[acb-diabetics] increased rate of obesity

[Patricia LaFrance-Wolf]

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This article originally posted 18 January, 2010 and appeared in  

Issue 505

 

Most Americans Overweight and One-Third Are Obese: NHANES

 

Two new studies last week draw attention to the alarming number of
individuals in the US considered overweight or obese [1,2]. Based on the
latest surveys,

more than two-thirds of US adults are overweight or obese, one-third are
considered obese, and more than 10% of children and adolescents are also
considered

too heavy for their age.

 

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The good news, however, is that the increasing obesity trends observed over
the past decade appear to be leveling off, according to investigators.

 

Dr. Cynthia Ogden (Centers for Disease Control, Hyattsville, MD), an
investigator on both studies, stated that, "The levels are still very high,
and obesity

is a significant health concern.... On the other hand, we've seen a slowing
down, if you will, in the rate of increase compared with what it was in the

1980's and 1990's, so that's a positive thing. But the prevalence remains
very high, and significant disparities remain, and we did see an increase
within

this 10-year period. It's not as if there were no increase."

 

The data, from analyses of the National Health and Nutrition Examination
Survey (NHANES), were published online January 13, 2010 in the Journal of
the American

Medical Association. In an editorial accompanying the studies [3], Dr. J.
Michael Gaziano (Brigham and Women's Hospital, Boston, MA) argues that
despite

the leveling off, the magnitude of the obesity problem threatens to undo
gains made in recent years.

 

"Despite the many advances in preventive medicine and treatment that reduced
cardiovascular disease, the new stage of the epidemiologic transition, the

age of obesity and inactivity, emerged to threaten the progress made in
postponing illness and death to later in adult life spans," he writes. "The
steady

gains made in both quality of life and longevity by addressing risk factors
such as smoking, hypertension, and dyslipidemia are threatened by the
obesity

epidemic."

 

Ogden, the first author of the study investigating trends in the prevalence
of high body-mass index (BMI) in children and adolescents and an author,
said

NHANES provides enough data every two years to examine the natural
prevalence of obesity in the US population. The purpose of these studies was
to document

trends over two-year periods for the past 10 years.

 

In the first study, they analyzed the prevalence of obesity and overweight
in 5,555 adult men and women based on height and weight measurements used to

calculate BMI. Overweight was defined as a BMI of 25.0 to 29.9 kg/m2 and
obesity defined as a BMI >30.0 kg/m2.

 

In 2007-2008, the overall prevalence of obesity was 33.8%, with more women
than men, 35.5% vs 32.2%, considered obese. Combining obesity and
overweight,

the overall prevalence was 68.0%, this time with more men than women, 72.3%
vs 64.1%, considered overweight and/or obese. The prevalence of obesity
varied

by age group and by racial and ethnic groups.

 

Prevalence of Obesity and Overweight (%) for Adults >20 Years

 

table with 6 columns and 7 rows

Category 

All (n=5555) 

Non-Hispanic white (n=2618) 

Non-Hispanic black (n=1114) 

All Hispanic (n=1566) 

Mexican-American (n=945)  

BMI >30 

33.8 

32.4 

44.1 

38.7 

40.4  

All men 

32.2 

31.9 

37.3 

34.3 

35.9  

All women 

35.5 

33.0 

49.6 

43.0 

45.1  

BMI >25 

68.0 

66.7 

73.8 

77.9 

78.8  

All men 

72.3 

72.6 

68.5 

79.3 

80.0  

All women 

64.1 

61.2 

78.2 

76.1 

76.9 

table end

 

Over the 10-year period, however, the prevalence of obesity did not
significantly increase for women. There was a significant linear trend for
men in the

prevalence in 2007-2008 compared with the prevalence in 1999-2000, but the
most recent figures were not statistically different when compared with data

in 2003-2004 and 2005-2006.

 

In the second NHANES analysis, 11.9% of children and adolescents aged two to
19 years were considered obese, in this case defined as being at or above
the

97th percentile of the BMI-for-age growth charts. Using less stringent
definitions, 16.9% and 31.7% of the kids were at or above the 95th and 85th
percentile

of the BMI-for-age growth charts. Like adults, disparities existed by age
and by race and ethnic groups.

 

"In children, we saw no change over the 10-year period except for in boys
six to 19 years of age," noted Ogden. "Here we saw an increase among the
heaviest

boys, among a cut point that is usually heavier than what we use to
determine obesity. For those kids, the prevalence did increase, so there is
a suggestion

that the heaviest kids are getting even heavier. There is definitely still a
concern."

 

Gaziano writes, "The results of the survey are sobering, given the wide
variety of deleterious health effects strongly linked to excess weight,"
such as

coronary heart disease, ischemic stroke, hypertension, dyslipidemia, Type 2
diabetes, joint disease, cancer, sleep apnea, asthma, and other chronic
conditions.

Early obesity, he notes, strongly predicts later cardiovascular disease, and
excess weight might help explain the dramatic increase in Type 2 diabetes,

a major risk factor for cardiovascular disease.

 

"If left unchecked, overweight and obesity have the potential to rival
smoking as a public-health problem, potentially reversing the net benefit
that declining

smoking rates have had on the US population over the last 50 years," writes
Gaziano.

 

References

list of 3 items

1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in
obesity among US adults, 1999-2008. JAMA 2010; DOI: 10.1001/jama.2009.2014.
Available

at: http://www.jama.com. 

2. Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of high body mass
index in US children and adolescents, 2007-2008. JAMA 2010; DOI:
10.1001/jama.2009.2012.

Available at: http://www.jama.com. 

3. Gaziano JM. Fifth phase of the epidemiologic transition. JAMA 2010; 303;
DOI: 10.1001/jama.2009.2025. Available at: http://www.jama.com. 

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