Children enrolled in a special supplemental nutrition program may not be at a higher risk for developing obesity, but may actually experience a decline in severe obesity, according to a study published in JAMA Pediatrics.

Researchers identified 22.6 million children aged 2 to 4 years enrolled in the special nutritional program for women, infants, and children (WIC), and performed a cross-sectional study to identify recent trends in severe obesity in this population.

Study results demonstrated an increase in obesity from 1.80% to 2.11% from 2000 to 2004 (adjusted prevalence difference [APD], 0.26%), and a small yet significant decrease in obesity from 2004 to 2010 APD, −0.05%), followed by another significant decrease from 2.12% to 1.96% from 2010 to 2014 (APD, −0.14%).

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The highest prevalence of severe obesity during all studied years was found to be among Hispanic and American/Indian/Alaskan Native (AIAN) children, with the most severe decline in obesity found in Hispanic, AIAN, and Asian/Pacific Islander children compared with non-Hispanic white and non-Hispanic black children. Children 4 years of age, non-Hispanic white children, and AIAN children experienced the largest increases (APR, 1.21, 1.22, and 1.19, respectively), whereas children 2 years of age and Hispanic, AIAN, and Asian/Pacific Islander children experienced the largest decreases (APR, 0.88, 0.92, 0.89, and 0.87, respectively).

Limitations of this study include the disproportionate representation of children, as only 50% of children eligible for WIC were included in this study, which limits the generalizability of this study. 

In addition, only children in non-tribal WIC programs were included, which may not accurately represent all AIAN children. Finally, inaccurate data regarding body mass index and weight entry errors could have potentially occurred, and therefore would influence the results of this study.

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Investigators concluded that there has been progress in reducing the rate and prevalence of severe obesity in children enrolled in special supplemental nutrition programs for WIC. However, clinicians need to be aware that severe obesity is still prevalent in early childhood, and nutritional guidance needs to be given to parents regarding the management of the nutritional supplementation provided by programs such as WIC.


  1. Pan L, Park S, Slayton R, Goodman AB, Blanck HM. Trends in severe obesity among children aged 2 to 4 years enrolled in special supplemental nutrition program for women, infants, and children from 2000 to 2014. 2018 Jan 8. JAMA Pediatr. doi: 10.1001/jamapediatrics.2017.4301

This article originally appeared on Endocrinology Advisor