See my post at: http://www.stopobesityalliance.org/blog/is-the-obesity-epidemic-leveling-off-don%e2%80%99t-be-too-sure/
Posts Tagged ‘prevalence’
Is the Obesity Epidemic Leveling Off? Not so fast.
January 26th, 2012American Heart Assn. Sees Tidal Wave of Cardiovascular Disease coming from Obesity Epidemic
December 16th, 2011The American Heart Association has published an update 
on the burden of cardiovascular disease and stroke. They warn that the recent drop in death rates is likely to be reversed by the continuing increases in the rates of diabetes and obesity. Dr. Donald Lloyd-Jones told MedPageToday that rising death rates in cardiovascular death in young adults is particularly troubling, “Because if they’re getting disease at this young of an age then they’re just the leading edge – the canaries in the coal mine, if you will – that suggests that we have a whole tidal wave of cardiovascular disease that is coming as a result of the obesity epidemic.” Medical News: Diabetes, Obesity Overshadow Lower CV Death Rate – in Cardiovascular, Prevention from MedPage Today
Here are the facts:
The estimated prevalence of overweight and obesity in US adults (>20 years of age) is 149 300 000, which represents 67.3% of this group in 2008. Fully 33.7% of US adults are obese (body mass index >30 kg/m2). Men and women of all race/ethnic groups in the population are affected by the epidemic of overweight and obesity.
● Among children 2 to 19 years of age, 31.9% are overweight and obese (which represents 23 500 000 children), and 16.3% are obese (12 000 000 children). Mexican American boys and girls and African American girls are disproportionately affected. Over the past 3 decades, the prevalence of obesity in children 6 to 11 years of age has increased from <4% to more than 20%.
● Obesity (body mass index >30 kg/m2) is associated with marked excess mortality in the US population. Even more notable is the excess morbidity associated with overweight and obesity in terms of risk factor development and incidence of diabetes mellitus, CVD end points (including coronary heart disease, stroke, and heart failure), and numerous other health conditions, including asthma, cancer, degenerative joint disease, and many others.
● The prevalence of diabetes mellitus is increasing dramatically over time, in parallel with the increases in prevalence of overweight and obesity.
● On the basis of NHANES 2003–2006 data, the age adjusted prevalence of metabolic syndrome, a cluster of major cardiovascular risk factors related to overweight/obesity and insulin resistance, is 34% (35.1% among men and 32.6% among women).
● The proportion of youth (<18 years of age) who report engaging in no regular physical activity is high, and the proportion increases with age. In 2007, among adolescents in grades 9 through 12, 29.9% of girls and 17.0% of boys reported that they had not engaged in 60 minutes of moderate-to-vigorous physical activity, defined as any activity that increased heart rate or breathing rate, even once in the previous 7 days, despite recommendations that children engage in such activity >5 days per week.
● Thirty-six percent of adults reported engaging in no vigorous activity (activity that causes heavy sweating and a large increase in breathing or heart rate).
● Data from NHANES indicate that between 1971 and 2004, average total energy consumption among US adults increased by 22% in women (from 1542 to 1886 kcal/d) and by 10% in men (from 2450 to 2693 kcal/d;
● The increases in calories consumed during this time period are attributable primarily to greater average carbohydrate intake, in particular, of starches, refined grains, and sugars. Other specific changes related to increased caloric intake in the United States include larger portion sizes, greater food quantity and calories per meal, and increased consumption of sugar-sweetened beverages, snacks, commercially prepared (especially fast food) meals, and higher energy-density foods.
For the full report, see Heart Disease and Stroke Statistics—2011 Update1. About 1. About These Statistics2. American Heart Association’s 2020 Impact Goals3. Cardiovascular Diseases4. Subclinical Atherosclerosis5. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris6.
Is California’s Childhood Obesity Picture Really Improving?
November 19th, 2011The UCLA Center for Health Policy Research and the California Center for Public Health Advocacy recently released a report, “A Patchwork of Progress, Changes in Overweight and Obesity Among California 5th, 7th, and 9th Grades, 2005-2010. California making headway in battle against childhood obesity but successes are uneven | UCLA Center for Health Policy Research The lead was that the state prevalence rate had dropped between 2005 and 2010 by 1.1%. This was widely picked up by the media and indicating that California had turned the corner on childhood obesity. Childhood obesity rates level off in California and L.A. County – latimes.com
The report and some of the media report did indicate wide variations. 31 of 58 counties showed an increase in the rates of obesity and five had rates at least 10% higher in 2010 than in 2005. 26 counties experienced a decrease in rates of obesity with 7 have rates at least 10% lower in 2010 than in 2005.
