TABLE 1—
Sources of Overweight, Obesity, or Both With Prevalence (%) Data Used in the Meta-analysis for the US-Affiliated Pacific Region and the 48 Contiguous United States, in Literature Published January 2001–April 2014
| Author | Region | Age, y | Sexa | No. of children | Racial/Ethnic Group(s) | Study Source and Cohort (Year of Data Collection) | Sampling Frame | Ref. Cutoff, CDC Criteriab | Age Group, % |
| Peer-reviewed literature (n = 10c) | |||||||||
| Bruss et al.10 | CNMI | 8–9 | Both sexes | 407 | Pacific Islander (Chamorro, Carolinian, Micronesian), Asian | Project Familia Giya Marianas—Children from 12 public schools in the CNMI (2005) | Caregivers from 12 public schools were invited to participate | ≥ 85th percentile | 47 |
| ≥ 95th percentile | 32 | ||||||||
| Paulino et al.18 | CNMI | 1–10 | Both sexes | 393 | Pacific Islander (Chamorro, Carolinian), mixed or other, Asian | Children randomly selected from 16 villages on Rota, Saipan, and Tinian (2005) | Random cluster survey sampling proportionate to 2000 US Census population estimate | ≥ 85th percentile | 2–3 y = 25 |
| 4–6 y = 26 | |||||||||
| 7–10 y = 45 | |||||||||
| 85th–94th percentile | 2–3 y = 12 | ||||||||
| 2–3 y = 83 | 4–6 y = 13 | ||||||||
| 4–6 y = 127 | 7–10 y = 18 | ||||||||
| 7–10 y = 136 | ≥ 95th percentile | 2–3 y = 13 | |||||||
| 2–10 y = 346 | 4–6 y = 13 | ||||||||
| 7–10 y = 27 | |||||||||
| ≥ 85th percentile | 34 | ||||||||
| 85th–94th percentile | 15 | ||||||||
| ≥ 95th percentile | 19 | ||||||||
| Novotny et al.19 | Hawaii | 2–10 | Both sexes | 554 | Native Hawaiian, Pacific Islander, Asian, White, other | Children who accessed one of the health maintenance organization’s (Kaiser Permanente’s) 10 Oahu clinics for a physical examination (2003) | Stratified random sample | 85th–94th percentile | 13 (all) |
| 15 males, 10 females | |||||||||
| 2–3 y = 10 | |||||||||
| 4–5 y = 14 | |||||||||
| 6–10 y = 13 | |||||||||
| Native Hawaiian = 11 | |||||||||
| Pacific Islander = 18 | |||||||||
| Filipino = 11 | |||||||||
| ≥ 95th percentile | 19 (all) | ||||||||
| 22 males, 15 females | |||||||||
| 2–3 y = 7 | |||||||||
| 4–5 y = 20 | |||||||||
| 6–10 y = 29 | |||||||||
| Native Hawaiian = 19 | |||||||||
| Pacific Islander = 40 | |||||||||
| Filipino = 19 | |||||||||
| Baruffi et al.8 | Hawaii | 2–4 | Both sexes | 12 709 | Asian, Black, White, Filipino, Native Hawaiian, Hispanic, Samoan, other | Hawaii WIC (1997–1998) | Data with complete date, age, sex, weight, and height information | ≥ 95th percentile | 2–4 y = 11.4 |
| Native Hawaiian = 11.3 | |||||||||
| Samoan = 27 | |||||||||
| Filipino = 12.4 | |||||||||
| Pobutsky et al.20 | Hawaii | 4–6 | Both sexes | 10 199 | Multiple racial/ethnic groups (children who entered kindergarten in the Hawaii public school system) | Public elementary schools (2002–2003) | All student health records with complete age, sex, weight, and height information and plausible anthropometric values | ≥ 85th percentile | 28.5 |
| 85th–94th percentile | 14.1 | ||||||||
| ≥ 95th percentile | 14.4 | ||||||||
| Novotny et al.9 | Hawaii | 5–8 | Both sexes | 4608 (with ethnic information) | White, Asian, Filipino, Native Hawaiian, Native Hawaiian-Asian, Samoan, other mixed, other | Health maintenance organization (Kaiser Permanente; 2010) | Cross-sectional study design of electronic medical record data with complete weight and height information | ≥ 85th percentile | 32.6 (with ethnic information) |
| 29.4 (with and without ethnic information) | |||||||||
| 85th–94th percentile | 12.9 (with ethnic information) | ||||||||
| ≥ 95th percentile | 19.7 (with ethnic information) | ||||||||
| Chai et al.21 | Hawaii | 6–17 | Males only and females only | 1437 | Native Hawaiian, Asian, Filipino, Portuguese, White, other | Public school students in a Hawaii district with a higher population of residents of Native Hawaiian ancestry (1992–1996) | Five years of semilongitudinal data from a cohort of students in grades 1–12 | ≥ 95th percentile | males = Native Hawaiian (6–11 y), 29.3 |
