Complete Indicator Profile of Overweight WIC Children
Definition
The USDA WIC program defines children at risk of overweight as being 2 to 5 years of age and greater than and equal to the 85th and less than the 95th percentile Body Mass Index (BMI) while overweight children are defined as being 2 years to 5 years of age and greater than and equal to the 95th percentile BMI.Numerator
The number of children, ages 2 to 5 years, receiving WIC services with a BMI at or above the 85th percentile.Denominator
The number of children, ages 2 to 5 years, receiving WIC services during the reporting period.Data Interpretation Issues
PedNSS uses existing data from the following public health programs for nutrition surveillance:-Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
-Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program; and
-Title V Maternal and Child Health Program (MCH)
A majority of the data are from the WIC program that serves children up to age 5 years. The PedNSS provides nutrition surveillance reports for the nation defined as "all participating contributors" as well as for each contributor. A contributor may be a state, U.S. territory, or tribal government. Each contributor can receive more specific reports by clinic, county, local agency, region, or metropolitan area (taken from the CDC web site). The data represent actual measurements taken in the local WIC clinics or referral data from the health care provider's office.
Why Is This Important?
Childhood overweight is a serious health problem in the United States, and the prevalence of overweight among preschool children has doubled since the 1970s. There have been significant increases in the prevalence of overweight in children younger than 5 years of age across all ethnic groups.Onset of overweight in childhood accounts for 25% of adult obesity; but overweight that begins before age 8 and persists into adulthood is associated with an even greater degree of adult obesity. Childhood overweight is associated with a variety of adverse consequences, including an increased risk of cardiovascular disease, type 2 diabetes mellitus, asthma, social stigmatization, and low self-esteem.
It was reported that 13% of children participating in the WIC program were overweight (Cole, 2001). According to the National Pediatric Nutrition Surveillance System (PedNSS) 2002 report, 14% of children aged 2 to 5 years enrolled in federally funded maternal and child health programs (survey population consisted of 83% of WIC children) were overweight (Polhamus et al., 2004). In Utah, according to the 2005 PedNSS report, 21.8% of all children ages 2 to 5 years exhibited a BMI at or greater than the 85th percentile. The increasing prevalence of childhood obesity has been especially pervasive among different minority groups. In the 2002 PedNSS report, it was illustrated that the highest rates were among Hispanic (19%) and American Indian children (18%) compared to non-Hispanic White and Black children (12%) (Polhamus et al., 2004). The highest rates in Utah, according to the 2005 PedNSS report, are among the Black, non-Hispanic and American Indian/Alaskan Native populations at 22% and 36%, respectively. This same report indicated that the rate for the non-Hispanic White children was 16.9%.
The rising rates of childhood overweight have also been influenced by maternal obesity. In a study of low-income families participating in the WIC program, children whose mothers were obese during early pregnancy were 2.5 times more likely to be overweight during the preschool years (Whitaker, 2004).
What Is Being Done?
The first step in weight control for most overweight children is not weight loss but rather maintenance of weight or a slowing of the rate of weight gain. Weight goals can be achieved through modest changes in diet and activity. It is important to avoid short term diets and/or physical activity programs that promote rapid weight loss. Also, it's critical for caregivers to model healthy eating and physically active lifestyles while emphasizing the importance of the entire family making positive changes. The Utah WIC Program staffs assist WIC participants in establishing diet behavior goals, starting slowly and monitoring changes as well as progress. Some general diet behavior goals are listed below:-healthy eating habits
-eating three meals per day and choosing healthy, low calorie snacks
-modestly reducing fat in the family's diet (do not restrict fat in the diets of children less than 2 years of age)
-drinking low fat and non fat milk after the age of 2 years
-limiting the consumption of high sugar foods like soda and juice (emphasize moderation)
-being aware of portion sizes, especially of high fat and high sugar foods
-limit the frequency of high calorie fast food meals
-eating a variety of foods by introducing new foods often
-drinking more water
-engaging in physical activities that the entire family enjoys
-reducing the time in front of the TV and computer to no more than 1-2 hours per day
Specifically, the Utah WIC Program has established a Memorandum of Agreement with the Food Stamp Nutrition Education Program (FSNEP) and the Expanded Food and Nutrition Education Program (EFNEP) with Utah State University to refer all WIC children who are at risk of overweight and overweight to the special healthy weight classes offered by FSNEP and EFNEP. These classes include food demonstrations, physical activity, and in-home visits. In addition, all of these WIC children receive core WIC classes on healthy eating, physical activity, and managing weight. The parents receive an educational brochure entitled, "Help Me Be Healthy" and a "Physical Activity Card". These parents, with the assistance of the WIC health professionals, set a goal related to improving nutritional intake and increasing physical activity.
It is extremely important for WIC health professionals to treat these families with sensitivity, compassion, and a conviction that overweight is an important chronic medical condition that can be addressed successfully. All Utah WIC health professional staffs have been trained in multi-ethnic and multi-racial nutrition assessment and counseling strategies. The goal in nutritional counseling provided by Utah WIC health professionals is to help the child achieve recommended rates of growth and development by emphasizing food choices of high nutritional quality while avoiding excessive amounts of calorie rich, non-nutrient dense foods and beverages.
