU - Hedderson, Monique M.
AU - Zhu, Yeyi
AU - Polk, Sarah
AU - Mihalopoulos, Nicole L.
AU - Vos, Miriam
AU - Pyles, Lee
AU - Roary, Mary
AU - Aschner, Judy
AU - Karagas, Margaret R.
AU - Trasande, Leonardo
N1 - Publisher Copyright:
© 2019, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Background: Few resources exist for prospective, longitudinal analysis of the relationships between early life environment and later obesity in large diverse samples of children in the United States (US). In 2016, the National Institutes of Health launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate influences of environmental exposures on child health and development. We describe demographics and overweight and obesity prevalence in ECHO, and ECHO’s potential as a resource for understanding how early life environmental factors affect obesity risk. Methods: In this cross-sectional study of 70 extant US and Puerto Rico cohorts, 2003–2017, we examined age, race/ethnicity, and sex in children with body mass index (BMI) data, including 28,507 full-term post-birth to <2 years and 38,332 aged 2–18 years. Main outcomes included high BMI for age <2 years, and at 2–18 years overweight (BMI 85th to <95th percentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI ≥ 120% of 95th percentile). Results: The study population had diverse race/ethnicity and maternal demographics. Each outcome was more common with increasing age and varied with race/ethnicity. High BMI prevalence (95% CI) was 4.7% (3.5, 6.0) <1 year, and 10.6% (7.4, 13.7) for 1 to <2 years; overweight prevalence increased from 13.9% (12.4, 15.9) at 2–3 years to 19.9% (11.7, 28.2) at 12 to <18 years. ECHO has the statistical power to detect relative risks for ‘high’ BMI ranging from 1.2 to 2.2 for a wide range of exposure prevalences (1–50%) within each age group. Conclusions: ECHO is a powerful resource for understanding influences of chemical, biological, social, natural, and built environments on onset and trajectories of obesity in US children. The large sample size of ECHO cohorts adopting a standardized protocol for new data collection of varied exposures along with longitudinal assessments will allow refined analyses to identify drivers of childhood obesity.
AB - Background: Few resources exist for prospective, longitudinal analysis of the relationships between early life environment and later obesity in large diverse samples of children in the United States (US). In 2016, the National Institutes of Health launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate influences of environmental exposures on child health and development. We describe demographics and overweight and obesity prevalence in ECHO, and ECHO’s potential as a resource for understanding how early life environmental factors affect obesity risk. Methods: In this cross-sectional study of 70 extant US and Puerto Rico cohorts, 2003–2017, we examined age, race/ethnicity, and sex in children with body mass index (BMI) data, including 28,507 full-term post-birth to <2 years and 38,332 aged 2–18 years. Main outcomes included high BMI for age <2 years, and at 2–18 years overweight (BMI 85th to <95th percentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI ≥ 120% of 95th percentile). Results: The study population had diverse race/ethnicity and maternal demographics. Each outcome was more common with increasing age and varied with race/ethnicity. High BMI prevalence (95% CI) was 4.7% (3.5, 6.0) <1 year, and 10.6% (7.4, 13.7) for 1 to <2 years; overweight prevalence increased from 13.9% (12.4, 15.9) at 2–3 years to 19.9% (11.7, 28.2) at 12 to <18 years. ECHO has the statistical power to detect relative risks for ‘high’ BMI ranging from 1.2 to 2.2 for a wide range of exposure prevalences (1–50%) within each age group. Conclusions: ECHO is a powerful resource for understanding influences of chemical, biological, social, natural, and built environments on onset and trajectories of obesity in US children. The large sample size of ECHO cohorts adopting a standardized protocol for new data collection of varied exposures along with longitudinal assessments will allow refined analyses to identify drivers of childhood obesity.
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U2 - 10.1038/s41366-019-0470-5
DO - 10.1038/s41366-019-0470-5
M3 - Article
C2 - 31649277
AN - SCOPUS:85074597364
SN - 0307-0565
VL - 44
SP - 617
EP - 627
JO - International Journal of Obesity
JF - International Journal of Obesity
IS - 3
ER -