Estimating the energy gap among US children: a counterfactual approach.

摘要: OBJECTIVE. Our goal was to quantify the magnitude of energy imbalance responsible for increase in body weight among US children during periods 1988–1994 and 1999–2002. METHODS. We adopted a counterfactual approach estimate gains excess normal growth implicit “energy gap”—the daily between intake expenditure. On basis Centers Disease Control Prevention charts, we constructed weight, height, BMI percentile distributions cohorts 2 4 5 7 years age National Health Nutrition Examination Survey (N = 5000). Under “normal-growth-only” scenario, assumed that these remained same as cohort aged 10 years. this assumption, projected height at 12 14 15 17 on their baseline weight-for-age stature-for-age percentiles. compared with those corresponding groups 1999–2002 3091) ∼10 after Survey. calculated differences observed translated difference into estimated average gap, adjusting increased total expenditure attributable gain. In addition, accumulated overweight adolescents Survey, validating our assumptions by analyzing longitudinal data from Longitudinal Youth Bogalusa Heart Study. RESULTS. Compared boys girls who were gained, average, an 0.43 kg/year over 10-year period. Assuming 3500 kcal leads 1-lb gain fat, results suggest reduction gap 110–165 kcal/day could have prevented increase. Among 1999–2002, indicate ranging 678 1017 because 26.5 kg CONCLUSIONS. Quantifying recent changes distribution can provide salient targets population intervention. Consistent behavioral averaging 110 165 may be sufficient counterbalance gap. Changes dietary (eg, eliminating one sugar-sweetened beverage 150 per can) easier attain than increases physical activity levels 30-kg boy replacing sitting 1.9 hours walking extra kcal). higher will likely need multiple behaviors environments close