| females = Native Hawaiian (6–11 y), 23.7 | |||||||||
| both = Native Hawaiian (6–11 y), 26.5 | |||||||||
| males = non-Native Hawaiian (6–11 y), 25.1 | |||||||||
| females = non-Native Hawaiian (6–11 y), 16.3 | |||||||||
| both = non-Native Hawaiian (6–11 y), 20.7 | |||||||||
| Okihiro et al.22 | Hawaii | 4–5 | Both sexes | 389 | Native Hawaiian, Samoan, Filipino | Children from 2 rural and impoverished communities who utilized Hawaii’s largest federally qualified CHC | Retrospective study of children: (1) Native Hawaiian, Samoan or Filipino; (2) lived in the CHC zip code; (3) born during 1 of 4 periods: 1981–1983, 1986–1988, 1991–1993, and 1996–1998; (4) attended the CHC for their well-child care; and (5) had a prekindergarten physical examination at the CHC | ≥ 95th percentile | 22.7 |
| 85th–94th percentile | 20.1 | ||||||||
| ≥ 85th percentile | 42.8 | ||||||||
| Manea23 | Hawaii | 4–5 | Both sexes | 586 | Unspecified | Kauai public elementary school 1st graders (2003) | Student health records of all Kauai children enrolled in the first grade during the period from August to December | ≥ 85th percentile | 4 y = 41.6 males, 27.9 females |
| 5 y = 38.8 males, 37.3 females | |||||||||
| 4 y = 316 (144 males, 172 females) | 4–5 y = 36 | ||||||||
| 85th–94th percentile | 4 y = 19.4 males, 8.7 females | ||||||||
| 5 y = 270 (144 males, 126 females) | 5 y = 15.9 males, 15.1 females | ||||||||
| 4–5 y = 14.5 | |||||||||
| ≥ 95th percentile | 4 y = 22.2 males, 19.2 females | ||||||||
| 5 y = 22.9 males, 22.2 females | |||||||||
| 4–5 y = 21.5 | |||||||||
| Ichiho et al.24 | Federated States of Micronesia, Yap | 2–14 | Both sexes | 1948 | Unspecified | Yap State Cancer Prevention and Control Program—Outer Island Household Survey (2008–2009) | Household survey | 85th–94th percentile | 15.6 |
| ≥ 85th percentile | 33.8 | ||||||||
| ≥ 95th percentile | 18.2 | ||||||||
| Agency literature (n = 14) | |||||||||
| Boles et al.25 | Alaska | 3–19 | Both sexes | 5902 | White, Alaska Native/American Indian, Asian, Black/African American, Pacific Islander/Native Hawaiian, Hispanic/Latino, mixed | Kenai Peninsula Borough school district (2011) | All student records with valid height and weight measures from the electronic student information system | ≥ 85th percentile | 3–6 y = 32.9 |
| 7–10 y = 34.2 | |||||||||
| 85th–94th percentile | 3–6 y = 19.7 | ||||||||
| 7–10 y = 17.8 | |||||||||
| ≥ 95th percentile | 3–6 y = 13.1 | ||||||||
| 7–10 y = 16.4 | |||||||||
| Alaska Special Supplemental Nutrition Program for Women, Infants, and Children26 | Alaska | 2–5 | Both sexes | 16 525 (2012) | Unspecified | Alaska WIC (2005–2012) | Data with complete age, sex, weight, and height information | ≥ 85th percentile | 22 (2012) |
| 16 192 (2011) | |||||||||
| 21.42 (2011) | |||||||||
| 17 273 (2010) | 21.52 (2010) | ||||||||
| 16 462 (2009) | 21.69 (2009) | ||||||||
| 15 662 (2008) | 21.54 (2008) | ||||||||
| 15 579 (2007) | 21.60 (2007) | ||||||||
| 15 667 (2006) | 21.7 (2006) | ||||||||
| 17 128 (2005) | 22.1 (2005) | ||||||||
| Eberling27 | Alaska | 5–8 | Males only, females only, and both sexes | 650 (334 males, 316 females) | White, American Indian/Alaska Native, Black/African American, Hispanic/Latino, Asian, Native Hawaiian/ Pacific Islander, mixed, unknown | Representative sample of kindergarten students at selected elementary schools (2010–2011) | A consent form and questionnaire was sent home to parents and guardians | ≥ 85th percentile | 35 both, 37 males, 32 females |
| 85th-94th percentile | 19 both, 20 males, 17 females | ||||||||
| ≥ 95th percentile | 16 both, 17 males, 15 females | ||||||||
