DULUTH — Nearly one in 10 Minnesota children — 53,200 in all — is obese, a report released Thursday, Oct. 10, says.

That’s good in comparison to kids across most of the rest of the country, according to the "State of Childhood Obesity" report from the Robert Wood Johnson Foundation.

But the number may be understated, said a pediatric obesity research specialist in Minnesota.

Minnesota was one of six states with "statistically significantly lower" rates of childhood obesity according to the 2017-18 data used in the study, said an accompanying news release. Minnesota had the second-best percentage overall, 9.4; Utah led the way with 8.7%. The national rate was 15.3%, down from 16.1% in 2016 — not a statistically significant difference, according to the report.

Wisconsin’s rate was 14.3%, tied for 28th highest in the nation.

On the top end, one in every four Mississippi students was obese, and one out of every five in West Virginia, Kentucky and Louisiana.

But Justin Ryder, assistant professor of pediatrics at the University of Minnesota Medical Center, said the data suffer from a small sample size — 500 to 700 children per state — and the fact that it was self-reported — people tend to underestimate their own weight.

U.S. Centers for Disease Control and Prevention, using actual measurements, found a national obesity rate of 20.6% for 12- to 19-year-olds in 2015-16, Ryder said in a telephone interview.

Either way, the numbers are concerning because children who develop obesity are at greater risk for health problems than their peers, he said. The risks include prediabetes and diabetes, early development of cardiovascular disease, pediatric liver disease and certain cancers.

Children who are obese also are more at risk for depression and anxiety and have higher rates of suicide and risky behavior such as alcohol and drug abuse, Ryder said.

Across the country, children in some racial groups were more likely to be obese than in others, and children living in impoverished circumstances more likely to be obese than children who are financially better off.

Black and Hispanic youth had obesity rates of 22.2% and 19%, respectively. For whites, it was 11.8 percent and for Asians 7.3%. Nearly 22% of youth in households making below the federal poverty level were obese. In households making at least 400% of the federal poverty level, it was 9.4%.

Economic and ethnic differences are reflected in a study released by the Minnesota Department of Health earlier this year that analyzed obesity numbers for children ages 2-5 enrolled in the Women, Infants and Children Program, which is available to those who meet income guidelines. They then looked at the data by ZIP code and by cultural identity.

Overall, 16% of the children in the program in 2017 were overweight and 13% obese, according to the analysis. Although it revealed stark ethnic disparities, they broke down differently than in the Robert Wood Johnson report: 28% of American Indian children in the program were obese, 17% of Hispanics, 15% of Asians, over 10% of whites and 11% of blacks and African Americans.

In nine ZIP codes, more than half of the children enrolled in the program were obese. Three of the top five were in Beltrami County, with well over 90% Native American populations. The other two — the Northome area of Koochiching County and the Brookston area in St. Louis County — have predominantly white populations, although their sample sizes were small (51 and 40, respectively).

Both hereditary and environmental factors can play into the disparities, said Victoria Brown, senior program officer for the Robert Wood Johnson Foundation, in a telephone interview.

"It’s the perfect storm of what happens when you have genetic factors and genetic predispositions to diseases like diabetes and other diseases associated with obesity coupled with living in neighborhoods that are not walkable or are not safe to walk," Brown said. "They don’t have streets designed where you can walk, coupled with food deserts where you can’t go out and get access to affordable, healthy foods."

The foundation’s prescription for change includes reversal of a couple of Trump administration policies. It calls for the Department of Agriculture to withdraw proposed policy changes that would reduce the number of families eligible for the Supplemental Assistance Nutrition Program, commonly known as food stamps.

It also says the USDA should restore school meal nutrition standards to those in effect before last December. The new standards represented a rollback of Obama administration policies regarding whole grains, sodium amounts and chocolate milk.

Brown also pointed to innovative approaches at the community level. Columbus, Ohio, for example, launched a "Water First for Thirst" campaign.

"All it did was just show that water is easy, it’s appealing, it’s free," she said. "And it should be the first beverage of choice for families."