Childhood obesity among head start enrollees in Southeastern Minnesota: Prevalence and risk factors

Background: Up to 32% of US Head Start enrollees in inner-city settings have been reported to be obese. However, little is known about the prevalence of overweight and associated risk factors in Head Start enrollees in non-inner-city settings. Objectives: To determine the prevalence of childhood obesity from 1998 to 2001 and associated risk factors for overweight among Head Start enrollees in southeast Minnesota. Methods: The study was designed as a cross-sectional study. Subjects were 788 children ages three to five years who were enrolled in Head Start of Olmsted and Freeborn Counties, Minnesota, between 1998 and 2001. Anthropometric data and other sociodemographic variables were collected. The Centers for Disease Control and Prevention (CDC) classification for body mass index (BMI) was used (ie, overweight is >95th percentile BMI for age). Data were fit to a logistic regression model to identify risk factors associated with overweight. Results: From 1998 to 2001, the overall prevalence of overweight and at risk for overweight was 12.9% and 12.2%, respectively. The prevalence of overweight from 1998 to 2001 remained steady, but the prevalence of at risk doubled from 8.2% in 1998 to 16.1% in 2001. On the basis of BMI at the time of enrollment in Head Start, Mexican origin (OR=2.76; P=.002) and speaking English as a second language (ESL) at home (OR=1.75; P=.026) were independent predictors for overweight. Conclusions: The Head Start setting in a non-urban area does not confer any more or less risk for overweight for enrollees, compared to those in urban settings. Children within a certain ethnic group (eg, Mexican) and those who speak English as a second language at home have a higher risk of being overweight. Specific early interventions for these children in a Head Start setting are warranted.