Bekelman, Traci A; Dabelea, Dana; Ganiban, Jody M; Law, Andrew; Reilly, Alexandra McGovern; Althoff, Keri N; Mueller, Noel; Camargo, Carlos A; Duarte, Cristiane S; Dunlop, Anne L; Elliott, Amy J; Ferrara, Assiamira; Gold, Diane R; Hertz‐Picciotto, Irva; Hartert, Tina; Hipwell, Alison E; Huddleston, Kathi; Johnson, Christine C; Karagas, Margaret R; Karr, Catherine J; Hershey, Gurjit K Khurana; Leve, Leslie; Mahabir, Somdat; McEvoy, Cindy T; Neiderhiser, Jenae; Oken, Emily; Rundle, Andrew; Sathyanarayana, Sheela; Turley, Christine; Tylavsky, Frances A; Watson, Sara E; Wright, Rosalind; Zhang, Mingyu; Zoratti, Edward; Outcomes, program collaborators for Environmental influences on Child Health

doi:10.1002/oby.23235

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Regional and sociodemographic differences in average BMI among US children in the ECHO program

Published Web Location

https://doi.org/10.1002/oby.23235

Abstract

Objective

The aim of this study was to describe the association of individual-level characteristics (sex, race/ethnicity, birth weight, maternal education) with child BMI within each US Census region and variation in child BMI by region.

Methods

This study used pooled data from 25 prospective cohort studies. Region of residence (Northeast, Midwest, South, West) was based on residential zip codes. Age- and sex-specific BMI z scores were the outcome.

Results

The final sample included 14,313 children with 85,428 BMI measurements, 49% female and 51% non-Hispanic White. Males had a lower average BMI z score compared with females in the Midwest (β = -0.12, 95% CI: -0.19 to -0.05) and West (β = -0.12, 95% CI: -0.20 to -0.04). Compared with non-Hispanic White children, BMI z score was generally higher among children who were Hispanic and Black but not across all regions. Compared with the Northeast, average BMI z score was significantly higher in the Midwest (β = 0.09, 95% CI: 0.05 to 0.14) and lower in the South (β = -0.12, 95% CI: -0.16 to -0.08) and West (β = -0.14, 95% CI: -0.19 to -0.09) after adjustment for age, sex, race/ethnicity, and birth weight.

Conclusions

Region of residence was associated with child BMI z scores, even after adjustment for sociodemographic characteristics. Understanding regional influences can inform targeted efforts to mitigate BMI-related disparities among children.

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