Professional Documents
Culture Documents
CDC 11908 DS1
CDC 11908 DS1
2009 Report
Suggested Citation
Polhamus B, Dalenius K, Mackintosh H, Smith B, Grummer-
Strawn L. Pediatric Nutrition Surveillance 2009 Report. Atlanta: U.S.
Department of Health and Human Services, Centers for Disease
Control and Prevention; 2011.
Acknowledgments
We gratefully acknowledge and thank all contributors to the Pediatric
Nutrition Surveillance System (PedNSS). The efforts of state, territorial,
and Indian Tribal Organization surveillance coordinators; informatics
staff; and local clinic staff to collect data and use nutrition surveillance
systems make the national PedNSS possible.
Contributor 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Alabama
American Samoa
Arizona
Arkansas
California
Cheyenne River Sioux Tribe (SD)
Chickasaw Nation (OK)
Colorado
Connecticut
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Inter Tribal Council of Arizona
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Navajo Nation (AZ)
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oregon
Pennsylvania
Puerto Rico
Rhode Island
Rosebud Sioux (SD)
South Carolina
South Dakota
Standing Rock Sioux (ND)
Tennessee
Texas
Three Affiliated Tribes (ND)
U.S. Virgin Islands
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Number of Contributors 45 47 48 49 50 49 48 52 53 55
Total Unique Child Records Submitted (x 1,000) 5,019 4,943 5,519 6,359 6,930 7,118 7,599 7,996 8,165 8,939
* Shaded blocks indicate years that data were contributed.
10
(7.0%) infants. Healthy People
2010 objective 16-10a proposes
reducing low birthweight to
no more than 5.0% of all live
births.4 The overall prevalence of 5
low birthweight remained stable
from 2000 (8.9%) through 0
2009 (8.9%) (Figure 2). 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
2004 2005 2006 2007 2008
Year
High Birthweight
Total Hispanic
High birthweight (>4,000 American Indian/Alaska Native
White, non-Hispanic
grams) puts infants at increased Black, non-Hispanic Asian/Pacific Islander
risk for death and for birth
injuries such as shoulder * Among infants born during the reporting period. Defined as birthweight <2,500 grams. Healthy
dystocia.5 In the 2009 PedNSS, People 2010 proposes reducing low birthweight to 5% of all live births.
Source: 2009 National PedNSS Data Table 18D. Available at http://www.cdc.gov/pednss/
6.4% of infants had high pednss_tables/tables_numeric.htm.
birthweights, compared with
* Infants born during the reporting period before their mothers were surveyed are included in the ever breastfed analysis. Only children who had
turned 6 months old during the reporting period are included in the breastfed at least 6 months analysis. Only children who had turned 12 months
old during the reporting period are included in the breastfed at least 12 months analysis.
Percentage
breastfed at 1 year to 25.0%.4 50
† Contributors of supplementary breastfeeding data include Arizona, Arkansas, Florida, Idaho, Illinois, Indiana, Kansas, Maryland, Michigan,
Minnesota, Missouri, New Hampshire, New Jersey, New York, North Dakota, Oregon, Rhode Island, Washington, West Virginia, Wisconsin, the
District of Columbia, and the following ITOs: the Inter Tribal Council of Arizona and the Navajo Nation.
Percentage
middle ear infections, eczema,
and childhood obesity.9
15
Anemia
Anemia (low hemoglobin or
10
low hematocrit)‡ is an indicator
of iron deficiency, which is 0
q 2003q 2004qassociated with
2005q 2006q developmental
2007q 2008q 2009q 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
delays and behavioral5problems Year
in children.10,11 In the 2009 Total Hispanic
PedNSS, the prevalence of White, non-Hispanic American Indian/Alaska Native
anemia was 14.9%. The highest Black, non-Hispanic Asian/Pacific Islander
prevalence was among children
* Defined as hemoglobin concentration or hematocrit level <5th percentile. (CDC. Recommen-
aged 6–23 months (17.8%) dations to prevent and control iron deficiency in the United States. MMWR Recommendations
and those aged 12–17 months and Reports 1998;47[RR-3]:1–30).
