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The newspaper of The Johns Hopkins University May 30, 2006 | Vol. 35 No. 36
Poor Adolescents More Likely to Be Overweight Than 30 Years Ago

By Kenna Lowe
School of Public Health

The percentage of adolescents aged 15 to 17 who are overweight today is about 50 percent higher in families below the poverty line in comparison to those at or above it. That difference was not present in the 1970s and 1980s, according to researchers from the Johns Hopkins Bloomberg School of Public Health and other institutions.

The scientists based their analysis on U.S. national health surveys spanning 33 years. Adolescents aged 15 to 17 who were in families with an income below the poverty line were more likely to have higher caloric intake from sweetened beverages, to be physically inactive and to skip breakfast. Each of these factors may have played a role in the growing difference in the percentage of overweight teens associated with family poverty. This trend was specific to adolescents aged 15 to 17 and was not found among adolescents aged 12 to 14. The study is published in the May 24/31 issue of the Journal of the American Medical Association.

"The prevalence of overweight adolescents in the United States has more than doubled in the past three decades. And the percentage of adolescents who are overweight has increased significantly faster among the poor in comparison to the nonpoor over the past decade," said Richard A. Miech, lead author of the study and an associate professor in the Bloomberg School's Department of Mental Health.

The study authors analyzed four U.S. National Health and Nutrition Examination Surveys: 1971-1974, 1976-1980, 1988-1994 and 1999-2004. Children with a body mass index at or above the 95th percentile for their age and sex in the 2000 Centers for Disease Control and Prevention growth charts were classified as overweight. The authors found that 15-to-17-year-old adolescents with higher daily intake of calories from sweetened beverages were significantly more likely to be overweight. In addition, among high school adolescents, the percentage of daily calories from drinking sweetened beverages has increased by more than 20 percent over the past decade (from 10.7 percent to 13.2 percent). Sweetened beverage consumption also increased at a faster rate among poor vs. nonpoor adolescents (67 percent vs. 14 percent). Today, high school adolescents who live below the poverty line are more likely to be physically inactive and are also more likely to skip breakfast — two behaviors associated with excessive weight gain. The researchers did not see this same trend in adolescents aged 12 to 14; in this age range, however, nonpoor black adolescents were more likely to be overweight than their poor counterparts.

The researchers note that as more and more adolescents gain excessive weight, the associated consequences — type 2 diabetes, hypertension, sleep apnea, poor quality of life and morbidity in adulthood — will also increase.

"I believe that the trend in poverty and adolescent obesity can be reversed if there is sustained public will to do so. While there is no silver bullet that will end this trend or the obesity epidemic in general, we know many of the major factors involved, and we are beginning to do something about them," Miech said. "The recent, voluntary withdrawal of soft drinks from schools is a good step. We need to further develop and implement additional programs to improve adolescent nutrition and physical exercise, especially among the poor."

Study authors include Miech, Shiriki K. Kumanyika, Nicolas Stettler, Bruce G. Link, Jo C. Phelan and Virginia W. Chang.

The authors were supported by grants from the National Institutes of Health, the National Center for Minority Health and Health Disparities and the Robert Wood Johnson Foundation Health Policy Investigator Award.


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