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Title: Demographic and socioeconomic correlates of adiposity assessed with dual-energy X-ray absorptiometry in US children and adolescents

Author
item TUAN, NGUYEN - Johns Hopkins School Of Public Health
item BUTTE, NANCY - Children'S Nutrition Research Center (CNRC)
item WANG, YOUFA - Johns Hopkins School Of Public Health

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/15/2012
Publication Date: 11/1/2012
Citation: Tuan, N.T., Butte, N.F., Wang, Y. 2012. Demographic and socioeconomic correlates of adiposity assessed with dual-energy X-ray absorptiometry in US children and adolescents. American Journal of Clinical Nutrition. 96(5):1104-1112.

Interpretive Summary: The relationship between demographic-socioeconomic characteristics and childhood obesity is complex in the US. In this study, we examined the associations between demographic-socioeconomic characteristics and adiposity measured by dual-energy X-ray absorptiometry (DXA) in US children. We found that the prevalence of excess fat was higher in Mexican American (36%) than white (27%) and black (21%) boys; higher in Mexican American (45%) than white (38%) and black (35%) girls; and higher in US-born (42%) than foreign-born (33%; P < 0.05) Mexican Americans. Adiposity was negatively associated with family income in white boys and girls and Mexican American girls. Ethnic/racial differences in adiposity persisted after controlling for other demographic-socioeconomic factors. Importantly, the demographic-socioeconomic factors only account for a small percentage of the variation in adiposity among US children. Therefore, to reduce obesity. browder-population based interventions that target all populations is needed.

Technical Abstract: Associations between demographic-socioeconomic characteristics and childhood obesity are complex in the United States. We examined associations between demographic-socioeconomic characteristics (age, sex, race-ethnicity, family income, household size, and birthplace) and adiposity measured by dual-energy X-ray absorptiometry in US children. Data were from 8-19-y-old US children enrolled in NHANES 2001-2004 (n = 5436). Adiposity was expressed as the fat mass index (FMI = fat mass/height(2); in kg/m(2)), percentage body fat (%BF), and prevalence of normal, overfat, and excess fat corresponding to %BF <25%, 25-29.9%, and =30% in boys and <30%, 30-34.9%, and =35% in girls, respectively. We used sex-specific linear and multinomial logistic regression models adjusted for demographic-socioeconomic factors. The prevalence of excess fat was higher in Mexican American (36%) than in white (28%; P = 0.10) and black (21%; P < 0.05) boys; higher in Mexican American (44%) than in white (36%; P = 0.10) and black (35%; P < 0.05) girls; and higher in US-born (38%) than in foreign-born (29%; P = 0.10) Mexican American boys. In boys, %BF was higher in Mexican Americans and lower in blacks than in whites (P < 0.05). Adiposity was negatively associated with family income in white boys and girls and in Mexican American girls (P < 0.05). Racial-ethnic disparities in adiposity persisted (P < 0.001) after control for demographic-socioeconomic factors available in NHANES. The R(2) for sex-specific models of %BF or FMI regressed on age, race-ethnicity, family income, household size, and birthplace ranged from 2% to 11%. We concluded that the association between demographic-socioeconomic factors and adiposity among US children varied substantially by age, sex, and race-ethnicity.