Posts Tagged ‘CDC’

Is CDC Massaging the Obesity Stats?

November 22nd, 2015

The world was positively giddy this week following the release of a new CDC Obesity prevalence report. There was so much self-congratulation going on in the childhood obesity world I was afraid of an outbreak of carpal tunnel syndrome.

The headlines shouted that the childhood obesity numbers had stabilized and many groups claimed credit for the success. The CDC reported that, “the prevalence of obesity among U.S. youth was 17% in 2011-2014. Overall, the prevalence of obesity among preschool-aged children (2-5 years) (8.9%) was lower than among school-aged children (6-11 years) (17.5%) and adolescents (12-19) (20.5%).” The report goes on to state, “Between 2003-2004 and 2013-14, however, no change in prevalence was seen among youth.”

Hey, great news, no?  Well, the 17% figured was derived from averaging three groups: 2-5YOA, 6-11 YOA and 12-19 YOA. I question of including 2-5 year olds. The prevalence for this group is about half for the other age groups. And, frankly, they are toddlers. Their prevalence figure probably represents parental panic at the prospects of raising an overweight child. This panic may lead to restrained eating strategies which often fail as the child grows up. As soon as the child starts to exercise more control over their own feeding and behavior, the prevalence rate doubles. Doubles! Taking the 2-5 years old out of the equation, the youth prevalence rate is 19%, not 17%. , 19% is not leveling off. (Truth be told I did not attempt to re-calculate the historical figures without the 2-5 age group.) Keep in mind that CDC views obesity as a binary switch. You are either obese or not. They do not take into account the growth of body weights within the obesity category, i.e. class III or severe obesity growth.

Finally, the CDC does note, “The prevalence of obesity among U.S. adults remains higher than the Healthy People 2020 goal of 30.5%. Although the overall prevalence of childhood obesity is higher than the Healthy People 2020 goal of 14.5%, the prevalence of obesity among children aged 2-5 is below the goal of 9.4%.”

Before popping the champagne, advocates and the media should consider that we are moving further and further away from the targets of Healthy People 2020, not to mention Healthy People 2010. Therefore, it is reasonable to ask if self-congratulation based on failure is an appropriate response.

CDC Spins Breastfeeding-Obesity Link

October 27th, 2015

CDC is continuing to perpetuate the old canard that breastfeeding is protective against childhood obesity. In the recently released publication, Vital Signs: Improvements in Maternity Care Policies and Practices that Support Breastfeeding-United States, 2007-2013,  the CDC states “In addition, evidence suggests that breastfeeding is associated with a reduction in the risk for obesity and diabetes in children (3).”

The reference is a 2007 evidence report on CDC’s sister agency, the Agency for Healthcare Research and  Quality website. However, unlike several other citations, there is no link to the paper. Why? Perhaps because AHRQ identifies the paper as “Archived” and states, “It (the paper) was current when produced and now may be out of date.” Here’s the link:

Maybe out of date? No fooling! See here, here and here for updated research which CDC decided to overlook.


Did White House Spin CDC study to show progress in childhood obesity?

October 20th, 2015

The Daily Caller reports receiving emails under the Freedom of Information Act purporting to show White House influence to spin CDC prevalence figures to support Michelle Obama’s Let’s Move initiative. This does not come as a big surprise. We have been reporting here on the over-optimistic predictions of the end of the obesity epidemic. See here, here, here, herehere and here.


Statin Use on the Rise

January 6th, 2015

CDC reports statin usage for the control of cholesterol has increased  by one-third over the past decade. In 2012, 28% of people over age 40 reported using a cholesterol-lowering medication, up from 2003 rate of 20%. Most of the increase was in statins. 71% of adults with cardiovascular disease and 54% of adults with high cholesterol reported medication usage to control their cholesterol, according to an article in the Washington Post by Tanya Lewis.

The high use of statins has several implications for persons with obesity. Obviously, this trend improves the health of many persons with obesity and  are at greater risk of cardiovascular disease. However, it can also be a confounding factor in research studies. Looking for changes in cardiovascular disease through weight loss (by any method) can be more difficult to find because of the effectiveness of statins. High use of statins was referenced as one of the reasons by the Look Ahead trial was terminated early.


Do CDC’s Obesity Stats Tell the Whole Story?

October 18th, 2013

Nanci Hellmich reported in USA Today on a just-released update from the Centers for Disease Control and Prevention their data on the prevalence of adult obesity in the United States. They found that 78 million adults are obese or 34% of the adult population in 2012 and that this has not significantly changed since 2010. But does this the whole picture? Maybe not.

Three studies draw a more complex picture. Razak and colleagues in Canada analyzed surveys from 37 low- and middle-income countries looking at BMI distribution among women. Their study found a “consistent pattern of unequal weight gain across percentiles of the BMI distribution as mean BMI increases, with increased weight gain at high percentiles of the BMI distribution and little change at low percentages.” They conclude, “Mean changes in BMI, or in single parameters such as percent overweight do not capture the divergence in the degree of weight gain occurring between BMI at low and high percentiles. Population weight gain is occurring disproportionately among groups with already high baseline BMI levels. Studies that characterize population change should examine patterns of change across the entire distribution and not just average trends or single parameters.”