So, does this look like progress? Consider this: the number of children who are overweight or obesity actually increased from 2010 to 2005. Reason: school enrollment increased from 1,137,122 in 2005 to 1,214,061 in 2010. So, while the prevalence figured may have dropped during this 5 year period, the number of children considered overweight or obesity increased by 16, 729 or 3.7%.
A study by this group last year indicated that income disparities in obesity prevalence was significantly increasing, principally affecting low income male adolescents. Income disparities in obesity trends amon… [Am J Public Health. 2010] – PubMed – NCBI
Asian Rates of Diabetes and Obesity Set to Explode
July 7th, 2011
An analysis of over 900,000 individuals in 18 cohorts from 7 Asian nations (Bangladesh, China, India, Japan, Korea, Singapore and Taiwan) show an overall prevalence of diabetes of 4.3%, ranging from 0.5% TO 8.2%. The positive association between BMI and diabetes prevalence was observed in all cohorts and all subgroups, although the association was stronger for younger individuals. The results were similar no matter whether the standard or ‘Asian” cutoffs are used. The authors note that the fast rising rates of obesity in these countries, For example, in rural China, the prevalence of overweight has increased from 5.3% in men to 13.6% and from 9.8% in women to 14.4%. Rates of obesity increased from 0.5% in men to 1.8% and from 0.7% in women to 3.0%. This, the authors note, “ has profound implications for the expected number of diabetes patients who will be diagnosed in this region in future decades. PLoS ONE: Body Mass Index and Diabetes in Asia: A Cross-Sectional Pooled Analysis of 900,000 Individuals in the Asia Cohort Consortium
Is obesity leveling off and what does it matter?
January 23rd, 2010Ten days ago, the media was touting new reports from the CDC that the obesity epidemic was ‘leveling off’ or ‘reaching a plateau.’ The news was taken in some quarters with a sense of relief:”Whew, I’m glad that’s over.” Well, don’t get too comfortable. The reports have a lot more to say and overall, this is not a time for complacency.
What the reports actually say.
First, regarding adults, (Prevalence and trends in obesity among US adults, … [JAMA. 2010] – PubMed result), the authors note that the prevalence of obesity is high, exceeding 30% in most age and sex groups except for men 20-39 years old. Strong racial and ethnic differences persist with very high rates among African-American and Hispanic Americans compared to white Americans. Prevalence of severe or morbid obesity, called class 3, (a BMI of 40 or more) was 5.7% overall, with 4.2% for mean and 7.2% for women, including a rate of 14.2% among non-Hispanic black women. What their analyses found was that the earlier rates of increase were on the order of 6 to 7 percentage points. In the this analysis, over the past ten years, the rate of increase is 4.7 percent. Bottom line: rates are still going up.
Second, regarding children, (Prevalence of high body mass index in US children … [JAMA. 2010] – PubMed result) the authors found no statistically significant increases over the last 10 years among girls. Among boys, there is a different picture. Heavy boys between 6 and 19 years of age are getting heavier. Bottom line: the prevalence of obesity has tripled among school-age children and adolescents if you go back to the 1980s. It is high – 17%- and remains high.
So, is the epidemic leveling off? Answer: we don’t know yet. These analyses look at the last ten year trends and they are less than the peak periods of increase. Is this a pause on an upward track or the start of a decline?
Experts I talked with are not too optimistic. First, there is the perennial question of relying on the BMI. A recent paper indicates that more precise tools, like skinfold tests, would have predicted the obesity epidemic by 10-20 years. The timing of the rise in U.S. obesity varies with… [Econ Hum Biol. 2009] – PubMed result. Second, there isn’t a clear explanation of why the rates should be leveling off. We’d like to think people are changing their behavior but the evidence is there is less compliance with recommended dietary and physical activity standards than ever. Adherence to healthy lifestyle habits in US adults… [Am J Med. 2009] – PubMed result Compliance with the DASH diet among persons with hypertension has slipped. Deteriorating dietary habits among adults with hyp… [Arch Intern Med. 2008] – PubMed result
The recession may be causing people to forgo buying more expensive but healthier foods Recession Weighs on Waistlines – chicagotribune.com. Many clinicians running medical weight management programs I have talked with report their volume is down 20-30%.
Hopefully, this is the beginning of a levelling or downard trend in obesity but we will not know for sure until more information comes in. In the meantime, we should consider that we don’t to be having phenomenal increases in obesity to justify more programs for treatment and prevention. An editorial by J Michael Graziano on the two reports from CDC, states, “Even if these trends can be maintained, 68% of US adults are overweight or obese, and almost 32% of school-aged US children and adolescents are at or above the 85th percentile of BMI for age. Given the risk of obesity-related major health problems, a massive public health campaign to raise awareness about the effects of overweight and obese is necessary..Major research initiatives are needed to identify better management and treatment options. The longer the delay is taking aggressive action, the higher the likelihood that the significant progress achieved in decreasing chronic disease rates during the last 40 years will be negated, possibly even with a decrease in life expectancy.” Amen.
