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completion. For our purposes, chronic health conditions in childhood include those amenable to some kindof school-based intervention, such as obesity, asthma, and diabetes, and those conditions that respondchiefly to medical management, such as epilepsy. How prevalent are these conditions in Texas? What isthe effect of these health conditions on academic performance? Can academic achievement be enhancedwith more effective school-based health interventions? In each instance, we look first to the peerreviewed,scientific literature for an answer. At times, the results we cite will be accompanied by sometechnical detail in parentheses; these figures refer to either statistical estimates of particular measures orto their likelihood.Overweight and ObesityPrevalence. Overweight and obesity in children are widely perceived to be reaching alarming proportions.In Texas, a 2003 surveillance of children at the state level (Hoelscher et al., 2004) found the prevalence ofoverweight (body mass index greater than 95% of same-age and gender) to be 22.4% in fourth grade,19.2% in eighth grade, and 15.5% in eleventh grade and to be highest among Hispanic boys (29.5% -32.6%), fourth grade Hispanic girls (26.7%) and fourth and eighth-grade African-American girls (30.8%and 23.1%). For a more complete view of the range of estimates from a variety of sources, see Table 1.Among children found to be overweight, are there consequences for their academic performance?Overweight and Academic Performance. Two recent studies examined the effect of overweight onacademic achievement and factors related to academic performance. Datar, Sturm, and Magnabosco(Datar et al., 2004) examined data from 11,192 kindergartners participating in the Early ChildhoodLongitudinal Study, a nationally representative sample of kindergarteners in the U.S. in 1998. Thislongitudinal study measured height and weight of the children in the fall of kindergarten, spring ofkindergarten, and spring of first grade. Overweight was significantly associated with lower scores inreading for boys (1.42 points, p < .05) and girls (1.66 points, p95 th percentile) girlswere 1.51 times more likely to report being held back a grade (95% CI: 1.09, 2.10) and 2.09 times morelikely to consider themselves poor students (95% CI: 1.35, 3.24). Obese boys were 1.46 times more likelyto consider themselves poor students (95% CI: 1.05, 2.03) and 2.18 times more likely to report that theyexpect to quit school (95% CI: 1.45, 3.30) than average. Overweight (85 th to 95 th percentile) boys were1.36 times more likely to consider themselves poor students (95% CI: 1.05, 1.76) and 1.54 times morelikely to report that they expect to quit school (95% CI: 1.07, 2.22) than average weight boys.Study Limitations. In children and adolescents who are growing at different rates related to age andgender, establishing a criterion for overweight or obese, or for at-risk of overweight, has been challenging.Current guidelines are derived from the Centers for Disease Control and Prevention’s (CDC) GrowthCharts (Kuczmarski, 2000). Charts are presented separately for age and gender groups but not forracial/ethnic groups, since factors related to differential growth by race/ethnicity are as yet unclear. Theresearch on the relationship between overweight and academic performance is limited by the smallnumber of studies, self-report measures of overweight, and controversy over the CDC Growth Charts.E-4