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Cynthia L. Ogden, PhD; Katherine M. Flegal, PhD; Margaret D. Carroll, MS; Clifford L. Johnson, MSPH

JAMA. 2002;288:1728-1732.

ABSTRACT
Context  The prevalence of overweight among children in the United States increased between 1976-1980 and 1988-1994, but estimates for the current decade are unknown.

Objective  To determine the prevalence of overweight in US children using the most recent national data with measured weights and heights and to examine trends in overweight prevalence.

Design, Setting, and Participants  Survey of 4722 children from birth through 19 years of age with weight and height measurements obtained in 1999-2000 as part of the National Health and Nutrition Examination Survey (NHANES), a cross-sectional, stratified, multistage probability sample of the US population.

Main Outcome Measure  Prevalence of overweight among US children by sex, age group, and race/ethnicity. Overweight among those aged 2 through 19 years was defined as at or above the 95th percentile of the sex-specific body mass index (BMI) for age growth charts.

Results  The prevalence of overweight was 15.5% among 12- through 19-year-olds, 15.3% among 6- through 11-year-olds, and 10.4% among 2- through 5-year-olds, compared with 10.5%, 11.3%, and 7.2%, respectively, in 1988-1994 (NHANES III). The prevalence of overweight among non-Hispanic black and Mexican-American adolescents increased more than 10 percentage points between 1988-1994 and 1999-2000.

Conclusion  The prevalence of overweight among children in the United States is continuing to increase, especially among Mexican-American and non-Hispanic black adolescents.

INTRODUCTION

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The prevalence of overweight among children in the United States has been increasing. Between the 1960s and 1988-1994, the prevalence among 6- through 11-year-old children increased from 4% to 11%. During this same period, the prevalence among 12- through 19-year-olds increased from 5% to 11%.¹ Overweight children often become overweight adults,² and overweight in adulthood is a health risk.³ Although childhood overweight may not result in adult health risk,⁴ immediate consequences of overweight in childhood are often psychosocial and also include cardiovascular risk factors such as hypertension, high cholesterol levels, and abnormal glucose tolerance.⁵

This article presents the most recent national estimates of overweight prevalence in US children. It is based on examination data from the 1999-2000 National Health and Nutrition Examination Survey (NHANES).

METHODS

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NHANES is a series of cross-sectional, nationally representative examination surveys conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. Beginning in 1999, NHANES became a continuous survey. The procedures followed to select the sample and conduct the interviews and examinations were similar to those for previous surveys. Two or more years of data are necessary to have adequate sample sizes for subgroup analyses. This report is based on the first 2 years of the continuous NHANES data collection (1999-2000). Previous survey results presented include NHANES III conducted from 1988-1994,⁶ NHANES II conducted from 1976-1980,⁷ NHANES I conducted from 1971-1974⁸; the National Health Examination Survey (NHES) cycle 3 conducted from 1966-1970⁹; and NHES cycle 2 conducted from 1963-1965.¹⁰

NHANES 1999-2000 is a nationally representative cross-sectional survey of the total civilian noninstitutionalized population in the United States. The design was a stratified multistage probability sample based on selection of counties, blocks, households, and persons within households. NHANES 1999-2000 was designed to oversample Mexican Americans, non-Hispanic blacks, and adolescents to improve estimates for these groups.

All surveys included a standardized physical examination with measurement of recumbent length, stature, and weight. Recumbent length was measured in children younger than 4 years and stature in children aged 2 years or older. The NHANES 1999-2000 sample included weight and height measurements for 4722 children and youth from birth through age 19 years.

Overweight prevalence from NHANES 1999-2000 was estimated by age at examination, sex, and race/ethnicity. Race/ethnicity was reported by a member of the household. For the purposes of this analysis, children were categorized as non-Hispanic white, non-Hispanic black, Mexican American, or other. Numbers for racial/ethnic groups in the "other" category were too small for meaningful analysis when considered separately, but these children were included in the totals. Trend estimates based on all the surveys were estimated by age at examination and sex. Trend estimates by race/ethnicity are available only for NHANES III and NHANES 1999-2000 because these were the only surveys with comparable racial/ethnic information.

