Prevalence of overweight and obesity in a population of Pacific Island children

Abstract

Background: Native Hawaiian (NH) and other Pacific Island (PI) adults have a high prevalence of obesity and obesity-related illness such as diabetes and cardiovascular disease. There is little data on childhood obesity in NH and PI children. The Wai'anae area on Oahu is an ideal place to study these children since it is home to the largest community of NH. The Wai'anae Coast Comprehensive Health Center (WCCHC) is the largest medical provider to NH. Objective: To determine the prevalence of overweight in a population of NH and PI children who attend a health center in Hawai'i Methods: This was a cross-sectional analysis of height, weight and demographic data obtained from WCCHC clinical electronic database. Participants were children from 1 month to 19 years of age who attended WCCHC from 1998 to 2004. Based on Center for Disease Control 2000 Growth Charts, infants<2 years old (yo) were classified as overweight if weight-for-Iength > 95% for age/sex. Children ~ 2 yo were classified as overweight (BMI-for-age/sex>95%) or "at risk" (BM I-for -age/sex=85-95%). " Results: There were 13,408 participants and 33,547 observations; 62.8% were NH, 10.1% Caucasian, 7.2% Samoan (Sam), 9.7% Filipino (Fil). Overweight status differed markedly among the ethnicities. Sam infants had much higher prevalence of overweight starting from 6-11 months, increasing to 39.3% by 18- 23 months. Overweight prevalence for children ~ 2 yo exceeded NHANES 1999- 2002 in all age groups except Fil teen girls. By 8-9 years almost 50% of children were either "at risk" or overweight. Overweight prevalence between males and females diverged in later teen years as the number of overweight girls dropped. Sam clearly showed the highest prevalence of overweight across all age groups, peaking at 62% in 14-15 yo. Based on mean BMI z-scores, Sam also had the highest degrees of overweight. Fil infants were more likely to be underweight and stunted but older Fil children still had a high overweight prevalence. Conclusions: Overweight prevalence was high from early childhood in this health center population. Sam children clearly showed the highest prevalence and degree of overweight starting from infancy. The cause and consequence of the high prevalence and the dramatic difference between ethnic groups needs further investigation but may include prenatal and early childhood growth as well as cultural, environmental and socio-economic factors. Childhood obesity prevention, and possibly intervention programs, for NH and Sam children should begin in early childhood.