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Objective: The aim is to determine the disparity between the overweight and obesity prevalence of Chinese American school-aged children and adolescents as measured by the Centers for Disease Control and Prevention (CDC) growth reference and the prevalence as measured by international and ethnic-specific-growth references., Design: This retrospective, cross-sectional study measured overweight and obesity prevalence among a paediatric population using the CDC, International Obesity Task Force (IOTF), World Health Organization (WHO) and an ethnic Chinese growth curve., Setting: A community health centre in New York City, USA., Participants: Chinese American children aged 6-17 years in 2017 (N 9160)., Results: The overweight prevalence was 24 % (CDC), 23 % (IOTF), 30 % (WHO) and 31 % (China). The obesity prevalence was 10 % (CDC), 5 % (IOTF), 10 % (WHO) and 10 % (China). When disaggregated by age and sex, the difference was the most prominent in girls; using the China reference compared with using the CDC reference almost doubles the overweight prevalence (school-aged: 31 v. 17 %, P < 0·001, adolescent: 27 v. 14 %, P < 0·001) and the obesity prevalence (school-aged: 11 v. 5 %, P < 0·001, adolescent: 7 v. 4 %, P < 0·001)., Conclusions: Use of the CDC reference compared with the Chinese ethnic-specific reference results in lower overweight and obesity prevalence in Chinese American girls. Almost half of the girls who were overweight and half of the girls who were obese were not identified using the CDC reference. Using ethnic-specific references or ethnic-specific cut-points may help improve overweight identification for Chinese American children.

Prevalence of overweight and obesity was measured in 12,275 Chinese American children and adolescents, ages 2-19, who were patients at a large federally qualified health center in 2015. Demographic characteristics sex, age, and birthplace were further stratified to explore disaggregated prevalence. Comparison of this 2015 cohort to an ethnically similar study cohort from the same health center in 2004 showed that the overall prevalence in overweight and obesity dropped to 21% from previously recorded 24%. US Born school-aged males continue to have the highest prevalence of overweight and obesity at 36%. School-aged children have higher odds of being overweight or obese (OR 1.61, P < 0.001; OR 1.99, P < 0.001) compared to adolescents. Although the foreign-born females had the lowest prevalence of overweight and obesity (12%), they were the only group in 2015 to have increased prevalence in overweight and obesity since 2004 (by 5.8%).