标题：Systematic Review of Prevalence of Young Child Overweight and Obesity in the United States–Affiliated Pacific Region Compared With the 48 Contiguous States: The Children’s Healthy Living Program
摘要：We estimated overweight and obesity (OWOB) prevalence of children in US-Affiliated Pacific jurisdictions (USAP) of the Children’s Healthy Living Program compared with the contiguous United States. We searched peer-reviewed literature and government reports (January 2001–April 2014) for OWOB prevalence of children aged 2 to 8 years in the USAP and found 24 sources. We used 3 articles from National Health and Nutrition Examination Surveys for comparison. Mixed models regressed OWOB prevalence on an age polynomial to compare trends (n = 246 data points). In the USAP, OWOB prevalence estimates increased with age, from 21% at age 2 years to 39% at age 8 years, increasing markedly at age 5 years; the proportion obese increased from 10% at age 2 years to 23% at age 8 years. The highest prevalence was in American Samoa and Guam. There are few data on overweight and obesity (OWOB) of children in the US-Affiliated Pacific Islands, Hawaii, and Alaska, collectively referred to as the US-Affiliated Pacific region (USAP) in this article (Figure A, available as a supplement to the online version of this article at http://www.ajph.org ). The USAP has not been included in the National Health and Nutrition Examination Survey (NHANES) or other national surveillance systems with measured anthropometric data. 1,2 Native ethnic populations (Native Hawaiians, Pacific Islanders, Alaska Natives) of the USAP have not been reported on in national surveillance, 3 yet Native Hawaiians and other Pacific Islanders constitute 1.2 million people (0.4% of the total US population) and have increased 40% in the past decade, 4 and Native Alaskans constitute another quarter million people. 5 The USAP has political ties to the United States (Table A, available as a supplement to the online version of this article at http://www.ajph.org ). 4 The high prevalence of obesity and noncommunicable diseases in USAP adult populations 6 and consequent state of emergency declared 7 underpins the urgency of obesity prevention, starting with children. The mean OWOB prevalence for children aged 5 to 8 years in Hawaii was 33% (13% overweight and 20% obese) and the risk for OWOB varied by ethnicity, from 2-fold in Asians to 17-fold in Samoans, compared with Whites. 8,9 Data from the Commonwealth of the Northern Mariana Islands (CNMI) showed similar OWOB prevalence. 10 Aggregating prevalence estimates for the region and by jurisdiction will allow programs to target their activities and policies. The purpose of this article is to (1) estimate prevalence of OWOB of children aged 2 to 8 years living in the USAP and (2) determine how that prevalence compares with children aged 2 to 8 years living in the 48 contiguous states.
