Abstract 17055: Underweight and Obesity Among Asian Children at Age 3 to 5 Years: Implications for Counseling to Promote Cardiometabolic Health Across the Lifecourse

Background: Body mass index (BMI) is an important pediatric measurement that supports nutrition/weight counseling in children, especially for obesity. However, children with low BMI (<5 ^th percentile or “underweight”) should be considered, as Asian children are at risk for adverse cardiometabolic health at lower BMI as adults.

Mehods: Using electronic record data from well-child visits from 5361 Chinese, 6215 Filipino, 5775 South Asian, and 48,666 Non-Hispanic White (NHW) children with BMI at age 3 and 5 years in a US healthcare system, we examined BMI distribution, underweight (<5th percentile), obesity (≥95th percentile), and changes in BMI from age 3 to 5 years.

Results: Underweight was higher in Asian vs NHW (highest for South Asian, 15.0%, age 3, p<0.01). Obesity was highest for Filipino (11.3%, age 5) and lowest for Chinese (3.6%) vs NHW (p<0.01). At age 3, trends in greater proportion with underweight vs obesity for Chinese (6.3% vs 3.0%) and South Asian (15.0% vs 6.5%) children were seen, but not Filipino (5.0% vs 9.7%) and NHW (4.0 vs 7.8%) children (Table), similar to age 5. Most children with underweight had height <25th percentile. By age 5, large proportions shifted out of underweight, with modest obesity increases (Table). Obesity transition was greatest for South Asian children.

Conclusions: Among major Asian groups and NHW children, underweight was most prevalent in South Asian (1 in 7, age 3) and obesity most prevalent in Filipino (1 in 10, age 5) children. High obesity prevalence in Filipino children and greater BMI transition in South Asian children highlight ethnic differences in BMI that support targeted lifestyle counseling to improve future cardiometabolic health.