Objectives: To report prevalences of overweight and obesity in a large sample of American Indian children from a survey in 2002-2003, and to evaluate the change in prevalences since 1995-1996 when children on the same reservations were measured. Design: Analysis of survey data. Setting: Aberdeen Area Indian Health Service (North Dakota, South Dakota, Iowa, and Nebraska). Participants: A total of 11 538 American Indian children (aged 5-17 years) attending 55 schools on 12 reservations. Main

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... me Measure: Height and weight measured during the 2002-2003 school year by the same team as in the earlier survey. Prevalences of overweight (Ն85th percentile) and obesity (Ն95th percentile) were calculated on the basis of body mass index (calculated as weight in kilograms divided by the square of height in meters) and the Centers for Disease Control and Prevention growth charts. Results: At 5 years of age, 47% of boys and 41% of girls were overweight, and 24% of the children were obese. Prevalences of overweight and obesity exceeded those for the most recent available data for all US children at almost every age. In the intervening 7 to 8 years between surveys, prevalences of overweight and obesity continued to increase in the children by 4.5% and 4.3%, respectively. Conclusions: Prevalences of overweight and obesity in the most recent sample of American Indian children indicate that they are at even higher risk for these conditions and their health-related sequelae than the best estimates for all US children, with prevalences as high as or higher than those for any other racial or ethnic groups of children reported in the most recent national surveys.