Overweight Definition

The definition of overweight among children is a statistical definition based on the 2000 Centers for Disease Control and Prevention growth charts for the United States.¹¹ Overweight is defined as at or above the 95th percentile of body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) for age. At risk for overweight is defined as at or above the 85th percentile, but less than the 95th percentile of BMI for age. The BMI-for-age growth charts were developed from 5 of the national data sets used in this analysis (NHES 2 and NHES 3; NHANES I and NHANES II; and NHANES III for children <6 years). The Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services recommended use of the 95th percentile of BMI to classify adolescents as overweight.¹² There are no BMI-for-age references or consistent definitions for overweight for children younger than 2 years. However, nutrition programs such as the Special Supplemental Nutrition Program for Women, Infants and Children have used weight-for-length recommendations to determine overweight and thus program eligibility.^13-14 Consequently, overweight in this age group is defined as at or above the 95th percentile of weight for length.

For adults 20 years or older, the definition of obesity recommended by the National Heart, Lung, and Blood Institute and the World Health Organization is a BMI of 30 or higher.^15-16 We calculated the percentage of 12- through 19-year-old adolescents that met the adult definition of obesity.

Data Analysis

Data were analyzed using SAS (Version 8.02; SAS Institute Inc, Cary, NC) and SUDAAN (Version 8.0; Research Triangle Institute, Research Triangle Park, NC) statistical software programs. All analyses included sample weights that account for the unequal probabilities of selection, oversampling, and nonresponse. The SEs were estimated using the SUDAAN program. The SEs for NHANES 1999-2000 were estimated by means of the delete 1 jackknife method.¹⁷ For NHES and prior NHANES, the Taylor series linearization method was used to estimate SEs. Both methods incorporate the sample weights and account for the complex sample design.

Differences by sex, age group, race/ethnicity, and survey were tested univariately at the .05 significance level using the t statistic. Differences between the 3 most recent surveys only were tested for statistical significance. These 3 surveys were independently designed and independently drawn with no intended overlap. Therefore, in testing differences between surveys, a covariance of zero was assumed. For racial/ethnic differences within age and age differences within race/ethnicity, the Bonferroni method of multiple comparisons was applied. Because there were 3 implied comparisons, the level was .05 divided by 3 (a value of .01667).

RESULTS

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The sample sizes from NHANES 1999-2000 for children by sex, age group, and race/ethnicity are shown in Table 1.

View this table: [in this window] [in a new window] Table 1. Number of Survey Respondents by Sex, Race/Ethnicity, and Age Groups: NHANES 1999-2000*

The prevalence of overweight (BMI for age 95th percentile) was approximately 10% for 2- through 5-year-olds and approximately 15% for 6- through 11-year-olds and 12- through 19-year-olds (Table 2). The prevalence of overweight among males was not significantly different than among females, although among Mexican-American adolescents a trend toward an increase in males was seen (P = .06). Non-Hispanic black and Mexican-American 2- through 5-year-olds had lower prevalences of overweight than did the older age groups (P<.001 and P = .002, respectively). Comparisons between racial/ethnic groups showed that the prevalence of overweight among 12- through 19-year-old non-Hispanic blacks (23.6%) and Mexican Americans (23.4%) was significantly higher than among non-Hispanic whites (12.7%) (P<.001 for both comparisons).

View this table: [in this window] [in a new window] Table 2. Prevalence of Overweight or at Risk for Overweight in Children by Sex, Race/Ethnicity, and Age Group: NHANES 1999-2000*

Among infants from birth through 23 months, 11.4% were overweight (weight for length 95th percentile; Table 3). There were no differences in prevalence between younger boys and girls. However, as with the older children, there were differences between racial/ethnic groups. About 10% of non-Hispanic whites were at or above the 95th percentile, whereas 18.5% of non-Hispanic blacks were at or above the 95th percentile (P = .009). Differences by race/ethnicity within sex were not significant possibly because of the small sample sizes.

