Focus Area 19: Nutrition and Overweight

Progress ReviewEdward J. Sondik

National Center for Health Statistics

April 3, 2008

Nutrition and Overweight• Diet is associated with

heart disease stroke some cancers type 2 diabetes overweight and obesity osteoporosis

• Diet-related conditions contribute to reduced quality of life premature death substantial medical costs lost productivity

19-3. Overweight or obesity in children and adolescents

19-5. Fruit consumption19-6. Vegetable consumption19-7. Grain product consumption19-10. Total sodium intake19-11. Total calcium intake

Improving

Getting worse

Little or no progress*

Highlighted Objectives

*Percent of targeted change achieved is between -10% and 10%, or change not statistically significant.

Child and Adolescent Overweight1988-94 2003-06 2010 Target: 5%

Decrease desired

Note: I= 95% confidence interval. Overweight is defined for ages 6-19 years as BMI ≥ gender- and age-specific 95th percentile from the 2000 CDC Growth Charts for the United States. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-3c

Total White Black Mexican Female Male American

Percent4

0

3

0

2

0

1

0

0

Child and Adolescent Overweight1988-94 2003-06 2010 Target: 5%

Decrease desired

* Statistically unreliable. ** Baseline data are for 1991-94.Note: I= 95% confidence interval. Overweight is defined for ages 6-19 years as BMI ≥ gender- and age-specific 95th percentile from the 2000 CDC Growth Charts for the United States. Higher income is defined as > 130 % poverty threshold, and lower as ≤ 130%. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-3c

Total Higher Lower With Without Income Disabilities**

Percent

*

4

0

3

0

2

0

1

0

0

1963-67 1971-74 1976-80 1988-1994 2003-06 1966-70 1999-2002

Percent 2010 Target: 5% Decrease

desired

*Data for 1966-70 are for adolescents 12-17 years of age.Note: Overweight is defined as BMI ≥ gender- and age-specific 95th percentile from the 2000 CDC Growth Charts for the United States. Source: National Health Examination Surveys II (ages 6-11) and III (ages 12-17), National Health and Nutrition Examination Surveys I, II, III and National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-3a, b

1963-65 1971-74 1976-80 1988-1994 2003-06 1966-70* 1999-2002

Child and Adolescent Overweight

Male 12-19Male 6-11Female 12-19Female 6-11

4

0

3

0

2

0

1

0

0

2003

2005

Prevalence of Adolescent Overweight

Note: Data are for high school students in grade 9 – 12. Overweight is defined as ≥ 95th percentile for body mass index, by age and sex, on the basis of reference data, based on self-reported weight and height. Source: Youth Risk Behavior Survey, NCCDPHP, CDC.

2010 Target: 15% Decrease

desired1988-94 2003-06Percent

Obj. 19-2

6

0

4

0

2

0

0

White BlackFemale Male

Note: I = 95% confidence interval. Data are for ages 20 years and over, and age adjusted to the 2000 standard population. Obesity is defined as BMI ≥ 30.0. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Adult Obesity

MexicanAmerican White Black Mexican

American

Trends in Adult Obesity

1960-62 1976-80 1988-94 2003-06 1971-74 1999-2002

Note: Data are for ages 20 years and over, and age adjusted to the 2000 standard population. Obesity is defined as BMI ≥ 30.0. Source: National Health Examination Survey, National Health and Nutrition Examination Surveys I, II, III and National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 19-2

Trends in Adult Obesity

2010 Target: 15 Decrease

desired

Female MaleTotal

Percent6

0

4

0

2

0

0

Percent

Fruits: 2+ servings Vegetables Grains

75

50

25

0

Fruits, Vegetables and Grains Consumption, 2003-04

Objs. 19-5, 19-6 & 19-7

* Statistically unreliable. Note: I = 95% confidence interval. Data are for 2 years and over excluding pregnant or lactating women and breast-fed children, and are age adjusted to the 2000 standard population. One serving has been calculated as two-thirds of a standard serving for all children age 2-3. The categories black and white includes persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Increase desiredTotal White

BlackMexican American

3+ Servings 6+ Servings

Percent

Fruits: 2+ servings Vegetables: 3+ servings Grains: 6+ servings

* **

75

50

25

0

2010 Target

Fruits, Vegetables and Grains Consumption, 2003-04

Objs. 19-5, 19-6 & 19-7

* Statistically unreliable. Note: I = 95% confidence interval. Data are for 2 years and over excluding pregnant or lactating women and breast-fed children, and are age adjusted to the 2000 standard population. One serving has been calculated as two-thirds of a standard serving for all children age 2-3. The categories black and white includes persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Increase desiredTotal White

BlackMexican American

With 1/3 Dark Green/Orange With 3+ Whole Grain

Obj. 19-6Notes: Excludes pregnant or lactating women and breast-fed children. One serving has been calculated as two-thirds of a standard serving for all children age 2-3.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Tomatoes 22%