(18.2%). The lowest prevalence Source: 2009 National PedNSS Data Table 18D. Available at http://www.cdc.gov/pednss/
pednss_tables/tables_numeric.htm.
was among children aged 3–4
years (11.2%).
‡ Defined as hemoglobin (Hb) concentration or hematocrit (Hct) level <5th percentile. Children aged 6–23 months are considered anemic if their
Hb concentration is <11.0 g/dL or their Hct level is <32.9%. Children aged 2–4 years are considered anemic if their Hb concentration is <11.1 g/
dL or their Hct level is <33.0%. Values are adjusted for altitude. Hb concentration and Hct level are not reported for children younger than age 6
months.12
§ Based on sex-specific percentiles from the 2000 CDC growth chart for the United States. For children younger than age 2 years, short stature is
defined as <5th percentile of length-for-age. For children aged 2–4 years, short stature is defined as <5th percentile of height-for-age.
Percentage
in the WIC program. The
prevalence of short stature in 6
the 2009 PedNSS was above
both the expected level (5.0%) 5
and the Healthy People 2010
objective 19-4 of 5.0% among 4
low-income children from
0
birth to age 4 years.4 Sixteen
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
contributors achieved the
Year
005q 2006q
Healthy2008q
2007q
People 2010 objective
2009q
Total Hispanic
of 5.0% in 2009 (Table 2).
White, non-Hispanic American Indian/Alaska Native
Black, non-Hispanic Asian/Pacific Islander
The prevalence of short
stature among children in * Defined as <5th percentile length or height-for-age according to the 2000 CDC growth charts. Healthy
People 2010 proposes reducing short stature among low-income children aged <5 years to 5%.
the PedNSS remained stable
Source: 2009 National PedNSS Data Table 18D. Available at http://www.cdc.gov/pednss/
from 2000 (6.0%) through pednss_tables/tables_numeric.htm.
2009 (6.0%). Some variation
was evident among racial and
ethnic groups. Short stature increased among white The highest prevalence of underweight in the
and Hispanic children and decreased among Asian PedNSS was among Asian or Pacific Islander (5.9%)
or Pacific Islander, black, and American Indian or and black (5.6%) children. Black infants younger
Alaska Native children (Figure 5). In 2009, the than age 1 year had an underweight rate of 7.6%,
highest prevalence of short stature was among black which may reflect the high rate of low birthweight
infants younger than age 1 year (10.9%), which may in this group. The overall prevalence of underweight
reflect the high prevalence of low birthweight among among children in the PedNSS decreased from 5.4%
this group (data not shown). in 2000 to 4.3% in 2009.
¶ Based on sex-specific percentiles from the 2000 CDC growth chart for the United States. For children younger than age 2 years, underweight is
defined as <5th percentile of weight-for-length. For children aged 2 years or older, underweight is defined as <5th percentile of BMI-for-age.
** BMI is calculated as follows: Weight (kg) ÷ Stature (cm) × 10,000 or Weight (lb) ÷ Stature (in) × 703.
†† Based on sex-specific percentiles from the 2000 CDC growth chart for the United States. For children aged 2 years or older, overweight is defined
as the 85th–95th percentile of BMI-for-age.
‡‡ Based on sex-specific percentiles from the 2000 CDC growth chart for the United States. For children aged 2 years or older, obesity is defined as
≥95th percentile of BMI-for-age.
