Incidence and remission rates of overweight among children aged 5 to 13 years in a district-wide school surveillance system

Objectives. To monitor annual changes in weight status, we determined incidence and remission rates of overweight among school-aged children with longitudinal school-based surveillance. Methods. We estimated 1-year changes in weight status among students enrolled in public schools in Cambridge, Mass. Physical education teachers measured height and weight annually. Adjusted odds ratios (ORs) were estimated via multivariate logistic regression, accounting for repeated observations of individual children across years. Results. The 1-year incidence of overweight was 4%, and the remission rate was 15%. Among overweight children, 85% remained overweight at a 1-year follow-up, while 18% of children at risk for overweight became overweight. Overweight incidence rates were higher among children aged 7 and 8 years than among those aged 11 to 13 years (boys: OR= 1.68; 95% confidence interval [CI]=1.14, 2.47; girls: OR =1.86; 95% Cl =1.25, 2.77). Conclusions. Both incidence and remission rates were higher among younger children. Children who were at risk for overweight were more likely to change their weight status than those who were already overweight. Our results support targeting overweight prevention efforts toward younger children and children at risk for overweight.