Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Abstract

A ccording to national survey data, one-third of Cana-dian children and adolescents aged 5 to 17 years are overweight or obese. 1 Children with obesity have higher risk for both short-term health consequences 2–5 and long-term persistence of obesity into adulthood. 6–8 Evidence shows that early childhood is a critical time for obesity pre-vention strategies and that early markers of obesity could be targeted for universal and individual intervention strategies to show positive, long-term, health benefits. 9–11 In Canada, child and adolescent population health monitoring is lim-ited. There are a few national surveys, such as the Canadian Community Health Survey (CCHS) (ages ≥ 12 yr), the Health Behaviour in School-Aged Children Survey (ages 11–15 yr) and the National Longitudinal Study of Children and Youth that provide population-level surveillance data. 12–14 In 2004 and 2005 the CCHS included representa-tive subsamples in which height and weight were measured. Measured heights and weights are also obtained as part of the Canadian Health Measures Survey (CHMS) (aged 3–79 yr). 15 However, data on 3–5 year olds represents about 500 children from across Canada. The absence of data for chil-dren less than 3 years of age is a critical gap, given that early CMAJ Open 2016. DOI:10.9778/cmajo.20150108 Background: Population monitoring and surveillance of objectively measured child weight data in Canada is limited to national sur-veys with poor regional applicability, and no healthy weight data are available for children less than 2 years of age. We aimed to determine the prevalence of childhood overweight and obesity using objective measures derived from primary care electronic medi-cal records. Methods: Observational data included all height and weight records for children less than 20 years of age, between 2004 and 2013, from 3 Ontario primary care research networks. We calculated body mass index (BMI)-for-age and weight-for-length using the World Health Organization Growth Standards and Reference to assign growth status indicator categories by age group. Descriptive data and prevalence estimates were generated for 2013. We also compared weight-for-length for children less than 2 years of age with a corresponding billing code for known well-child visits.