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Changes in Body Mass Index Z Score Over the Course of the Academic Year Among Children Attending Head Start

  • Julie C. Lumeng
    Correspondence
    Address correspondence to Julie C. Lumeng, MD, Center for Human Growth and Development, 300 NIB, 10th Floor, University of Michigan, Ann Arbor, Michigan 48109-0406.
    Affiliations
    From the Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich (Dr Lumeng and Dr Kaciroti); Department of Pediatrics, Division of Child Behavioral Health, University of Michigan, Ann Arbor, Mich (Dr Lumeng); and Department of Economics, Emory Univ, Atlanta, GA (Dr Frisvold)
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  • Niko Kaciroti
    Affiliations
    From the Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich (Dr Lumeng and Dr Kaciroti); Department of Pediatrics, Division of Child Behavioral Health, University of Michigan, Ann Arbor, Mich (Dr Lumeng); and Department of Economics, Emory Univ, Atlanta, GA (Dr Frisvold)
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  • David E. Frisvold
    Affiliations
    From the Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich (Dr Lumeng and Dr Kaciroti); Department of Pediatrics, Division of Child Behavioral Health, University of Michigan, Ann Arbor, Mich (Dr Lumeng); and Department of Economics, Emory Univ, Atlanta, GA (Dr Frisvold)
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Published:April 16, 2010DOI:https://doi.org/10.1016/j.acap.2010.01.008

      Objective

      We tested the hypothesis that among 3- to 5-year-old children attending Head Start, body mass index z score will decline during the academic year and increase during the summer.

      Methods

      We used retrospective longitudinal growth data collected over 5 academic years from 1914 children (51% boys, 62% white) enrolled in a Michigan Head Start program. Changes in body mass index (BMI) z score, calculated as annual rate of change, during 2 academic years and the intervening summer were assessed by piecewise linear regression analysis. Potential covariates were gender, single-parent status, program year, race/ethnicity, age at initial enrollment, and family income (divided by household size).

      Results

      Mean BMI z score at the start of Head Start enrollment was 0.52 (95% confidence interval [95% CI] 0.39 to 0.65). Mean annual rates of BMI z score change were: −0.07 (95% CI −0.28 to 0.14) during the first year of enrollment, 0.62 (95% CI −0.0005 to 1.23) over the summer, and −0.82 (95% CI −1.50 to −0.13) during the second year of enrollment. The effect was most robust among girls of minority race/ethnicity.

      Conclusions

      Head Start is associated with a shifting of BMI z scores toward the norm among low-income preschool-aged children, particularly among girls of minority race/ethnicity.

      Key Words

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