Also, the importance of reducing inactivity by encouraging a decrease in screen time (TV, computer/video games) to less than 1-2 hours per day and an increase in age appropriate physical activity is a major educational priority for parents/caregivers. Suggestions for increasing physical activity include increased outdoor time such as family walking in the neighborhood or local parks.
Finally, in addition to participant centered nutrition assessment and intervention, the Utah WIC Program staffs provide referral resources which can greatly assist families in identifying medical providers and services that may be necessary.
More Information
1. Cole, N. The prevalence of overweight among WIC children. Report No. WIC 01 PCOM. 2001. Alexandria, VA: Food and Nutrition Service, U.S. Department of Agriculture. Available at: http://www.abtassociates.com/reports/ES-overwgt.pdf. Accessed 2/7/06.2. Polhamus B, Dalenius K, Thompson D, Scanlon K, Borland E, Smith B, Grummer-Strawn L. Pediatric Nutrition Surveillance 2002 Report. Atlanta: U.S. Department of Health and Human Service, Center for Disease Control and Prevention, 2004. Available at: http://www.cdc.gov/pednss/pdfs/PedNSS_2002_Summary.pdf
3. Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004 Jul;114(1):e29-36.
4. http://www.cdc.gov/pednss/
5. Centers for Disease Control and Prevention report, Overweight and Obesity: Resource Guide for Nutrition and Physical Activity Interventions to Prevent Obesity and Other Chronic Diseases. Available at: http://www.cdc.gov/nccdphp/dnpa/obesity/resource_guide.htm
Related Indicators
Related IBIS-PH Indicator Profile Links for Relevant Population Characteristics:
Graphical Data Views
Percentage of 2- to 5-year-old WIC Children With a BMI >= 85th Percentile in Utah by Race, 2000-2005
| BrthDef Race/Eth | Year | Percentage of 2- to 5-year-old WIC Children | Note | Denom |
|---|---|---|---|---|
| All Races | 2000 | 28 | ||
| All Races | 2001 | 28.7 | ||
| All Races | 2002 | 29.7 | ||
| All Races | 2003 | 30.4 | ||
| All Races | 2004 | 31 | ||
| All Races | 2005 | 30.8 | ||
| American Indian/Native Alaskan | 2000 | 35.1 | ||
| American Indian/Native Alaskan | 2001 | 37 | ||
| American Indian/Native Alaskan | 2002 | 35.2 | ||
| American Indian/Native Alaskan | 2003 | 31.3 | ||
| American Indian/Native Alaskan | 2004 | 38.6 | ||
| American Indian/Native Alaskan | 2005 | 36 | ||
| Asian/Pacific Islander | 2000 | 20 | ||
| Asian/Pacific Islander | 2001 | 23.3 | ||
| Asian/Pacific Islander | 2002 | 27.9 | ||
| Asian/Pacific Islander | 2003 | 29.4 | ||
| Asian/Pacific Islander | 2004 | 32.6 | ||
| Asian/Pacific Islander | 2005 | 32 | ||
| Black | 2000 | 17.8 | ||
| Black | 2001 | 23.8 | ||
| Black | 2002 | 24.2 | ||
| Black | 2003 | 23.9 | ||
| Black | 2004 | 20.8 | ||
| Black | 2005 | 22 | ||
| Hispanic | 2000 | 23.7 | ||
| Hispanic | 2001 | 25.8 | ||
| Hispanic | 2002 | 28.4 | ||
| Hispanic | 2003 | 27.3 | ||
| Hispanic | 2004 | 27.4 | ||
| Hispanic | 2005 | 28.1 | ||
| White | 2000 | 16.3 | ||
| White | 2001 | 16.6 | ||
| White | 2002 | 17.9 | ||
| White | 2003 | 16.8 | ||
| White | 2004 | 17.1 | ||
| White | 2005 | 16.9 | ||
| Other | 2000 | 17.6 | ||
| Other | 2001 | 21.5 | ||
| Other | 2002 | 23.8 | ||
| Other | 2003 | 24.5 | ||
| Other | 2004 | 21.9 | ||
| Other | 2005 | 19.9 |
Record Count: 49
Data Sources
CDC Pediatric Nutrition Surveillance System (PedNSS); Utah Women, Infants and Children (WIC) Program, Division of Community and Family Health Services, Utah Department of Health;Percentage of 2- to 5-year-old WIC Children With a BMI >= 85th Percentile in Utah Compared to U.S., 2000-2005
| Utah vs. U.S. | Year | Percentage of 2- to 5-year-old WIC Children |
|---|---|---|
| Utah | 2000 | 19.2% |
| Utah | 2001 | 20.4% |
| Utah | 2002 | 22.2% |
| Utah | 2003 | 21.2% |
| Utah | 2004 | 21.6% |
| Utah | 2005 | 21.8% |
| U.S. | 2000 | 28.0% |
| U.S. | 2001 | 28.7% |
| U.S. | 2002 | 29.7% |
| U.S. | 2003 | 30.4% |
| U.S. | 2004 | 31.0% |
| U.S. | 2005 | 30.8% |
Record Count: 12
Data Sources
CDC Pediatric Nutrition Surveillance System (PedNSS);
Page Content Updated On 04/24/08,
Published on 05/07/08
