Obesity in US Children and Adults

To the Editor: The main findings of the articles by Dr Ogden and colleagues¹ and Dr Flegal and colleagues² were that in recent years the obesity epidemic in the United States among children and adults might be leveling off but that substantial differences continue to exist by race/ethnicity. We were surprised to see that neither article considered the role of socioeconomic status as a risk factor for obesity. Socioeconomic status is a major determinant of obesity,^3- 4 and socioeconomic status is a large part of the reason for racial and ethnic differences in obesity.^4- 5 The authors quoted several reports from other countries on obesity rates stratified by socioeconomic status. The National Health and Nutrition Examination Survey (NHANES) data set that was used in the studies does contain questions about household income. Age, sex, and race/ethnicity cannot be changed, but many of the obesogenic correlates of low socioeconomic status, such as education and access to healthy foods and physical activity, can be modified, so it would be useful for the authors to provide these data.