Further reductions in the prevalence of obesity in 4-year-old New Zealand children from 2017 to 2019

OBJECTIVE: To examine whether the prevalence of age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles continues to decline in New Zealand preschool children, over time. METHODS: As part of a national screening programme, 438,972 New Zealand 4-year-old children had their height and weight measured between 2011 and 2019. Age- and sex-adjusted BMI was calculated using WHO Growth Standards and the prevalence of children at, or above, the 85th, 95th, and 99.7th percentiles and at, or below, the 2nd percentile were determined. Log-binomial models were used to estimate linear time trends of ≥85th, ≥95th and ≥99.7th percentiles for the overall sample and separately by sex, deprivation, ethnicity and urban-rural classification. RESULTS: The percentage of children at, or above, the 85th, 95th and 99.7th percentile reduced by 4.9% [95% CI: 4.1%, 5.7%], 3.5% [95% CI: 2.9%, 4.1%], and 0.9% [95% CI: 0.7%, 1.2%], respectively, between ‘2011/12’ and ‘2018/19’. There was evidence of a decreasing linear trend (risk reduction, per year) for the percentage of children ≥85th (risk ratio (RR): 0.980 [95% CI: 0.978, 0.982]), ≥95th (RR: 0.966 [95% CI: 0.962, 0.969]) and ≥99.7th (RR: 0.957 [95% CI: 0.950, 0.964]) percentiles. Downward trends were also evident across all socioeconomic indicators (sex, ethnicity, deprivation, and urban-rural classification), for each of the BMI thresholds. Larger absolute decreases were evident for children residing in the most deprived compared with the least deprived areas, at each BMI threshold. There appeared to be no consistent trend for the percentage of children ≤2nd percentile. CONCLUSIONS: Reassuringly, continued declines of children with age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles are occurring over time, overall and across all sociodemographic indicators, with little evidence for consistent trends in the prevalence of children at, or below, the 2nd percentile.