Journal of Community Health

, Volume 37, Issue 1, pp 242–252 | Cite as

State Disparities in Time Trends of Adolescent Body Mass Index Percentile and Weight-Related Behaviors in the United States

  • Daniel R. Taber
  • June Stevens
  • Charles Poole
  • Matthew L. Maciejewski
  • Kelly R. Evenson
  • Dianne S. Ward
Original Paper


Evidence is conflicting as to whether youth obesity prevalence has reached a plateau in the United States overall. Trends vary by state, and experts recommend exploring whether trends in weight-related behaviors are associated with changes in weight status trends. Thus, our objective was to estimate between-state variation in time trends of adolescent body mass index (BMI) percentile and weight-related behaviors from 2001 to 2007. A time series design combined cross-sectional Youth Risk Behavior Survey data from 272,044 adolescents in 29 states from 2001 to 2007. Self-reported height, weight, sports participation, physical education, television viewing, and daily consumption of 100% fruit juice, milk, and fruits and vegetables were collected. Linear mixed models estimated state variance in time trends of behaviors and BMI percentile. Across states, BMI percentile trends were consistent despite differences in behavioral trends. Boys experienced a modest linear increase in BMI percentile (ß = 0.18, 95% CI: 0.07, 0.30); girls experienced a non-linear increase, as the rate of increase declined over time from 1.02 units in 2001–2002 (95% CI: 0.68, 1.36) to 0.23 units in 2006–2007 (95% CI: −0.09, 0.56). States in which BMI percentile decreased experienced a greater decrease in TV viewing than states where BMI percentile increased. Otherwise, states with disparate BMI percentile trends did not differ with respect to behaviors. Future research should explore the role of other behaviors (e.g., soda consumption), measurement units (e.g., portion size), and societal trends (e.g., urban sprawl) on state and national adiposity trends.


Adiposity Adolescents Weight-related behaviors Time trends Mixed models 



This study was supported by funding from the National Heart, Lung, and Blood Institute (R21 HL097374) and the Caroline H. and Thomas S. Royster Fellowship of the University of North Carolina—Chapel Hill. We thank the Centers for Disease Control and Prevention, and the state education agencies and health departments that generously shared their Youth Risk Behavior Survey data. We also thank David Murray for his thoughtful comments on this manuscript.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Daniel R. Taber
    • 1
    • 6
  • June Stevens
    • 2
  • Charles Poole
    • 1
  • Matthew L. Maciejewski
    • 3
    • 4
  • Kelly R. Evenson
    • 1
  • Dianne S. Ward
    • 5
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  2. 2.Department of Nutrition (Chair) and Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  3. 3.Department of MedicineDuke University School of MedicineDurhamUSA
  4. 4.Center for Health Services Research in Primary CareDurham VA Medical CenterDurhamUSA
  5. 5.Department of Nutrition, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  6. 6.Health Policy Center, Institute for Health Research and PolicyUniversity of Illinois at ChicagoChicagoUSA

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