20.2
27 17.6 prevalence of obesity among
16.4 children from birth to age 4
15.9 14.5 14.0
18 years was 14.7%, compared
with 12.4% for U.S. children
17.9 20.7
9 14.7 aged 2–5 years in 2003 through
12.3 11.9 11.9
2006.17 In the PedNSS, the
0
White Black Hispanic American Asian Total highest prevalence of obesity
Indian was among American Indian
or Alaska Native (20.7%) and
Obese Overweight
Hispanic (17.9%) children. The
* Defined as >95th percentile BMI-for-age according to the 2000 CDC growth charts. lowest prevalence was among
† Defined as 85th–95th percentile BMI-for-age according to the 2000 CDC growth charts. white (12.3%), black (11.9%),
Source: 2009 National PedNSS Data Table 8D. Available at http://www.cdc.gov/pednss/
pednss_tables/tables_numeric.htm. and Asian or Pacific Islander
(11.9%) children (Figure 6).
15
(14.7%), and this trend was
observed among all racial and
10
ethnic groups except American
Indians or Alaska Natives. This
group experienced a 3.0%
increase in the prevalence of
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
obesity from 2003 through 2009.
Year
Among all contributors, only
Total Hispanic
Colorado, Hawaii, Utah, and
White, non-Hispanic American Indian/Alaska Native
Black, non-Hispanic Asian/Pacific Islander the U.S. Virgin Islands had a
prevalence of obesity less than
* Defined as >95th percentile BMI-for-age according to the 2000 CDC growth charts. 12.0%, and 15 contributors had
Source: 2009 National PedNSS Data Table 18D. Available at http://www.cdc.gov/pednss/ a prevalence of obesity of 16.0%
pednss_tables/tables_numeric.htm.
or higher (Figure 8).
Pediatric Behavioral
<12%
Indicators 12.0%–13.9%
14.0%–15.9%
Television Viewing ≥16.0%
To prevent obesity and a variety No Data
of other problems during
childhood, the American * Defined as >95th percentile BMI-for-age according to the 2000 CDC growth charts; 5.0% of children
Academy of Pediatrics (AAP) are expected to be above the 95th percentile.
† Includes the District of Columbia (13.6%), Puerto Rico (18.1%), the U.S. Virgin Islands (11.9%), and the
recommends that parents following ITOs: the Cheyenne River Sioux Tribe (SD) (19.0%), the Inter Tribal Council of Arizona (24.2%), the
Navajo Nation (AZ) (17.3%), the Rosebud Sioux Tribe (SD) (18.7%), the Standing Rock Sioux Tribe (ND, SD)
limit the amount of time (26.1%), and the Three Affiliated Tribes (ND) (31.5%).
that children spend watching Source: 2009 National PedNSS Data Table 6D. Available at http://www.cdc.gov/pednss/
pednss_tables/tables_numeric.htm.
television or other media to
no more than 1–2 hours per
day for children aged 2 years or older. AAP also Rates were lowest among black (67.9%) and
discourages exposure to any television for infants and Hispanic (72.7%) children and highest among
children younger than age 2 years. 18 white (84.4%) children.
§§ Contributors of supplementary television viewing data include Indiana, Iowa, Kansas, Kentucky, Maryland, Michigan, Missouri, Nebraska, New
Hampshire, New Jersey, New York, North Dakota, Rhode Island, South Carolina, Utah, West Virginia, Wisconsin, the District of Columbia, the U.S.
Virgin Islands, and the following ITOs: the Inter Tribal Council of Arizona, the Cheyenne River Sioux (SD), the Rosebud Sioux (SD), the Standing
Rock Sioux (ND), and the Three Affiliated Tribes (ND).
¶¶ Contributors of supplementary data on exposure to household smoking include Arizona, Arkansas, California, Connecticut, Illinois, Indiana, Iowa,
Kansas, Kentucky, Maine, Maryland, Michigan, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Rhode Island, South
Carolina, Utah, Virginia, West Virginia, Wisconsin, the District of Columbia, the U.S. Virgin Islands, and the following ITOs: the Inter Tribal Council of
Arizona, the Cheyenne River Sioux Tribe (SD), the Navajo Nation (AZ), the Rosebud Sioux Tribe (SD), the Standing Rock Sioux Tribe (ND), and the Three
Affiliated Tribes (ND).