Other vegetables

39%Legumes

6%

Potatoes 23%

11%

Children 2-19 years Adults 20 years and over

Tomatoes 27%

Other vegetables

28%

Legumes 6%

Potatoes 31% Dark green

or orange vegetables

Proportion of Vegetable Servings2003-04

7%

Target33% dark green

or orange vegetables

Children 2-19 years Adults 20 years and over

Target50% whole grain

Proportion of Grain Servings2003-04

Obj. 19-7Notes: Excludes pregnant or lactating women and breast-fed children. One serving has been calculated as two-thirds of a standard serving for all children age 2-3.Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Other grains 93%

Whole grain

7% Other grains 90%

10%

Percent

1988-94 2003-04 2010 Target: 65%

75

50

25

0

Increase desired

Total Usual Sodium Intake

Objs. 19-10

Note: I = 95% confidence interval. Data are for 2 years and over excluding pregnant or lactating women and breast-fed children, and are age adjusted to the 2000 standard population. Total sodium intake is from food, supplements, tap water and salt added at table. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

2,400mg of Sodium or Less

Total White Black

From Food

94.2%

Added at Table

5.2%

From Tap

Water 0.6%

Sources of Sodium Intake Ages 2 and over,

2003-04

From Supplements

0%

MexicanAmerican

Percent 1988-94 2003-04

10

5

0

Increase desired

* Institute of Medicine, National Academies, Food and Nutrition Board, Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, 2004. ** Statistically unreliable.Note: I = 95% confidence interval. Data are for 2 years and over excluding pregnant or lactating women and breast-fed children, and are age adjusted to the 2000 standard population. Total potassium intake is from food and supplements. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

From Food

99.4%

Sources of Potassium Intake Ages 2 and over, 2003-04

** **

Total Usual Potassium Intake

From Supplement

s 0.6%

Total White BlackMexicanAmerican

100% of Adequate Intake* or More

7

5

5

0

2

5

0

Percent

* Institute of Medicine, National Academies, Food and Nutrition Board, Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, 1997.Note: I = 95% confidence interval. Data exclude pregnant or lactating women and breast-fed children. Data for total are for 2 years and over, and age adjusted to the 2000 standard population. Total calcium intake is from food, supplements and antacids. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-11

Total Female Male

Total Usual Calcium Intake

2-11 12-19 20-39

40-59 60+ Increase

desired2010 Target: 74

100% of Adequate Intake* or More

Females 51 and over Males 51 and over

Obj. 19-11Source: National Health and Nutrition Examination Survey, NCHS, CDC.

From Supplements

From Antacids

Sources of Calcium Intake, 2003-04

From Food 66%

32%

2%

15% From Food 83%

3%

•Weight status objectives for children, adolescents and adults moved away from their targets.

•Fruit, vegetable and grain objectives, total usual sodium intake showed little or no progress.

•Total usual calcium intake moved toward the target.

•The weight status and diets of Americans remain an important public health and economic concern.

Summary

Moved Toward Target19-11. Total calcium

intake19-18. Food security

Target MetNo Objective

Moved Away from Target19-1. Healthy weight in adults 19-2. Obesity in adults 19-3. Overweight or obesity, 6-19

years19-9. Percent calories from total

fat19-12b. Iron deficiency, 3-4 years 19-12c. Iron deficiency, non-

pregnant females 12-49 years

19-13. Anemia in low-income pregnant females in 3rd trimester

19-17. Diet and nutrition counseling

Progress Toward 2010 Targets

Little or No Progress*19-4. Growth

retardation among low-income children

19-5. Fruit consumption

19-6. Vegetable consumption

19-7. Grain product consumption

19-8. Percent calories from saturated fat

19-10. Total sodium intake

19-12a.Iron deficiency, 1–2 years

No Data19-14. Iron deficiency in

pregnant females

Baseline Only19-16. Worksite counseling

Deleted at Midcourse Review19-15. Meals and snacks at

school*Percent of targeted change achieved is between -10% and 10%, or change not statistically significant.

Nancy Crane, FDA Sarah Cusick, NCCDPHP/CDC

Kevin Dodd, NCI/NIHJoseph Goldman, ARS/USDA

Van Hubbard, DNRC/NIHClifford Johnson, NCHS/CDC

Margaret McDowell, NCHS/CDCKathryn McMurry, ODPHP

Alanna Moshfegh, ARS/USDAMark Nord, ERS/USDA

Barbara Schneeman, FDA Bettylou Sherry, NCCDPHP/CDCPamela Starke-Reed, DNRC/NIH

Jean Williams, NCHS/CDC

Data Contributors and Federal Interagency Work Group

Acknowledgements

Progress review data and slides

can be found on the web at:

http://www.cdc.gov/nchs/hphome.htm