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. 2023 Feb 13;177(4):401–409. doi: 10.1001/jamapediatrics.2022.5828

Table 2. Change in BMI z-Score Following Implementation of the Healthy, Hunger-Free Kids Act of 2010 Overall and in Subgroupsa.

Characteristic Annual change in BMI z score (95% CI)
Preintervention period Postintervention period Postintervention period vs preintervention period
Overall (N = 14 121) 0.004 (−0.002 to 0.010) −0.036 (−0.060 to −0.012) −0.041 (−0.066 to −0.016)
US census region (n = 14 112)
Northeast 0.026 (0.017 to 0.035) 0 (−0.026 to 0.025) −0.026 (−0.051 to 0)
Midwest 0.003 (−0.006 to 0.012) −0.007 (−0.033 to 0.018) −0.010 (−0.036 to 0.016)
South −0.003 (−0.027 to 0.021) 0.006 (−0.023 to −0.035) 0.009 (−0.021 to 0.038)
West −0.037 (−0.056 to −0.018) −0.046 (−0.071 to −0.020) −0.009 (−0.037 to 0.019)
Age group (n = 14 121), y
5-11 −0.0003 (−0.008 to 0.007) −0.034 (−0.059 to −0.010) −0.034 (−0.059 to −0.009)
12-18 0.016 (0.005 to 0.027) −0.029 (−0.055 to −0.003) −0.045 (−0.071 to −0.018)
Sex (n = 14 121)
Female 0.015 (0.007 to 0.023) −0.031 (−0.055 to 0.006) −0.046 (−0.070 to −0.020)
Male −0.005 (−0.013 to 0.003) −0.042 (−0.066 to −0.018) −0.037 (−0.062 to −0.012)
Median annual household income (n = 9565)
<$50 000 0.007 (−0.002 to 0.017) −0.031 (−0.056 to −0.006) −0.038 (−0.063 to −0.013)
≥$50 000 −0.0042 (−0.037 to 0.012) −0.037 (−0.061 to −0.013) −0.041 (−0.066 to −0.016)
Baseline BMI category (n = 14 121)b
Underweight or normal −0.007 (−0.012 to −0.002) −0.010 (−0.026 to 0.006) −0.003 (−0.02 to 0.013)
Overweight or obesity 0.009 (0.004 to 0.014) 0.002 (−0.014 to 0.018) −0.008 (−0.024 to 0.009)

Abbreviation: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared).

a

All models were adjusted for self-reported race, Hispanic ethnicity, cohort group, and maternal educational level. Each subgroup model was also adjusted for the corresponding covariate as a main effect in addition to including the appropriate interaction terms.

b

A BMI of less than 18.5 indicated underweight; 18.5 to less than 25.0, normal weight; 25.0 to less than 30.0, overweight; and 30.0 or more, obesity.