| Vargo28 | American Samoa | 4–20 | Males only and females only | 5390 | Unspecified | A sample of public and private school children attending grades K, 3, 6, 9, and 12 (2006–2007) | School-based measurement | ≥ 85th percentile | males = 46 (kindergarten) |
| K–5: 1015 (524 males, 491 females) | |||||||||
| males = 46 (3rd grade) | |||||||||
| females = 42 (kindergarten) | |||||||||
| females = 45 (3rd grade) | |||||||||
| 85th–94th percentile | males = 21.4 (kindergarten) | ||||||||
| 3rd grade: 1189 (615 males, 574 females) | males = 17.4 (3rd grade) | ||||||||
| females = 21.4 (kindergarten) | |||||||||
| females = 17.8 (3rd grade) | |||||||||
| ≥ 95th percentile | males = 25.4 (kindergarten) | ||||||||
| males = 29.4 (3rd grade) | |||||||||
| females = 20.8 (kindergarten) | |||||||||
| females = 27.4 (3rd grade) | |||||||||
| Vargo29 | American Samoa | 5–18 | Males only and females only | 4214 | Unspecified | Students in grades K through 12 at public and private schools (2007–2008) | School-based measurement | ≥ 85th percentile | 5 y = 36.05 males, 41.4 females |
| 5 y = 213 (114 males, 99 females) | |||||||||
| 6 y = 38.4 males, 34.9 females | |||||||||
| 7 y = 51.1 males, 47.6 females | |||||||||
| 8 y = 50 males, 39 females | |||||||||
| 9 y = 42 males, 51.4 females | |||||||||
| 10 y = 54.2 males, 54.7 females | |||||||||
| 6 y = 264 (138 males, 126 females) | 85th–94th percentile | 5 y = 21.1 males, 18.2 females | |||||||
| 6 y = 18.1 males, 22.2 females | |||||||||
| 7 y = 18.5 males, 14.8 females | |||||||||
| 8 y = 19.1 males, 15.8 females | |||||||||
| 9 y = 16.2 males, 15.5 females | |||||||||
| 10 y = 16.1 males, 25.0 females | |||||||||
| 7 y = 263 (135 males, 128 females) | |||||||||
| 8 y = 256 (136 males, 120 females) | ≥ 95th percentile | 34.4 males, 36.3 females | |||||||
| 5 y = 14.9 males, 23.2 females | |||||||||
| 6 y = 20.3 males, 12.7 females | |||||||||
| 7 y = 32.6 males, 32.8 females | |||||||||
| 8 y = 30.9 males, 23.4 females | |||||||||
| 9 y = 26.1 males, 35.9 females | |||||||||
| 10 y = 38.1 males, 29.7 females | |||||||||
| 9 y = 284 (142 males, 142 females) | |||||||||
| 10 y = 246 (118 males, 128 females) | |||||||||
| Vargo30 | American Samoa | 2–20 | Males only and females only | 3478 | Unspecified | Students in grades 2, 5, and 8 from each of the 23 public elementary schools and juniors from each of the 6 public high schools (2008–2009) | School-based measurement | ≥ 85th percentile | 20 males, 23.5 females |
| 6–11 y = 47.7 males, 46.8 females (2008–2009) | |||||||||
| 48.5 males, 47.4 females (2007–2008) | |||||||||
| 52.4 males, 50.1 females (2006–2007) | |||||||||
| ≥ 95th percentile | 33.6 males, 34.3 females | ||||||||
| 6–11 y = 29.2 males, 25.1 females (2008–2009) | |||||||||
| 30.2 males, 27.8 females (2007–2008) | |||||||||
| 33.5 males, 31.3 females (2006–2007) | |||||||||
| American Samoa Maternal and Child Health Program31 | American Samoa | 2–5 | Both sexes | 4225 | Unspecified | American Samoa WIC (2009) | Data with complete date, age, sex, weight, and height information | ≥ 85th percentile | 33.7 |
| 85th–94th percentile | 19.1 | ||||||||
| ≥ 95th percentile | 14.6 | ||||||||
| American Samoa Maternal and Child Health Program31 | American Samoa | 2–4 | Both sexes | 576 | Unspecified | Tafuna Health Center and Leone Health Center (2010) | Data with complete date, age, sex, weight, and height information | ≥ 85th percentile | 35.1 |
| 85th–94th percentile | 19.1 | ||||||||
| ≥ 95th percentile | 16 | ||||||||
| Federated States of Micronesia Maternal and Child Health Program32 | Federated States of Micronesia | 2–5 | Both sexes | 800 (Chk) | Unspecified | Maternal and Child Health data collection in Chuuk, Kosrae, Pohnpei, and Yap (2010) | School-based measurement | ≥ 85th percentile | 3 (Chuuk) |
| 812 (Kos) | |||||||||
| 2.5 (Kosrae) | |||||||||
| 580 (Poh) | 1.5 (Pohnpei) | ||||||||
