By OPEN MINDS Circle
About 2% of toddlers (children ages 2 to 4) enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have severe obesity in terms of their body mass index (BMI) or their weight and height, compared to growth charts. A child is considered having severe obesity if their sex-specific BMI for their age is 120% or more of the 95th percentile on the Centers for Disease Control and Prevention growth charts, or the child had a BMI of 35 kg/m2 or higher.
During 2020, in 17 states, the prevalence of severe obesity exceeded 2%, and the prevalence was below 2% in 33 states and the District of Columbia. The prevalence was highest in California, where about 2.77% of toddlers enrolled in WIC, and lowest in Montana, at 1.16%.
Between 2010 and 2020, the prevalence of severe obesity among toddlers has fluctuated around 2%. Between 2010 and 2016, it declined from 2.1% in 2010 to 1.8% in 2016. However, between 2016 and 2020, the prevalence increased to 2.0%. The increase between 2016 and 2020 affected all sociodemographic subgroups, except for American Indian/Alaskan Native and non-Hispanic white children.
The prevalence of severe obesity increased the most, and in 2020 was highest, among four-year-olds (3.14%) and among Hispanic children (2.79%). Additional trends included the following:
- Across the decade, more girls than boys had severe obesity, affecting 2.11% of girls and 1.95% of boys in 2020.
- Severe obesity was more common among lower income families, affecting 2.19% of toddlers in families at 50% to 100% of the federal poverty level (FPL); 1.88% of toddlers in families with 100% to less than 150% FPL income, and 1.72% of toddlers in families at 150% or more FPL in 2020.
These findings were reported in “Trends in Severe Obesity Among Children Aged 2 to 4 Years in WIC: 2010 to 2020” by Lixia Zhao, Ph.D.; David S. Freedman, Ph.D.; Heidi M. Blanck, PhD; and Sohyun Park, Ph.D. The researchers analyzed data about children ages 2 to 4 years who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2010 to 2020. The initial population included approximately 17.2 million children aged 2 to 4 years enrolled in WIC from 50 states, the District of Columbia, and five territories. More than 500,000 children were excluded, yielding an analytical sample of approximately 16.6 million. The data was collected in the six WIC Participant and Program Characteristics (WIC-PC) censuses that took place between 2010 and 2020. The researchers noted that of the 47,17 children in this analysis who had a BMI at or above 35 kg/m2, none were below 120% of the 95th percentile.
For more information about the report, contact: Lixia Zhao, Ph.D., Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, Georgia 30341; Email: ynl3@cdc.gov; Website: https://www.cdc.gov/chronicdisease/index.htm
For more information about the commentary, contact: Sarah C. Armstrong, M.D., Professor of Pediatrics, Chief, Division of General Pediatrics and Adolescent Health, Professor in the Department of Family Medicine and Community Health, Professor in Population Health Sciences, Affiliate, Duke Global Health Institute, Member of the Duke, Departments of Pediatrics and Population Health Sciences, Duke University School of Medicine, 3116 North Duke Street, Durham, North Carolina 27704; Email: sarah.c.armstrong@duke.edu; Website: https://pediatrics.duke.edu/profile/sarah-commisso-armstrong