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Trends in Weight-for-Length Among Infants in WIC From 2000 to 2014
David S Freedman1, Andrea J Sharma2,3, Heather C Hamner4
1Divisions of Nutrition, Physical Activity, and Obesity, and dxf1@cdc.gov.
Insights
High infant weight-for-length prevalence in the WIC program initially rose, then declined after 2010. This decrease was observed across most states, suggesting effective interventions for infant health.
Area of Science:
- Pediatric Nutrition
- Public Health Surveillance
- Growth Monitoring
Background:
- High weight-for-length in infants (ages 3-23 months) is a public health concern.
- Understanding trends in this metric is crucial for targeted interventions.
Purpose of the Study:
- To analyze the prevalence and secular trends of high weight-for-length among infants.
- Utilize data from the Women, Infants, and Children Program and Participants Characteristic (WIC-PC) Survey (2000-2014).
Main Methods:
- Defined high weight-for-length as ≥2 SDs above the sex- and age-specific median (WHO standards).
- Employed Poisson regression to calculate adjusted prevalence ratios.
- Analyzed data from 16,927,120 WIC-PC survey participants.
Main Results:
- Overall prevalence increased from 13.4% (2000) to 14.5% (2004), then decreased to 12.3% (2014).
- High weight-for-length was associated with male sex, American Indian/Alaskan Native race-ethnicity, younger age, and lower family income.
- Prevalence decreased from 2010-2014 in most US states and territories, with notable declines in Puerto Rico and Kentucky.
Conclusions:
- A decrease in high weight-for-length was observed among WIC infants since 2010.
- Variations across jurisdictions suggest the impact of local policies and programs on maternal and infant health outcomes.
Objectives:
To describe the prevalence and secular trends of high weight-for-length among infants (ages, 3-23 months) in the biennial US Department of Agriculture Women, Infants, and Children Program and Participants Characteristic (WIC-PC) Survey from 2000 through 2014 (n = 16 927 120).
Methods:
Weight-for-length was considered to be "high" if it was ≥2 SDs above the sex- and age-specific median in the World Health Organization growth standards. Poisson regression was used to calculate adjusted prevalence ratios.
Results:
The overall prevalence of high weight-for-length increased from 13.4% in 2000 to 14.5% in 2004, remained constant until 2010, and then decreased by >2 percentage points (to 12.3%) through 2014. The prevalence of high weight-for-length was associated with sex (higher among boys), race-ethnicity (highest among American Indians/Alaskan Natives), and with both age (positive) and family income (inverse). The secular trends, however, were fairly similar within categories of these variables. From 2010 to 2014, the prevalence of high weight-for-length decreased in 40 states and 3 (of 5) US territories, with the largest decreases seen in Puerto Rico (-9 percentage points) and Kentucky (-7 percentage points), and the largest increase (+2 percentage points) seen in West Virginia.
Conclusions:
Although the current results cannot be considered representative of infants in the populations, the prevalence of a high weight-for-length has decreased among infants in WIC-PC since 2010. These decreases were similar across categories of most characteristics, but there were substantial differences across jurisdictions, possibly reflecting differences in policy and local programs that target maternal and infant health.
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