Adjusting for Pubertal Status Reduces Overweight and Obesity Prevalence in the United States

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Abstract

Objective: To compare pediatric overweight and obesity prevalence among non-Hispanic white, Mexican American, and non-Hispanic black US youths before and after adjusting body mass index (BMI) for pubertal status, as assessed by Tanner stage. Study design: We analyzed cross-sectional anthropometric and pubertal data from non-Hispanic white, Mexican American, and non-Hispanic black youths in the National Health and Nutrition Examination Survey (NHANES) III. We developed specialized Tanner stage and chronological age-adjusted models to establish Tanner-stage adjusted BMI z-scores, which were then used to determine adjusted overweight/obesity prevalence. We compared pediatric overweight/obesity prevalence before and after pubertal status adjustment. Results: Among 3206 youths aged 8-18 years (50% male; 26% non-Hispanic white, 35% Mexican American, 39% non-Hispanic black), adjusting BMI for Tanner stage significantly reduced overweight (males, from 29% to 21%; females, from 29% to 17%) and obesity (males, from 14% to 7%; females, from 11% to 5%) prevalence across all races/ethnicities. The obesity prevalence reduction was more pronounced in Mexican Americans (males, 11% reduction; females, 9% reduction) and non-Hispanic blacks (males and females, 10% reduction) compared with non-Hispanic whites (males, 6% reduction; females, 5% reduction). Similar patterns were seen in overweight prevalence. Conclusions: Adjusting for pubertal status reduced the prevalence of overweight/obesity in non-Hispanic white, Mexican American, and non-Hispanic black youth. This suggests that adjusting for puberty incorporates changes otherwise not captured when only considering the age of a child. Adjusting BMI for pubertal status may be important when interpreting a youth's weight status and consideration for obesity management, as well as when interpreting pediatric overweight/obesity prevalence data.

Original languageEnglish (US)
Pages (from-to)200-206.e1
JournalJournal of Pediatrics
Volume231
DOIs
StatePublished - Apr 2021

Bibliographical note

Funding Information:
E.B. is a site principal investigator for Novo Nordisk. Research reported in this publication was supported by the National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health under Award Number K23DK125668. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. B.M. is a consultant for Abbvie, Ascendis, BioMarin, Bluebird Bio, Endo Pharmaceuticals, Novo Nordisk, Pfizer, Sandoz, Sanofi Genzyme, Tolmar, and Vertice and has received research support from Alexion , Abbvie , Amgen , Ascendis , BioMarin , Novo Nordisk , OPKO , Protalix , Sandoz , Sangamo , Sanofi Genzyme , and Takeda . K.S. receives research support from the Food and Drug Administration , National Cancer Institute , National Science Foundation , Spruce Biosciences , Alexion , and Neurocrine . O.A. declares no conflicts of interest.

Funding Information:
E.B. is a site principal investigator for Novo Nordisk. Research reported in this publication was supported by the National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health under Award Number K23DK125668. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. B.M. is a consultant for Abbvie, Ascendis, BioMarin, Bluebird Bio, Endo Pharmaceuticals, Novo Nordisk, Pfizer, Sandoz, Sanofi Genzyme, Tolmar, and Vertice and has received research support from Alexion, Abbvie, Amgen, Ascendis, BioMarin, Novo Nordisk, OPKO, Protalix, Sandoz, Sangamo, Sanofi Genzyme, and Takeda. K.S. receives research support from the Food and Drug Administration, National Cancer Institute, National Science Foundation, Spruce Biosciences, Alexion, and Neurocrine. O.A. declares no conflicts of interest.

Publisher Copyright:
© 2020 Elsevier Inc.

Keywords

  • body mass index
  • epidemiologic methods
  • ethnic groups
  • growth charts
  • health care surveys
  • pediatric obesity
  • puberty

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