In the second study, Sperrin and colleagues looked at rates of adult obesity in England from 1992 to 2010. Like the CDC picture, they found a less steep increase in the rate of obesity in recent years. But they found two different cohorts. They found about 23.5% of men and 33.7% of women were in a hi-BMI subpopulation. The rest appeared to be an obesity “resistant” normal-BMI population. The high-BMI group continued to increase in body weight while the “resistant” group stayed the same.

A 2002 study out of Finland by Kautianinen et al of Finnish adolescents from 1977-1999 found that the BMI distribution changes were not equal. Those in the lower percentiles had little increase while those at the upper end of the BMI scale had significant increases. They even found the 95th percentile increase was more marked than the 85th percentile increase.

The problem with the CDC approach is that they treat obesity like a light switch. One is either above a BMI of 30 or not. The problem is that this approach may make the current numbers look flat, while, in fact, the fat are getting fatter and the ‘obesity-resistant’ population is staying the same. It may look like progress but it isn’t. But of course, we won’t know for sure until the studies are done in the United States. Until then, our public health authorities should avoid indicating that the obesity epidemic is leveling off and creating a false sense that the obesity problem is receding.


Slight drop in fast food consumption

February 21st, 2013

New data released by the Centers for Disease Control and Prevention, National Center for health statistics finds a modest drop in calories consumed by adults eating at fast food outlets (and, somewhat ambiguously, “pizza”). An earlier report by the U.S. Department of Agriculture found that the percentage of adults eating fast food increased from the early 1990s to the mid-1990s. Moreover, previous studies have reported that more frequent fast-food consumption is associated with higher energy and fat intake and lower intake of healthful nutrients. This report indicates that for 2007–2010, on average, adults consumed just over one-tenth of their percentage of calories from fast food, which represents a decrease from 2003–2006 when approximately 13% of calories were consumed from fast food. During 2007–2010, the highest percentage of calories from fast food was consumed among adults who were aged 20–39 or non-Hispanic black or obese. Among young non-Hispanic black adults, more than one-fifth of their calories were consumed from fast food.

Most Obese States Drop Medicaid Expansion

October 17th, 2012

If you follow developments in obesity at all, you are familiar with the CDC maps showing the increases in obesity across the nation. Likewise, it is clear from these maps, the obesity is a major problem in the South.

Unfortunately, and tragically for many obese poor persons, the governors of Florida, Louisiana, Georgia, South Carolina and Texas have now been joined by the governor of Mississippi in rejecting the expansion of Medicaid in their states. The expansion is authorized under the Affordable Care Act (Obamacare). St.LouisPostDispatch_Mississippi Decides Medicaid Dollars not Worth Cost

Under the Affordable Care Act, the federal government will pay 100% of the cost of expanding Medicaid from 2014 to 2016. Between 2017 and 2020, the federal share drops to 90% and the states’ contribution gradually rises. The Kaiser Family Foundation projected that Mississippi would receive $23 dollars from Washington for every $1 from the state.

While state budgets are clearly under pressure, many see politics at work as all of the Governors in these states are Republicans and are opposed to Obamacare. Regardless, Mississippi has the highest rate of childhood obesity in the nation with nearly 40% of children up to age 17 meeting the obesity criteria. In all of these states, the lower income groups, who would be covered by the expansion of Medicaid, have major health problems. Refusing to participate in the Medicaid expansion only perpetuates these issues.


Weight of the Nations

October 9th, 2012

What is the Weight of the Nations? Earlier in the year, the CDC hosted a conference, the Weight of the Nation. Now come researchers Sarah Catherine Walpole and colleagues from the London School of Hygiene and Tropical Medicine who have assessed global human biomass, its distribution by regions and by proportions attributable to overweight and obesity. Their findings are, well, a ‘gut-check,’ (if you don’t mind the metaphor.)  The numbers are staggering.

They note that more than a billion adults are overweight and, in all regions of the world, the entire population distribution is moving upwards.

So, they calculated that, in 2005, the global human biomass was approximately  287 million tons, of which 15 million tons was attributable to overweight. Biomass due to obesity was 3.5 million tons, equal to 56 million people of average body mass. North America has 6% of the world population but 34% of the biomass due to obesity. Asia has 61% of the world population but 13% of the biomass due to obesity.

One ton of human biomass equates to approximately 12 adults in North America, 17 adults in Asia. According to the authors, “The average BMI in USA in 2005 was 28.7. If all countries had the same age-sex BMI distribution as the USA, total human biomass would increase by 58 million tonnes, a 20% increase in global biomass and the equivalent of 935 million people of world average body mass in 2005. This increase in biomass would increase energy requirements by 261 kcal/day/adult, which is equivalent to the energy requirement of 473 million adults. Biomass due to obesity would increase by 434%”. In contrast, they note that if all countries had the same BMI distribution as Japan, total biomass would fall by 14.6 million tons, a 5% reduction in global biomass or the mass equivalent of 235 million people of world average body mass. This would decrease energy requirements by an average of 59 kcal/day per adult, equivalent to the energy requirement of 107 million adults. Biomass due to obesity would be reduced by 93%.

The authors conclude that, “Increasing population fatness could have the same implication for world food energy demands as an extra half a billion people living on the earth.” See PubMed: The weight of nations: an estimation of adult human biomass