摘要：Objectives. We estimated overweight and obesity in New York City elementary school children. Methods. A multistage cluster sample of New York City public elementary school children was selected. Nurses measured children’s height and weight and used a standard protocol to determine body mass index (BMI). Demographic information was obtained from official school rosters. Overweight and obese were defined as BMI-for-age at or above the 85th and 95th percentiles, respectively. Results. Of 3069 sampled students, 2681 (87%) were measured. The prevalence of overweight was 43% (95% confidence interval [CI] = 39%, 47%), more than half of whom were obese. Overall prevalence of obesity was 24% (95% CI = 21%, 27%), with at least 20% obesity in each grade, including kindergarten. Hispanic children had significantly higher levels (31%; 95% CI = 29%, 34%) than Black (23%; 95% CI = 18%, 28%) or White children (16%; 95% CI = 12%, 20%). Asian children had the lowest level of obesity among all racial/ethnic groups (14.4%, 95% CI = 10.9, 18.7). Conclusions. Obesity among public elementary school children in New York City is an important public health issue. Particularly high levels among Hispanic and Black children mirror national trends and are insufficiently understood. Childhood obesity is a rapidly worsening epidemic in the United States. Findings from the most recent National Health and Nutrition Examination Survey (NHANES) indicate that in 1999–2000, the prevalence of obesity among children aged 6 through 11 years was 15%. 1 This was a dramatic increase from earlier NHANES surveys, which documented prevalence at 5% in 1960 and 11% in 1988–1994. Increases were particularly marked in Mexican American and Black children. In both groups, prevalence increased more than 10 percentage points between 1988–1994 and 1999–2000, compared with an increase of less than 5 percentage points in White children. 1 Findings from the National Longitudinal Survey of Youth on children aged 4 through 12 years found similar trends and disparities in obesity prevalence. 2 Obesity during childhood has important short-term medical consequences, including adverse effects on growth, blood pressure, blood lipids, and glucose metabolism. 3, 4 Other complications include respiratory conditions, such as asthma and obstructive sleep apnea. 5, 6 The long-term medical consequences of childhood obesity are also substantial and include a greater risk of hypertension, diabetes, cardiovascular disease, gall bladder disease, and osteoarthritis in adulthood. 5, 7 Childhood obesity also has been shown to have important short- and long-term psychosocial consequences, such as negative self-image, decreased self-esteem, eating disorders, and lower health-related quality of life. 8, 9 For obese children, the probability that obesity persists into adulthood increases with a child’s age, from 20% among obese 4-year-olds to 80% among obese teenagers. 10 This suggests that a brief yet critical window of opportunity for prevention and intervention exists during childhood if poor health consequences are to be reduced. National surveys provide important information on prevalence and trends for the country, but more tailored information is often needed for smaller regions to allow targeted local evaluation and intervention. New York City is a large, multiethnic metropolitan area, with more than 550 000 public elementary school children. Routine surveillance on the prevalence of childhood obesity and overweight has not been conducted; thus, the magnitude of the problem can be determined only through special studies. In May 2003, the New York City Department of Health and Mental Hygiene (DOHMH) and Department of Education conducted a height and weight survey in New York City public elementary schools, including children from all grades from kindergarten through fifth grade. The objective was to estimate the prevalence of obesity by gender, grade, and race/ethnicity, as well as to ascertain whether a substantial change in prevalence had occurred since the last such survey, conducted in 1996. 11 Findings from that survey identified that 20% of elementary school children surveyed in New York City (third- and sixth-grade students) were obese. Results of the 2003 survey are the subject of this article.
