Online Program

Role of fitness in racial disparities of weight status transition among elementary and middle school youth

Tuesday, November 5, 2013

Virginia Chomitz, PhD, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Lisa Arsenault, PhD, Institute for Community Health, Institute for Community Health, Cambridge, MA
Bernice Garnett, MPH, ScD, College of Education and Social Services, University of Vermont, Somerville, MA
José Wendel, MS, RD, LDN, School Health Program, Cambridge Public Health Department, Cambridge, MA
Leroi Hicks, MD, MPH, Division of Hospital Medicine, University of Massachusetts, Worcester, MA
Justeen Hyde, PhD, Institute for Community Health, Cambridge, MA
Robin Harris, Fletcher Maynard Academy, Cambridge, MA
Chandra Banks, Ed.M., Cambridge Public School Department, Cambridge, MA
Richard Harding, Cambridge Public Health Department, Cambridge, MA
Karen Hacker, MD, MPH, Institute for Community Health, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA
Introduction: Despite some stabilizing of childhood obesity rates, racial/ethnic disparities persist. Because determinants of obesity and weight transition trajectories may differ among racial/ethnic populations, race/ethnic-specific research is needed to guide prevention/intervention efforts. Methods: A longitudinal public school student health surveillance dataset (2003-2008) of 3,348 students (black=1687/white=1661) was used to assess race-specific weight and fitness trajectories among Kindergarten-8th grade students in Cambridge, MA, a diverse urban city of 108,000. Personal and environmental predictors of weight trajectories were tested using multivariable logistic regression models stratified by race. Results were shared with community groups to guide development of local interventions. Results: At baseline, white students were more likely than black students to be of healthy weight (70.7% vs. 53.5%; P<0.0001) and aerobically fit (56.8% versus 46.8%; P<0.0001). At follow-up, white students were more likely than black students to have maintained (91.7% vs. 88.8%; P<0.05) or achieved a healthy weight (38.7% vs. 30.5%; P<0.05). Likewise, white students were more likely than black students to have maintained (82.2% vs. 73.5%; P<0.0001) or achieved aerobic fitness (49.9% vs. 37.3%; P<0.0001). Achieving or maintaining aerobic fitness was the primary predictor of improved weight status at follow-up in multivariable models. This effect of fitness appeared greater among the white than black students. Community input corroborated the need for fitness promotion among black youth in Cambridge, MA. Discussion: Race/ethnic-specific analyses and community input may be useful for guiding culture-focused obesity prevention efforts. Results suggest complex relationships between fitness and weight transition among racial/ethnic populations that warrant further study.

Learning Areas:

Diversity and culture
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess racial/ethnic disparities in excess weight and lack of fitness and implications on the health and welfare of students in this sample. Demonstrate a complex relationship between fitness and weight transition among the study populations. Explain the importance of race/ethnic-specific research in guiding prevention/intervention efforts.

Keyword(s): Health Disparities, Physical Activity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal investigator on the grant investigating BMI diparities among youth in Cambridge. I have actively researched BMI, fitness, and health disparities for over 20 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.