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Focus Area 19: Nutrition and Overweight Progress Review

Focus Area 19: Nutrition and Overweight Progress Review. Edward 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

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Focus Area 19: Nutrition and Overweight Progress Review

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  1. Focus Area 19: Nutrition and OverweightProgress Review Edward J. SondikNational Center for Health Statistics April 3, 2008

  2. 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

  3. 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 Getting worse Little or no progress* Improving *Percent of targeted change achieved is between -10% and 10%, or change not statistically significant.

  4. Child and Adolescent Overweight Decrease desired 2003-06 2010 Target: 5% 4030 20 10 0 1988-94 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

  5. Child and Adolescent Overweight Decrease desired 2003-06 2010 Target: 5% 4030 20 10 0 1988-94 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 > 130 % poverty threshold, and lower as ≤ 130%. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 19-3c

  6. 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 the2000 CDC Growth Charts for the United States. Source: National Health Examination Surveys II (ages 6-11) and III (ages 12-17), NationalHealth 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

  7. 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.

  8. 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

  9. 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, NationalHealth and Nutrition Examination Surveys I, II, III and National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 19-2

  10. 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 ageadjusted 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

  11. 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 ageadjusted 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

  12. Proportion of Vegetable Servings2003-04 Target 33% dark green or orange vegetables Legumes 6% Other vegetables 28% Other vegetables 39% Legumes 6% Tomatoes 27% 11% 7% 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

  13. Proportion of Grain Servings2003-04 Target 50% whole grain Other grains 93% Other grains 90% 7% 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

  14. 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 ageadjusted 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

  15. 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 ageadjusted 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.

  16. 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 ageadjusted 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

  17. 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.

  18. 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.

  19. 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. Grain product consumption 19-8. Percent calories from saturated fat 19-10. Total sodium intake 19-12a. Iron deficiency, 1–2 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.

  20. 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

  21. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/ hphome.htm

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