| 205 (Yap) | 14 (Yap) | ||||||||
| Department of Education33 | Guam | 3–5 | Both sexes | 576 | Unspecified | Guam Headstart Program (2011–2012) | School-based measurement | 85th–94th percentile | 13 |
| ≥ 95th percentile | 14.2 | ||||||||
| Department of Public Health and Social Services34 | Guam | 2–5 | Both sexes | 4410 | Unspecified | Guam WICd (2006–2009) | Data with complete date, age, sex, weight, and height information | ≥ 85th percentile | 52.7 (2009) |
| 4029 | |||||||||
| 34.9 (2008) | |||||||||
| 2653 | 26.8 (2007) | ||||||||
| 3369 | 31.8 (2006) | ||||||||
| Hawaii Special Supplemental Nutrition Program for Women, Infants, and Children35 | Hawaii | 2–5 | Both sexes | 1766 (2010) 1748 (2009) 1531 (2008) | Unspecified | Hilo WICd (2008–2010) | Data with complete date, age, sex, weight, and height information | 85th–94th percentile | 15.7 (2010) |
| 14.9 (2009) | |||||||||
| 15.7 (2008) | |||||||||
| ≥ 95th percentile | 10.6 (2010) | ||||||||
| 11.6 (2009) | |||||||||
| 10.3 (2008) | |||||||||
| Hawaii Special Supplemental Nutrition Program for Women, Infants, and Children35 | Hawaii | 2–5 | Both sexes | 731 (2010) 650 (2009) 650 (2008) | Unspecified | Kona WICd (2008–2010) | Data with complete date, age, sex, weight, and height information | 85th–95th percentile | 13.3 (2010) |
| 13.8 (2009) | |||||||||
| 15.5 (2008) | |||||||||
| ≥ 95th percentile | 10.8 (2010) | ||||||||
| 8.5 (2009) | |||||||||
| 8.8 (2008) | |||||||||
| Centers for Disease Control and Prevention36 | Hawaii | 2–5 | Both sexes | 17 879 | Unspecified | Pediatric Nutrition Surveillance System data (2011) | WIC data with complete date, age, sex, weight, and height information | ≥ 85th percentile | 21.5 |
| 85th–94th percentile | 12.3 | ||||||||
| ≥ 95th percentile | 9.2 | ||||||||
| Reference data (n = 3) | |||||||||
| Ogden et al.11 | Contiguous US | 0–19 | Both sexes | 4111 | White, Hispanic, Black, Mexican American | NHANES 2009–2010 | Cross-sectional analyses of all children and adolescents with measured heights and weights from NHANES | ≥ 85th percentile | 2–5 y = 26.7 |
| 0 to < 2 y = 703; | |||||||||
| 2–5 y = 903; | 6–11 y = 32.6 | ||||||||
| 6–11 y = 1213; | ≥ 95th percentile | 2–5 y = 12.1 | |||||||
| 12–19 y = 1292 | 6–11 y = 18.0 | ||||||||
| Ogden et al.37 | Contiguous US | 0–19 | Both sexes | 4000 | White, Hispanic, Black, Mexican American (beginning in 2007, all Hispanics were oversampled while allowing for a sufficient no. of Mexican Americans) | NHANES 2007–2008 | Cross-sectional analyses of all children and adolescents with measured heights and weights from NHANES | ≥ 85th percentile | 2–5 y = 21.2 |
| 0 to < 2 y = 719 | |||||||||
| 2–5 y = 885 | 6–11 y = 35.5 | ||||||||
| 6–11 y = 1197 | ≥ 95th percentile | 2–5 y = 10.4 | |||||||
| 12–19 y = 1199 | 6–11 y = 19.6 | ||||||||
| Ogden et al.38 | Contiguous US | 2–19 | Both sexes | 8165 | White, Black, Mexican American, and other (in 2005–2006 survey, Mexican Americans were oversampled) | NHANES 2003–2006 | Cross-sectional analyses of all children and adolescents with measured heights and weights from NHANES | ≥ 85th percentile | 2–5 y = 24.4 |
| 2–5 y = 1770 | 6–11 y = 33.3 | ||||||||
| 6–11 y = 2095 | ≥ 95th percentile | 2–5 y = 12.4 | |||||||
| 12–19 y = 4300 | 6–11 y = 17.0 |
Note. CDC = Centers for Disease Control and Prevention; CHC = community health center; Chk = Chuuk; CNMI = Commonwealth of the Northern Mariana Islands; K = kindergarten; Kos = Kosrae; Poh = Pohnpei; NHANES = National Health and Nutrition Examination Survey; US = United States; WIC = Supplemental Nutrition Program for Women, Infants, and Children.
a
Males only, females only, or both sexes combined.
b
85th–95th percentile defined as overweight (previously defined as at risk for overweight), ≥ 95 percentile defined as obese (previously defined as overweight).13