Adiposity Rebound as a Predictor for Obesity in Inner-City Black Girls

The prevalence of childhood obesity has been rising for two decades with no imminent declivity. Pre-adolescent Black females, in particular, transition from overweight (85%ile body mass index (BMI)) to obesity (95%ile BMI) more rapidly than their male counterparts, and age-peers of different ethnicities. Although there is no consensus on the most effective means for treating obesity, current recommendations call for clinical intervention once a patient attains a BMI within the 85%ile for age. At this level, the patient is already overweight with greater risk of obesity complications, and is thus subjected to secondary prevention methods. Often resistant to treatment, obesity requires stronger predictor variables for implementation of primary prevention strategies capable of counteracting the epidemic. While studies in pre-adolescent Black females have investigated physical predisposition to obesity, to our knowledge none have focused on the ability of adiposity rebound—early-childhood's second period of rapid growth in body fat— to forecast obesity.

Objective: To assess age of adiposity rebound (AR) as a predictor of adolescent obesity in a sample of black females. We hypothesize that early or absence of AR indicates higher likelihood of pre-adolescent overweight/obesity.

Design: Retrospective Chart Review: Statistical analysis of growth-data collected on 200 pre-adolescent healthy Black females coming for medical care over a 10-year period.

Setting: A large urban academic medical center, serving a predominantly Black population.

Research Questions: 1. How well does early or absence of AR predict obesity? 2. At what rate do the sample's overweight/obese pre-adolescents cross BMI percentile lines after AR? 3. Based on the sample's BMI statistics, is the standardized growth-chart applicable to a large sample of Black female pediatric patients?

To observe a recession in incidence of pre-adolescent obesity in Black females, methods that accurately evaluate the population's growth patterns must be employed. Thus, development of anticipatory tools can diminish the health disparity. A statistically significant relationship between age of AR and likelihood of pre-adolescent obesity allows earlier identification of obesity-risk and implementation of primary intervention approaches. Healthcare providers' pre-emptive assessments of patients' AR-rates can prevent overweight by encouraging vigilance for rapid upward percentile-crossing regardless of a patient's current BMI percentile.