Daily Dose: Association of Racial Discrimination with Adiposity in Children

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On July 12, 2023, we reported on a study published in JAMA Network Open that examined the prospective association between self-reported experiences of racial discrimination and adiposity (body mass index [BMI] and waist circumference) in a large sample of children and adolescents.

The study

Researchers used participant data from the Adolescent Brain Cognitive Development (ABCD) study. The ABCD study was designed to examine brain development and associations of various individual, social, and familial variables on health outcomes in a diverse population of children aged between 9 and 11 years at 21 sites in the US.

To assess interpersonal racial discrimination, researchers used the child-reported Perceived Discrimination Scale. The scale included 3 questions regarding how frequently participants were treated unfairly or negatively by peers, teachers, and other adults, and 4 questions about their feelings of unacceptance by society due to their race or ethnicity. A higher score indicated greater racial discrimination.

In addition, trained research assistants measured weight, height, and waist circumference; BMI z scores were calculated using the US Centers for Disease Control and Prevention’s age and sex-specific reference standards for children. Researchers assessed these measurements from time 1 (ie, 2017-2019) and time 2 (ie, 2018-2020). The current study included 6463 children (mean age, 9.95 years; 47.8% girls) who took part in the ABCD study.

The findings

In the unadjusted model, investigators observed that greater exposure to racial discrimination at time 1 was associated with a higher BMI (β 0.05, 95% CI 0.02-0.08) as well as a higher waist circumference (β 0.35, 95% CI 0.15-0.54) at time 2. Even after adjusting for covariates (ie, age, sex, household income, parent education and nativity status), racial discrimination was positively associated with BMI (0.04, 95% CI 0.01-0.08) and waist circumference (β 0.24, 95% CI 0.04-0.44).

A note from authors

"Our study highlights the need for a multifaceted approach to address racial discrimination and its impacts on the health of children and adolescents. Researchers, clinicians, educators, and policy makers should collaborate with communities to implement evidence-based strategies to prevent racial discrimination and improve the health outcomes of those disproportionately affected."

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