Poor Children Show a Decline in Obesity Rate

Jessica Kourkounis for The New York Times

In Baltimore, a class of 5-year-olds at Union Baptist Harvey Johnson Head Start jump during a motion break. Union Baptist makes a point of promoting health.

After years of growing concern about obesity among children, federal researchers have found the clearest evidence yet that the epidemic may be turning a corner in young children from low-income families.

The obesity rate among preschool-age children from poor families fell in 19 states and United States territories between 2008 and 2011, federal health officials said Tuesday — the first time a major government report has shown a consistent pattern of decline for low-income children after decades of rising rates.

Children from poor families have had some of the nation's highest rates of obesity. One in eight preschoolers in the United States is obese. Among low-income children, it is one in seven. The rate is much higher for blacks (one in five) and for Hispanics (one in six).

Several cities have reported modest drops among school-age children, offering hints of a change in course. But gains were concentrated among whites and children from middle- and upper-income families, and were not consistent across the country.

"We've seen isolated reports in the past that have had encouraging trends, but this is the first report to show declining rates of obesity in our youngest children," said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, which prepared the report. "We are going in the right direction for the first time in a generation."

The cause of the decline remains a mystery, but researchers offered theories, like an increase in breast-feeding, a drop in calories from sugary drinks, and changes in the food offered in federal nutrition programs for women and children. In interviews, parents suggested that they have become more educated in recent years, and so are more aware of their families' eating habits and of the health problems that can come with being overweight.

Health officials noted a small decline in the national rate for low-income children for the first time in December, but they did not regard it as important because they lacked a geographic breakdown to show whether the pattern had taken hold in many states.

The new report, based on the country's largest set of health data for children, used weight and height measurements from 12 million children ages 2 to 4 who participate in federally funded nutrition programs, to provide the most detailed picture of obesity among low-income Americans.

It included data from 40 states, as well as the District of Columbia, Puerto Rico and the United States Virgin Islands. Ten states were not included because of incomplete data. Trained health professionals took the children's measurements.

"This is the first time we have this many states in the U.S. showing a decline," said Heidi Blanck, a senior researcher at the C.D.C. "Until now, it has been a patchwork."

Researchers last analyzed these data in 2009, when only 9 states and territories had obesity declines and 24 had increases. In the report on Tuesday, the proportions were reversed, with only 3 states experiencing increases and 18 states and the Virgin Islands showing declines; 19 states, the District of Columbia and Puerto Rico were flat. The declines were modest: Most states dropped by less than 1 percentage point.

More children were added to the study because of a drop in their income during the economic downturn, leading researchers to investigate whether the decline could be attributed to an influx of new children with lower weights. They concluded that it was not, Dr. Blanck said.

Researchers agreed that the decline was real and held good implications for future health in America. Children who are overweight or obese between age 3 and 5 are five times as likely to be overweight or obese as adults, creating a higher risk of heart disease, stroke, diabetes and cancer.

But there was little consensus on why the decline might be happening.

Children now consume fewer calories from sugary beverages than they did in 1999, Dr. Blanck said. More women are breast-feeding, which can lead to healthier weight gain for young children. Federal researchers have also chronicled a drop in overall calories for children in the past decade, down by 7 percent for boys and 4 percent for girls, but health experts said those declines were too small to make much difference.

Another explanation is that some combination of state, local and federal policies aimed at reducing obesity is starting to have an effect. Michelle Obama has led a push to change young children's eating and exercise habits and 10,000 child care centers across the country have signed on.

Many scientists doubt that anti-obesity programs actually work, but proponents of the programs say a broad set of policies applied systematically over a period of time can affect behavior.

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