Downey Fact Sheet 2 – Quick Facts
September 27th, 2009
The Downey Obesity Report
ADULT OBESITY
The adult obesity rates have risen dramatically from 1960 to today; rates of overweight (BMI >30) have doubled, rates of obesity (BMI 30-39.9) have nearly tripled and rates of extreme or morbid obesity (BMI >40) have nearly increased seven fold.
ADULT (age 20-74) Prevalence 1
Overweight (BMI 25-30) Percentage
1960-1962 31.5%
2005-2006 33%
Obese (BMI>30)
1960-1962 13.4%
2005-2006 35.1%
Extreme or Morbid Obese( BMI>40)
1960-1962 0.9%
2005-2006 6.2%
The rates of obesity only tell half the story. During this period, the total US population has also increased. Therefore, the raw numbers of Americans affected have also increased. Looking at the numbers of people affected, the overweight population has doubled, the obese population has increased 5 fold and the population with extreme or morbid obesity as increased by a factor of nearly 12!
Number of Americans Overweight in 1960: 56.5 million
Number of Americans Overweight in 2006: 94.5 million
Number of Americans Obese in 1960: 24 million
Number of Americans Obese in 2006:
40 million
Number of American with extreme or morbid obesity in 1960:
1.6 million
Number of Americans with extreme or morbid obesity in 2006: 18.6 million
Since 1960-61 to 2006, the number of American adults who became obese or extremely obese*: 61.1 million
Average number per year: 1.3 million
Average number per month: 110,779
Average number per day: 3,693
Average number per hour: 153
Average increase per minute: 2.5
Since 1960-61 to 2006, the number of American adults who became extremely obese*: 11 million
Average number per year: 240,217
Average number per month: 20,018
Average number per day: 667
Average number per hour: 27
Adolescents Obesity age 12-19 3
Percent overweight/obese 2005-2006 18%
Young adult Obesity
Ages 18-29
Percent obese 1971-1974 8%
Percent obese 2005 24%
Childhood 2
Ages 6-11 15%
Ages 2-5 11%
Year at which each group will reach 80% obesity 4
All 2072
Men 2077
Women
2058
African American Women 2035
African American Men 2079
Mexican American Women 2073
Mexican American Men 20 91
White Women 2082
White Men
2073
Adipose Tissue (Fat Cells) 5
Age at which typical body has acquired its full number of fat cells: 13
Number of fat cells in average American Adult: 23-65 billion
Number of fat cells in persons with morbid obesity: 37-237 billion
Number of fat cells lost in weight-loss efforts: 0
By Julie Snider for the Downey Obesity Report
Daily Calories Needed and Available 6
Recommended calories per day by typical American adult:
Men 2,400 to 2,800
Women 2,000 to 2,200
Mean (meaning half were above and half below) adult daily calorie intake per day 7 :
Men
1971 2,450
2001-2004 2,593
Women
1971 1,542
2001-2004 1,886
Percent increase in food available for consumption per person from
1970 to 2003: 16%
Amount of food available for each person increase from
1.67 pounds in 1970 to 1.95 pounds in 2003
Daily caloric intake has grown by 523 calories from 1970 to 2003. Leading the way were fats, oils, grains, vegetables and sugars and sweeteners.
U.S. Government Biomedical Research 8
2008 Budget of National Institutes of Health $29.6 billion
NIH Spending 2008 on selected diseases:
Cancer
$5.6 billion
HIV/AIDS funding $2.9 billion
Cardiovascular Disease
$2.0 billion
Heart Disease $1.2 billion
Obesity
$664 million
U. S. Government Infrastructure on Combating Obesity
Name of coordinator of U.S. global anti-obesity efforts:
(Trick question: no such position exists)
Name of White House coordinator of federal anti-obesity efforts:
(Another trick question: no such position exists)
Name of coordinator of Department of Health and Human Services***anti-obesity efforts:
(No such position exists)
*Calculations were made by taking the CDC prevalence figures for 1960-1962 and 2005-2006and multiplying them against US census data for 1960 and census data for 2006,respectively. See Census Bureau Home Page
**Available in this context means the total US calories available for consumption, less spoilage and waste. See ERS/USDA Data – Food Availability (Per Capita) Data System)
*** Department of Health and Human Services includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, Office of the Surgeon General, the Agency for Healthcare Research and Quality among others.)