View this table: [in this window] [in a new window] Table 3. Prevalence of Overweight by Sex and Race/Ethnicity for Birth Through 23 Months: NHANES 1999-2000*

Table 4 contains the prevalence of overweight for preschool and school-aged children and adolescents from national surveys. The changes between the earlier surveys and NHANES III have been previously published.^{1, 18-19} After no change in the prevalence of overweight between NHANES I and NHANES II, there was an increase between NHANES II and NHANES III. Between NHANES III and NHANES 1999-2000, the increase in overweight prevalence was the same or greater than between NHANES II and NHANES III. Overweight has increased 5 percentage points among 12- through 19-year-olds from 10.5% to 15.5% between NHANES III and NHANES 1999-2000. There was a significant increase in overweight among non-Hispanic black and Mexican-American adolescents. The prevalence (95% confidence interval) of overweight for non-Hispanic black adolescents increased from 13.4% (10.8%-16.0%) to 23.6% (19.4%-27.8%) between 1988-1994 and 1999-2000. For Mexican Americans, the prevalence (95% confidence interval) increased from 13.8% (9.5%-18.1%) to 23.4% (19.3%-27.5%). Figure 1 shows the increase in overweight from NHANES III to NHANES 1999-2000 for adolescents in each racial/ethnic group. Among non-Hispanic black males (P<.001) and females (P = .002), the prevalence increased 10 percentage points. Among Mexican-American males, the prevalence increased 13 percentage points (P<.001). Among all adolescent boys virtually no difference existed between racial/ethnic groups in 1988-1994 (11.6% of non-Hispanic whites, 10.7% of non-Hispanic blacks, and 14.1% of Mexican Americans were overweight), whereas in 1999-2000, 12.8% of non-Hispanic whites, 20.7% of non-Hispanic blacks, and 27.5% of Mexican-American adolescent boys were overweight.

View this table: [in this window] [in a new window] Table 4. Trends in Overweight for Children Birth Through 19 Years by Sex and Age Group*

View larger version (29K): [in this window] [in a new window] Figure. Overweight Prevalence by Race/Ethnicity for Adolescent Boys and Girls Error bars represent SEs.

Analyses based on the adult definition of obesity indicated that 11.2% of 12- through 19-year-olds had a BMI of 30 or higher. Approximately 10% of non-Hispanic white females, 20% of non-Hispanic black females, and 16% of Mexican-American females exceeded the adult definition for obesity. The difference between non-Hispanic white girls and non-Hispanic black girls was significant (P = .003). In 1988-1994, the corresponding prevalences were 7.4%, 13.2%, and 9.2%. The 95th percentile of the BMI for age charts is greater than 30 for males aged 19.5 years or older and females aged 17.5 years or older.

COMMENT

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The prevalence of overweight among US children is continuing to increase. In 1999-2000, more than 15% of 6- through 19-year-olds were overweight and more than 10% of 2- through 5-year-olds were overweight. The increase in the prevalence of overweight between 1988-1994 and 1999-2000 is similar to that seen between 1976-1980 and 1988-1994. The current increase is particularly evident among non-Hispanic black and Mexican-American adolescents. The prevalence in these groups increased more than 10 percentage points between 1988-1994 and 1999-2000. More than 23% of non-Hispanic black and Mexican-American adolescents were overweight in 1999-2000. These results are consistent with data reported from the National Longitudinal Survey of Youth in which 21.5% of black and 21.8% of Hispanic 4- to 12-year-olds were overweight in 1998.²⁰ This study also showed a significant increase in overweight among black, Hispanic, and white children between 1986 and 1998. More recently, self-reported data from the Youth Risk Behavior Surveillance System suggested that 10.5% of high school students were overweight in 2001.²¹ This is considerably less than the 15.5% overweight based on measured weight and height in NHANES 1999-2000.

Overweight is due to an imbalance between dietary intake and energy expenditure, but the exact reason for the imbalance among children is not clear. Although diet and physical activity are difficult to measure, especially in children, poor eating habits are often established during childhood. In 2001, almost 80% of school children did not consume the recommended 5 or more servings of fruits and vegetables per day.²¹ Boys were significantly more likely than girls to have eaten 5 or more servings per day of fruits and vegetables. This was particularly true for black students. In terms of physical activity, only about half of individuals aged 12 to 21 years reported regular participation in vigorous physical activity and one fourth reported no vigorous physical activity in 1996.²² More females than males and more black females than white females reported being inactive. Moreover, the percentage of high school students who were enrolled in physical education classes and who reported being physically active for at least 20 minutes in physical education classes declined from approximately 81% to 70% during the first half of the 1990s.²²

