Childhood asthma and extreme values of body mass index: the Harlem Children's Zone Asthma Initiative.

To examine the association between body mass index (BMI) percentile and asthma in children 2-11 years of age, we performed a cross-sectional analysis of 853 Black and Hispanic children from a community-based sample of 2- to 11-year olds with measured heights and weights screened for asthma by the Harlem Children's Zone Asthma Initiative. Current asthma was defined as parent/guardian-reported diagnosis of asthma and asthma-related symptoms or emergency care in the previous 12 months. Among girls, asthma prevalence increased approximately linearly with increasing body mass index (BMI) percentile, from a low of 12.0% among underweight girls (BMI 95th percentile). After adjusting for age, race/ethnicity, and household smoking, among girls, having asthma was associated with being at risk for overweight (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4-5.0) and being overweight (OR, 2.1; 95% CI, 1.2-3.8) compared to normal weight; among boys, having asthma was associated both with overweight (OR, 2.4; 95% CI, 1.4-4.3) and with underweight (OR, 2.9; 95% CI, 1.1-7.7). Large, prospective studies that include very young children are needed to further explore the observed association between underweight and asthma among boys. Early interventions that concomitantly address asthma and weight gain are needed among pre-school and school-aged children.

Childhood obesity in New York City elementary school students.

OBJECTIVES: We estimated overweight and obesity in New York City elementary school children. METHODS: A multistage cluster sample of New York City public elementary school children was selected. Nurses measured children's height and weight and used a standard protocol to determine body mass index (BMI). Demographic information was obtained from official school rosters. Overweight and obese were defined as BMI-for-age at or above the 85th and 95th percentiles, respectively. RESULTS: Of 3069 sampled students, 2681 (87%) were measured. The prevalence of overweight was 43% (95% confidence interval [CI] = 39%, 47%), more than half of whom were obese. Overall prevalence of obesity was 24% (95% CI = 21%, 27%), with at least 20% obesity in each grade, including kindergarten. Hispanic children had significantly higher levels (31%; 95% CI = 29%, 34%) than Black (23%; 95% CI = 18%, 28%) or White children (16%; 95% CI = 12%, 20%). Asian children had the lowest level of obesity among all racial/ethnic groups (14.4%, 95% CI = 10.9, 18.7). CONCLUSIONS: Obesity among public elementary school children in New York City is an important public health issue. Particularly high levels among Hispanic and Black children mirror national trends and are insufficiently understood.