Notes
2. FASTSTATS – Overweight Prevalence
3. http://www.cdc.gov/nchs/data/hus/hus08.pdf
4. Studies of human adipose tissue. Adipose cell size…[J Clin Invest. 1973] – PubMed Result
5. Will all Americans become overweight or obese? est…[Obesity (Silver Spring). 2008] – PubMed Result. In this estimate, by 2030, 86.3% of adults will be overweight or obese and 51% obese; black women at a level of 96.9% will be the most effected, followed by Mexican-American men (91.1%). By 2048, all American adults would be overweight or obese but black women would reach that milestone by 2034. In children, the authors estimate, rates will nearly double by 2030.
6. http://www.mypyramid.gov/downloads/MyPyramid_Food_Intake_Patterns.pdf
7. http://www.ers.usda.gov/AmberWaves/November05/pdf/FindingsDHNovember2005.pdf
By Julie Snider for the Downey Obesity Report
Downey Fact Sheet 6 – Morbid Obesity
September 27th, 2009
Fact Sheet Morbid Obesity
Over two-thirds of Americans are overweight or obese; one-third are obese. But the obesity crisis in the United States is really the crisis of morbid obesity. It is this group – persons with morbid obesity – who have the most comorbid conditions, the highest health care costs and the greatest likelihood of death.
Morbid obesity is defined as a Body Mass Index (BMI) of 40 or more (roughly 100 pounds over ideal weight). (The Body Mass Index is a formula in which the weight in kilograms is divided by height in meters squared. A BMI of 30 to 39.9 is regarded as obese; 25-29.9 overweight and 20-24.9 normal weight; a BMI below 20 is considered unhealthy.) The number of Americans with morbid or severe obesity, defined as 100 pounds or more overweight or a BMI of 40, is growing twice as fast as the number of Americans who are overweight or obese.
The prevalence of Americans with a BMI over 50 has increased by 75 percent from 2000 to 2005. This statistic confirms that the heaviest BMI groups have been increasing at the fastest rates for 20 years. (Increases in morbid obesity in the USA: 2000-2005. [Public Health. 2007] – PubMed Result)
- The prevalence of morbid obesity is now 1 in 20 Americans. The prevalence is greater among women than men and among African-Americans than among non-Hispanic whites or Hispanics. The mortality due to morbid or extreme obesity is greater among the young than the older adults, greater for men than for women and greater among whites than blacks. Extreme obesity: a new medical crisis in the Unite…[Mayo Clin Proc. 2006] – PubMed Result.
- Unfortunately, it appears this trend will only grow worse. In a recently published paper, researchers noted the tendency for the heavier to become more heavy, especially among the young and minority groups. Gender-ethnic disparity in BMI and waist circumfer…[Obesity (Silver Spring). 2009] – PubMed Result
- While this population is only about 5 percent of the total U.S. population or 15 million people, it is greater than the entire population of Illinois and is roughly 3 times as large as the population with Alzheimer’s disease.
- The prevalence of morbid obesity is now 1 in 20 Americans. The prevalence is greater among women than men and among African-Americans than among non-Hispanic whites or Hispanics. The mortality due to morbid or extreme obesity is greater among the young than the older adults, greater for men than for women and greater among whites than blacks.7 7 Extreme obesity: a new medical crisis in the Unite…[Mayo Clin Proc. 2006] – PubMed Result
- A recent study found of thousands of employees found that those with morbid obesity have a significantly higher prevalence of more than 102 diseases and conditions out of 131 eligible diseases and conditions than other employees and had a lower prevalence in only 3 categories: normal delivery, placenta previa and liveborn. 8 The impact of morbid obesity and bariatric surgery…[J Occup Environ Med. 2009] – PubMed Result This study also revealed several conditions which were not noted in previous studies including intervertebral disc disorders, malaise and fatigue, anemia, other upper respiratory disease, abdominal pain, nonspecific chest pain.
- Higher BMI is associated with lower than expected life duration. Excess BMI is responsible for an estimated 95 million years-of-life-lost; white females account for more than 2/3 of the years-of-life-lost. Individual and Aggregate Years-of-life-lost Associ…[Obesity (Silver Spring). 2009] – PubMed Result
The Built Environment
September 27th, 2009Understanding the Relationship between Activity an…[BMC Public Health. 2009] – PubMed Result
Prevalence, trends and environmental influences on…[Med Sport Sci. 2007] – PubMed Result
Built Environments and Obesity in Disadvantaged Po…[Epidemiol Rev. 2009] – PubMed Result
Neighborhood environments: disparities in access t…[Am J Prev Med. 2009] – PubMed Result
Physical environmental correlates of childhood obe…[Obes Rev. 2009] – PubMed Result