Several disorders have been linked to overweight in childhood. Of particular concern has been a potential increase in type 2 diabetes mellitus related to the increase in overweight among children.²³ Until recently, type 2 diabetes mellitus had rarely been seen in children. Although the prevalence of type 2 diabetes mellitus in adolescents is low (<1%),²⁴ cases are now occurring among many population groups in the United States, especially among ethnic minorities.²⁵ In general, children and adolescents diagnosed as having type 2 diabetes mellitus were overweight, had a family history of type 2 diabetes mellitus, and had signs of insulin resistance. Impaired glucose tolerance has been shown to be highly prevalent among children with severe obesity.²⁶ The increase in type 2 diabetes mellitus has occurred particularly among minority youth in the United States.²⁷ The increase in prevalence of overweight seen in our current analysis also occurred primarily among minority adolescents.

It is not clear what interventions will work most effectively to reduce the high prevalence of overweight among youth. Changes that have contributed to the increase in overweight may relate to increasing food portion sizes, consumption of high-fat, energy-dense fast foods, and an increasingly sedentary lifestyle. These changes will need to be addressed to prevent overweight in childhood.²⁸ Interventions may focus on parental behaviors because parents determine the diet and physical activity practices of their children.²⁹ School-based programs also may help to change diet or reduce sedentary behaviors.³⁰

To address the problem of increasing prevalence of overweight in US children, research will need to focus on reasons for the increase and what interventions will help reduce the prevalence. Overweight is related to dietary intake and physical activity, both of which are influenced by social, economic, and physical environments. Whatever the causes of the increase in overweight among children, overweight among children in the United States is continuing to increase and the increase in prevalence is highest among Mexican-American and non-Hispanic black adolescents.

AUTHOR INFORMATION

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Author Contributions: Study concept and design: Ogden, Flegal.

Acquisition of data: Johnson.

Analysis and interpretation of data: Ogden, Flegal, Carroll, Johnson.

Drafting of the manuscript: Ogden.

Critical revision of the manuscript for important intellectual content: Ogden, Flegal, Carroll, Johnson.

Statistical expertise: Ogden, Flegal, Carroll.

Administrative, technical, or material support: Johnson.

Corresponding Author and Reprints: Cynthia L. Ogden, PhD, Division of Health Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, 6525 Belcrest Rd, Room 900, Hyattsville, MD 20782 (e-mail: cao9{at}cdc.gov).

Author Affiliations: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.

REFERENCES

Jump to Section  • Top  • Introduction  • Methods  • Results  • Comment  • Author information  • References

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Am J Clin Nutr. 1994;59:307-316. FREE FULL TEXT 13. Centers for Disease Control and Prevention. Pediatric Nutrition Surveillance System—United States, 1980-1991. MMWR CDC Surveill Summ. 1992;41:1-24. PUBMED 14. Institute of Medicine. WIC Nutrition Risk Criteria: A Scientific Assessment. Washington, DC: National Academy Press; 1996. 15. NHLBI Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res. 1998;6(suppl 2):51S-209S. 16. WHO Consultation on Obesity. Obesity: Preventing and Managing the Global Epidemic. Geneva, Switzerland: World Health Organization; 2000. WHO Technical Report Series 894. 17. Wolters KM. Introduction to Variance Estimation. New York, NY: Springer-Verlag; 1990. 18. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL. 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Am. J. Clin. Nutr. 2009;89:697S-701S.
ABSTRACT | FULL TEXT  

School Recess and Group Classroom Behavior
Barros et al.
Pediatrics 2009;123:431-436.
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A meta-analysis of leptin reference ranges in the healthy paediatric prepubertal population
Venner et al.
Ann Clin Biochem 2009;46:65-72.
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Age- and Ethnic-Specific Elevation of ALT Among Obese Children at Risk for Nonalcoholic Steatohepatitis (NASH): Implications for Screening
Leung et al.
CLIN PEDIATR 2009;48:50-57.
ABSTRACT  

Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea
Gozal and Kheirandish-Gozal
Pediatrics 2009;123:13-18.
ABSTRACT | FULL TEXT  

Childhood Obesity and Medical Neglect
Varness et al.
Pediatrics 2009;123:399-406.
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Benefits and barriers to medically supervised pediatric weight-management programs
Grimes-Robison and Evans
J Child Health Care 2008;12:329-343.
ABSTRACT  

