Focus Area 19: Nutrition and Overweight Progress Review

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Focus Area 19 Nutrition and Overweight
Progress Review
Edward J. SondikNational Center for Health
Statistics April 3, 2008
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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

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Highlighted Objectives
19-3. Overweight or obesity in children and
adolescents 19-5. Fruit consumption 19-6.
Vegetable consumption 19-7. Grain product
consumption 19-10. Total sodium
intake 19-11. Total calcium intake
Improving
Getting worse
Little or no progress
Percent of targeted change achieved is between
-10 and 10, or change not statistically
significant.
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Child and Adolescent Overweight
Decrease desired
2003-06
2010 Target 5
1988-94
4030 20 10 0
Percent

Total White Black Mexican
Female Male
American
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
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Child and Adolescent Overweight
Decrease desired
2003-06
2010 Target 5
1988-94
4030 20 10 0
Percent


Total Higher Lower
With Without
Income
Disabilities

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 gt 130 poverty
threshold, and lower as 130. Source
National Health and Nutrition Examination Survey,
NCHS, CDC.
Obj. 19-3c
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Child and Adolescent Overweight
Decrease desired
4030 20 10 0
Percent
2010 Target 5
Male 12-19 Male 6-11 Female 12-19 Female 6-11
1963-65 1971-74 1976-80
1988-1994 2003-06
1966-70
1999-2002
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.
1963-67 1971-74 1976-80
1988-1994 2003-06
1966-70
1999-2002
Obj. 19-3a, b
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Prevalence of Adolescent Overweight
2003
2005
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.
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Adult Obesity
Decrease desired
60 40 20 0
1988-94
2003-06
2010 Target 15
Percent

Mexican American
Mexican American
White Black
White Black
Female
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.
Obj. 19-2
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Trends in Adult Obesity
Trends in Adult Obesity
60 40 20 0
Decrease desired
2010 Target 15
Percent
Female Male Total
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
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Fruits, Vegetables and Grains Consumption, 2003-04
Increase desired
75 50 25 0
Mexican American
Total White Black
Percent
Fruits 2 servings Vegetables
Grains
3 Servings 6
Servings
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.
Objs. 19-5, 19-6 19-7
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Fruits, Vegetables and Grains Consumption, 2003-04
Increase desired
75 50 25 0
Mexican American
Total White Black
2010 Target
Percent


Fruits 2 servings Vegetables 3 servings
Grains 6 servings
With 1/3 Dark Green/Orange With 3 Whole
Grain
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.
Objs. 19-5, 19-6 19-7
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Proportion of Vegetable Servings2003-04
Target 33 dark green or orange vegetables
Legumes 6
Other vegetables 28
Other vegetables 39
Legumes 6
Tomatoes 27
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Tomatoes 22
Potatoes 31
Potatoes 23
Dark green or orange vegetables
Children 2-19 years
Adults 20 years and over
Notes 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.
Obj. 19-6
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Proportion of Grain Servings2003-04
Target 50 whole grain
Other grains 93
Other grains 90
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10
Whole grain
Children 2-19 years
Adults 20 years and over
Notes 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.
Obj. 19-7
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Total Usual Sodium Intake
Increase desired
1988-94 2003-04 2010 Target 65
Percent
75 50 25 0
From Tap Water 0.6
Added at Table 5.2
From Food 94.2
From Supplements 0
Mexican American
Total White Black
Sources of Sodium Intake Ages 2 and over, 2003-04
2,400mg of Sodium or Less
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.
Objs. 19-10
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Total Usual Potassium Intake
Increase desired
1988-94 2003-04
10 5 0
Percent
From Food 99.4
From Supplements 0.6


Mexican American
Total White Black
Sources of Potassium Intake Ages 2 and over,
2003-04
100 of Adequate Intake or More
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.
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Total Usual Calcium Intake
Increase desired
2-11
12-19
20-39
40-59
60
75 50 25 0
2010 Target 74
Percent

Total Female
Male
100 of Adequate Intake or More
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
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Sources of Calcium Intake, 2003-04
From Supplements
From Food 66
From Food 83
32
15
2
3
From Antacids
Females 51 and over
Males 51 and over
Obj. 19-11
Source National Health and Nutrition Examination
Survey, NCHS, CDC.
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Summary

• 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.

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Progress Toward 2010 Targets
Moved Away from Target 19-1. Healthy weight in
adults 19-2. Obesity in adults
19-3. Overweight or obesity, 6-19
years 19-9. Percent calories from total
fat 19-12b. 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
Target Met No Objective
Moved Toward Target 19-11. Total calcium
intake 19-18. Food security
Little or No Progress 19-4. Growth retardation
among low-income children 19-5. Fruit
consumption 19-6. Vegetable consumption 19-7. Gra
in product consumption 19-8. Percent calories
from saturated fat 19-10. Total sodium
intake 19-12a. Iron deficiency, 12 years
Baseline Only 19-16. Worksite counseling
No Data 19-14. Iron deficiency in pregnant females
Deleted at Midcourse Review 19-15. Meals and
snacks at school
Percent of targeted change achieved is between
-10 and 10, or change not statistically
significant.
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Acknowledgements
Data Contributors and Federal Interagency Work
Group
Nancy Crane, FDA Sarah Cusick, NCCDPHP/CDC Kevin
Dodd, NCI/NIH Joseph Goldman, ARS/USDA Van
Hubbard, DNRC/NIH Clifford Johnson,
NCHS/CDC Margaret McDowell, NCHS/CDC Kathryn
McMurry, ODPHP Alanna Moshfegh, ARS/USDA Mark
Nord, ERS/USDA Barbara Schneeman, FDA Bettylou
Sherry, NCCDPHP/CDC Pamela Starke-Reed,
DNRC/NIH Jean Williams, NCHS/CDC
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Progress review data and slides can be found on
the web at
http//www.cdc.gov/nchs/ hphome.htm