School-Based Screening for Overweight, Central Adiposity and Hypertension: Evidence of a Growing Epidemic

Thursday, 10 July 2008: 3:35 PM
Janet C. Meininger, PhD, RN, FAAN , School of Nursing, University of Texas Health Science Center, Houston, TX
Christine A. Brosnan, DrPH, RN , School of Nursing, University of Texas Health Science Center, Houston, TX
Mona A. Eissa, PhD, MD , Medical School, University of Texas Health Science Center, Houston, TX
Thong Q. Nguyen, MS , School of Nursing, University of Texas Health Science Center, Houston, TX
Melinda Phillips, BSN, RN , Director of Health Services, Aldine Independent School District, Houston, TX
Lisa R. Reyes, PhD, RN, FNP , School of Nursing, University of Texas Health Science Center, Houston, TX
Sharon Sterchy, EdD , Director of Wellness, Aldine Independent School District, Houston, TX
Sandra L. Upchurch, PhD, RN , School of Nursing, University of Texas Health Science Center, Houston, TX

Learning Objective 1: describe methods for school-based screening for overweight (obesity), central adiposity and hypertension.

Learning Objective 2: discuss the prevalence of childhood overweight (obesity) and related risk factors and the implications for child health worldwide.

Obesity (overweight) in children is a significant concern worldwide. This study aimed to assess the prevalence of overweight, at risk of overweight, central adiposity and hypertension in a target population of children in kindergarten through 6th grade in the United States (US).

A cross-sectional prevalence survey was conducted with a stratified (by grade level) random sample of homerooms in each of three schools in an urban school district in southeastern Texas. A total of 1070 children (92% response) participated; 67% were Hispanic, 26% were African American. Measurements included body mass index (BMI), central adiposity (waist circumference, waist/height ratio), screening systolic (SBP) and diastolic (DBP) blood pressure (BP), and hypertension identified by measurements on three separate occasions (final BP status). As part of their community health clinical course, BSN students were trained in data collection.

Using national standards for BMI by age and gender, 28.7% of the children were overweight (>/= 95th percentile) and 17.9% were at risk of overweight (>/= 85th and < 95th percentile). We found 1.5% of the children underweight. Differences in overweight by gender, ethnic/racial group and grade level were statistically nonsignificant. For central adiposity, 28.8% had a waist circumference >/= 90th percentile and 44.2% had a waist/height ratio >/= 0.5. The percentage with elevated SBP and DBP at screening was 35.9%; after measurement on three occasions, 9.4% remained hypertensive or pre-hypertensive (>/= 90th percentile). Overweight children compared with those < 85th percentile were 4.8 (95% confidence interval, 3.0 7.8) times more likely to have final BP status >/= 90th percentile.

The results indicate a high prevalence of excess BMI and related risk factors in this population of children. Findings will be discussed in comparison with estimates for children in other studies in the US and worldwide.