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Author: Rubinfeld, Rachel E.
Resulting in 2 citations.
1. Goldhaber-Fiebert, Jeremy D.
Rubinfeld, Rachel E.
Bhattacharya, Jay
Robinson, Thomas N.
Wise, Paul H.
The Utility of Childhood and Adolescent Obesity Assessment in Relation to Adult Health
Medical Decision Making 33,2 (February 2013): 163-175.
Also: http://mdm.sagepub.com/content/33/2/163.abstract
Cohort(s): Children of the NLSY79, NLSY79 Young Adult
Publisher: Sage Publications
Keyword(s): Body Mass Index (BMI); Child Health; Children, Health Care; Health/Health Status/SF-12 Scale; National Health and Nutrition Examination Survey (NHANES); Obesity; Panel Study of Income Dynamics (PSID); Weight

Permission to reprint the abstract has not been received from the publisher.

Background: High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children.

Objective: To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults.

Design: Longitudinal statistical analyses; microsimulations combining multiple data sets.

Data Sources: National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys. Methods: The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race.

Results: Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6. Limitation: Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future.

Bibliography Citation
Goldhaber-Fiebert, Jeremy D., Rachel E. Rubinfeld, Jay Bhattacharya, Thomas N. Robinson and Paul H. Wise. "The Utility of Childhood and Adolescent Obesity Assessment in Relation to Adult Health." Medical Decision Making 33,2 (February 2013): 163-175.
2. Goldhaber-Fiebert, Jeremy D.
Rubinfeld, Rachel E.
Bhattacharya, Jayanta
Wise, Paul H.
U.S. Childhood Obesity Policies and Their Projected Impact on Adult Health Through 2040
Presented: Toronto, Ontario, Canada, 32nd Annual Meeting of the Society for Medical Decision Making, October 24-27, 2010
Cohort(s): Children of the NLSY79, NLSY79 Young Adult
Publisher: Society for Medical Decision Making
Keyword(s): Body Mass Index (BMI); Child Health; Children, Health Care; Health/Health Status/SF-12 Scale; National Health and Nutrition Examination Survey (NHANES); Obesity; Panel Study of Income Dynamics (PSID); Weight

Permission to reprint the abstract has not been received from the publisher.

Method: We developed the Stanford Childhood Obesity Projection and Evaluation (SCOPE) model to simulate body mass index (BMI) dynamics for children starting at age 2. The SCOPE model follows children as they grow into adulthood, tracking their BMI and obesity status. The SCOPE model projects outcomes including BMI at ages 18 and 40, and diabetes and hypertension prevalence at age 40. The parameters of the SCOPE model were informed by nationally representative, longitudinal data: the National Health and Nutrition Examination Survey (NHANES 2006), National Longitudinal Survey of Youth (NLSY) Children and Young Adult samples; and Panel Study of Income Dynamics (PSID). Using the SCOPE model, we evaluated the following strategies: childhood obesity screening (at age 5, 10, or 15) with interventions for children at risk; and universal school-based obesity interventions (e.g., interventions such as Planet Health).

Result: Without intervention, 33% of U.S. children currently aged 5 through 10 will be overweight (BMI 25–30) or obese (BMI ≥30) by age 18. For obese 18 year-olds, the probability at age 40 of being obese is 70%, of being diabetic is 23%, and of being hypertensive is 39%. By contrast, for thin (BMI <25) 18 year-olds, the probability of being obese is 24%, of being diabetic is 1%, and of being hypertensive is 22%. Obesity screening in children under 10 misses more than 40% of those who become obese 18-year olds. Screening at age 15 misses less than 15%. Universal schoolbased interventions have greater health benefits than screeningguided interventions, reducing the number of 40 year-olds with BMI ≥30, diabetes, and hypertensions by as much as 1,000,000, 200,000, and 500,000, respectively.

Conclusion: Results from the SCOPE model support the role of universal school-based interventions as promising tools to address adult obesity-related illness compared to childhood obesity screening. If universal interventions are infeasible, targeting obesity screening in early teen years has a greater potential benefit than screening for young children. Such interventions complement the continued importance of obesity interventions during adulthood.

Bibliography Citation
Goldhaber-Fiebert, Jeremy D., Rachel E. Rubinfeld, Jayanta Bhattacharya and Paul H. Wise. "U.S. Childhood Obesity Policies and Their Projected Impact on Adult Health Through 2040." Presented: Toronto, Ontario, Canada, 32nd Annual Meeting of the Society for Medical Decision Making, October 24-27, 2010.