The Metabolic Syndrome
Cornier et al.
Endocr. Rev. 2008;29:777-822.
ABSTRACT | FULL TEXT  

Variations in Lay Health Theories: Implications for Consumer Health Care Decision Making
Shaw Hughner and Schultz Kleine
Qual Health Res 2008;18:1687-1703.
ABSTRACT  

Impact of Antidepressant Use on Gastric Bypass Surgery Patients' Weight Loss and Health-Related Quality-of-Life Outcomes
Love et al.
Psychosomatics 2008;49:478-486.
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Grandparental and Parental Obesity Influences on Childhood Overweight: Implications for Primary Care Practice
Davis et al.
J Am Board Fam Med 2008;21:549-554.
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Relation of N-terminal pro-brain natriuretic peptide levels and their prognostic power in chronic stable heart failure to obesity status
Frankenstein et al.
Eur Heart J 2008;29:2634-2640.
ABSTRACT | FULL TEXT  

Influence of Race, Ethnicity, and Culture on Childhood Obesity: Implications for Prevention and Treatment: A consensus statement of Shaping America's Health and the Obesity Society
Caprio et al.
Diabetes Care 2008;31:2211-2221.
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Fat Oxidation in Black and White Youth: A Metabolic Phenotype Potentially Predisposing Black Girls to Obesity
Lee and Arslanian
J. Clin. Endocrinol. Metab. 2008;93:4547-4551.
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A National Longitudinal Study of the Association Between Hours of TV Viewing and the Trajectory of BMI Growth Among US Children
Danner
J Pediatr Psychol 2008;33:1100-1107.
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Persistence of Pre-Diabetes in Overweight and Obese Hispanic Children: Association With Progressive Insulin Resistance, Poor {beta}-Cell Function, and Increasing Visceral Fat
Goran et al.
Diabetes 2008;57:3007-3012.
ABSTRACT | FULL TEXT  

Epidemiology of Obesity in the Western Hemisphere
Ford and Mokdad
J. Clin. Endocrinol. Metab. 2008;93:s1-s8.
ABSTRACT | FULL TEXT  

Obesity in Children and Adolescents
Cali and Caprio
J. Clin. Endocrinol. Metab. 2008;93:s31-s36.
ABSTRACT | FULL TEXT  

Obesity-Related Hypertension?: Weighing the Evidence
Kotchen
Hypertension 2008;52:801-802.
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Growth Patterns and Obesity Development in Overweight or Normal-Weight 13-Year-Old Adolescents: The STRIP Study
Lagstrom et al.
Pediatrics 2008;122:e876-e883.
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Association of Breastfeeding Intensity and Bottle-Emptying Behaviors at Early Infancy With Infants' Risk for Excess Weight at Late Infancy
Li et al.
Pediatrics 2008;122:S77-S84.
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Nutrition Therapy in Critically Ill Infants and Children
Skillman and Wischmeyer
JPEN J Parenter Enteral Nutr 2008;32:520-534.
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Early overnutrition impairs insulin signaling in the heart of adult Swiss mice
Martins et al.
J Endocrinol 2008;198:591-598.
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Walking and Bicycling to School: A Review
Sirard and Slater
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:372-396.
ABSTRACT  

Changes in macronutrient intake among HIV-infected children between 1995 and 2004
Sharma et al.
Am. J. Clin. Nutr. 2008;88:384-391.
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Age-Related Differences in Arterial Compliance Are Independent of Body Mass Index
Fjeldstad et al.
ANGIOLOGY 2008;59:454-458.
ABSTRACT  

Maternal Nonstandard Work Schedules and Adolescent Overweight
Miller and Han
AJPH 2008;98:1495-1502.
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Morbidity of Overweight (>=85th Percentile) in the First 2 Years of Life
Shibli et al.
Pediatrics 2008;122:267-272.
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Current Trends in Weight Management: What Advice Do We Give to Patients?
Boucher et al.
Clin. Diabetes 2008;26:115-120.
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Physicians' Perspectives on Increasing the Use of BMI Charts for Young Children
Woolford et al.
CLIN PEDIATR 2008;47:573-577.
ABSTRACT  

