by Marion Nestle
Feb 26 2014

Is obesity really leveling off? Yes, and falling in kids ages 2 to 5!

The biggest story—front page, right column—in the New York Times today is CDC’s report of a 43% drop in obesity among children ages 2 to 5 in the last decade.

  • 2003-2004: 14%
  • 2011-2012:   8%

A change this large is highly unusual.

The data come from a report in JAMA which found no change in overall obesity prevalence in that decade among infants and toddlers, youth ages 2 to 19, or adults.  When looking at the data for subgroups, however, the authors found two exceptions:

  • The big decline in obesity among children ages 2 to 5
  • A big increase in obesity among women ages 60 and older (oops)

What to make of this?

The decline in obesity among young children is consistent with previous reports, although these showed a smaller change.

To examine what the data show, it helps to look at an illustration.  The JAMA paper does not provide one, but a reporter sent me this:

Screenshot 2014-02-26 08.17.27

The lower curve is for children ages 2 to 5.  It shows a sharp uptick in 2003-2004 (what was that about?), followed by a decline in 2007-2008.  The new data extend the decline a little further.

Any decline in the rising prevalence of obesity is cause for celebration.  So is the no change in a decade among almost everyone else.

The reasons?  I can only speculate but the “eat less junk food and move more” message must be getting out.

Comments

  • JRTsFurever
  • February 26, 2014
  • 12:43 pm

May I comment on the increase in obesity in the 60+ female population? In my personal opinion this is because the unemployment rate in over-50 Americans tags along with the age (and in the 60 and over, therefore, the unemployment rate is over 60%). Where there is little or no income there is little or no appropriate nutrition. I’m in Oregon; older Oregonians relying upon SNAP to stave off food insecurity is also a dwindling resource as food costs in Oregon (despite its strong agriculture base) are astronomical for a variety of reasons so that even drawing the full SNAP benefit provides far less than a month’s even meager supply of food. Additionally, the mis-named “food banks” in Oregon provide an endless array of assorted canned and dried beans, dried pasta, rice – and of all inappropriate things, candy from foreign sources (view the packages, scary!!). Seldom fresh or frozen vegetables or fruit, nonexistent dairy or eggs, and virtually never any meat-type proteins. So visiting Oregon food pantries is an exercise in nutritional futility. While I personally am very lucky at 62 to have even part-time no-benefit very low paying series of temp jobs I can definitely tell there is an impact on my health including the incredible struggle to maintain a healthy weight. When there is little or no income, one eats what one can afford and too often the highly preferred fruits and vegetables and lean proteins are simply inaccessible.

  • Barbara Schibly MD
  • February 26, 2014
  • 7:42 pm

Well, poverty is a well known cause of obesity and poor health although we don’t often think of this in the over 60 population. The problem is that bad foods – like corn and wheat – are cheap because they are subsidized while good foods like meat and vegetables are expensive because they are not subsidized. But you may not be totally helpless. If you have even a little land or places where you can place or hang containers you may be able to grow some of your own vegetables. Some communities also have land set aside for people to use this way. And seek out hunters and fishermen in your area – perhaps you have some service you could exchange with them for some of the meat or fish they bring home.

  • valerie
  • February 26, 2014
  • 7:50 pm

I have yet to see a definition of childhood obesity that makes sense.

Usually, they say that children above the 95th percentile for the BMI-adjusted-for-age are classified as obsese. That would mean, by the very definition of percentiles, that exactly 5% of children are obsese. All the time. In any circumstances. During a famine, you still have exactly 5% of people above the 95th percentile. If everyone got enormously fat, you would still have exactly 5% of people above the 95th percentile. That is what percentiles mean.

Obviously, they must be using some sort of standard tables for their BMI-adjusted-for-age. But I never saw an explanation of where those references come from, if they are updated sometimes or not, if they are specific to some population, etc. For all I know, statistics might change only because the definition changes (the reference table is updated with more recent data, for example).

I find it weird that no one seems to ever raise that question.

  • JRTsFurever
  • February 27, 2014
  • 12:16 pm

I would have no idea whatsoever how to “seek out hunters and fishermen” in my area. Dr. Schibly with all due respect – this seems to be the typical easterner’s idea of Oregon. Years ago on a business trip to NYC I was actually asked (spoiler: non-pc comment follows here!) if we were “still fighting the indians out on Ory-gun”. I am a vegetarian (with egg and fish ok) with zero interest in eating Bambi and even if I WAS I would have no idea whatsoever how to meet and greet the gun zealots. As far as fishing and no I cannot afford to buy fishing gear nor do I have transportation to get to fishing holes, yes, there are “fishermen” who are local. And the prices are in a word astronomical. Halibut at over $20 per pound. I cannot eat shellfish. Salmon at most recent viewing was $15.99 per pound. At the local farmers markets during the season, approx tax time to Halloween, there is usually a booth or maybe two run by “fishermen” bringing some items in from the coast which is hours away – Coos Bay is the closest real fisherfolk harbor and is 4+ hours by car, not that I can afford the gas to drive down there. Their costs top $10 per pound and UP from there. In short, again with all due respect, I am sure as an MD you have never experienced food insecurity at least in recent times. Poverty/food issues cannot be circumvented as easily as you seem to believe. And not everyone has any space to grow their own especially if they rent and the landlord is definitely not friendly, and even the community plots springing up here and there aren’t always accessible especially for the older population. I am lucky to have what little income I have and I use it very wisely – my mother grew up in the great depression and trained me well. I shudder to think of what others in my situation are going through without the resources I myself am lucky to have.

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