Why Young Adults Hold the Key to Assessing the Obesity Epidemic in Children
Lee
Arch Pediatr Adolesc Med 2008;162:682-687.
ABSTRACT | FULL TEXT  

Obesity, Behavioral Lifestyle Factors, and Risk of Acute Coronary Events
Jensen et al.
Circulation 2008;117:3062-3069.
ABSTRACT | FULL TEXT  

Risk factors associated with obesity in children of different racial backgrounds
Urrutia-Rojas et al.
Health Education Journal 2008;67:121-133.
ABSTRACT  

A Validation and Reliability Study of the Physical Activity and Healthy Food Efficacy Scale for Children (PAHFE)
Perry et al.
Health Educ Behav 2008;35:346-360.
ABSTRACT  

The Impact of Child Obesity on Active Parental Consent in School-Based Survey Research on Healthy Eating and Physical Activity
Mellor et al.
Eval Rev 2008;32:298-312.
ABSTRACT  

Association Between 100% Juice Consumption and Nutrient Intake and Weight of Children Aged 2 to 11 Years
Nicklas et al.
Arch Pediatr Adolesc Med 2008;162:557-565.
ABSTRACT | FULL TEXT  

Role of Metformin for Weight Management in Patients Without Type 2 Diabetes
Desilets et al.
The Annals of Pharmacotherapy 2008;42:817-826.
ABSTRACT | FULL TEXT  

High Body Mass Index for Age Among US Children and Adolescents, 2003-2006
Ogden et al.
JAMA 2008;299:2401-2405.
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Romantic Relationships and Eating Regulation: An Investigation of Partners' Attempts to Control Each Others' Eating Behaviors
Markey et al.
J Health Psychol 2008;13:422-432.
ABSTRACT  

Food, Fun and Fitness Internet program for girls: influencing log-on rate
Thompson et al.
Health Educ Res 2008;23:228-237.
ABSTRACT | FULL TEXT  

Barriers to and Facilitators of Walking and Bicycling to School: Formative Results From the Non-Motorized Travel Study
Ahlport et al.
Health Educ Behav 2008;35:221-244.
ABSTRACT  

Short Sleep Duration in Infancy and Risk of Childhood Overweight
Taveras et al.
Arch Pediatr Adolesc Med 2008;162:305-311.
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Secular Trends in the Prevalence of Iron Deficiency Among US Toddlers, 1976-2002
Brotanek et al.
Arch Pediatr Adolesc Med 2008;162:374-381.
ABSTRACT | FULL TEXT  

Self-Management Behaviors, Racial Disparities, and Glycemic Control Among Adolescents With Type 2 Diabetes
Rothman et al.
Pediatrics 2008;121:e912-e919.
ABSTRACT | FULL TEXT  

Determination of Blood Pressure Percentiles in Normal-Weight Children: Some Methodological Issues
Rosner et al.
Am J Epidemiol 2008;167:653-666.
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Successes and Barriers for a Youth Weight-Management Program
Rice et al.
CLIN PEDIATR 2008;47:143-147.
ABSTRACT  

Breastfeeding Helps Explain Racial and Socioeconomic Status Disparities in Adolescent Adiposity
Woo et al.
Pediatrics 2008;121:e458-e465.
ABSTRACT | FULL TEXT  

Epidemiology of Pediatric Obstructive Sleep Apnea
Lumeng and Chervin
Proc Am Thorac Soc 2008;5:242-252.
ABSTRACT | FULL TEXT  

Themed Review: Clinical Interventions to Promote Physical Activity in Youth
Meriwether et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:7-25.
ABSTRACT  

Obesity, Inflammation, and the Potential Application of Pharmaconutrition
Cave et al.
Nutr Clin Pract 2008;23:16-34.
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Ethnic differences in overweight and obesity in early adolescence in the MRC DASH study: the role of adolescent and parental lifestyle
Harding et al.
Int J Epidemiol 2008;37:162-172.
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Three weeks of early-onset exercise prolongs obesity resistance in DIO rats after exercise cessation
Patterson et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2008;294:R290-R301.
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Racial and Ethnic Disparities in Medical and Dental Health, Access to Care, and Use of Services in US Children
Flores and Tomany-Korman
Pediatrics 2008;121:e286-e298.
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