Cynthia L Ogden

National Center for Health Statistics CDC; GWU Milken Institute School of Public Health · NHANES Program; Department of Epidemiology & Biostatistics

Background: Differences in food access, availability, affordability, and dietary intake are influenced by the food environment, which includes outlets where foods are obtained. These differences between food outlets within rural and urban food environments in the US are not well understood. Objective: The aim of this analysis was to describe the...

Background: In 2009, the US Department of Agriculture Food and Nutrition Service's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages were revised to include more whole fruits, vegetables, whole grains, and lower-fat milk. Objective: To describe trends over time in the consumption of fruits (total and who...

In the United States, obesity and severe obesity in children and adolescents are defined using threshold values from the 2000 Centers for Disease Control and Prevention (CDC) sex-specific body mass index (BMI)- for-age growth charts. BMI z-scores and percentiles from the 2000 CDC BMI-for-age growth charts are also used to monitor children's weight...

Objective-The United States Department of Agriculture's MyPlate is based on the Dietary Guidelines for Americans and serves as the primary educational tool to communicate federal dietary guidance. This report presents the percentage of adults who have heard of MyPlate and who have tried MyPlate along with their associations with self-rated diet qua...

Background The 2020–2025 Dietary Guidelines for Americans (DGAs) recommend intake of a variety of vegetables, including dark green, red and orange, starchy, and other vegetables. Objectives This study aims to describe sociodemographic differences in the contribution of different categories of vegetables, and the form in which they are consumed, i....

Objectives This report describes the creation of the NHANES 2017-March 2020 prepandemic data files, including the selection of the appropriate NHANES sample design (2015-2018) to create sample weights and variance units for public-use data files. Additionally, the development of a factor applied to the primary sampling units to adjust the 2017-Marc...

Background: The association between body mass index (BMI) and adiposity differs by race/ethnicity. Objective: To examine differences in adiposity by race/Hispanic origin among US youth and explore how those differences relate to differences in BMI using the most recent national data, including non-Hispanic Asian youth. Methods: Weight, height...

Objective This study aimed to evaluate trends in the use of obesogenic medications among adults. Methods Cross-sectional data on adults aged ≥20 years are from the 1999 to 2018 National Health and Nutrition Examination Survey (n = 52,340). Obesogenic medications were defined according to the 2015 Endocrine Society guidelines on the pharmacological...

Objective—This report presents trends in mean weight, recumbent length, height, waist circumference, and body mass index (BMI) among children and adolescents in the United States from 1999 through 2018. Methods—Data were obtained from physical examinations of nationally representative samples of children and adolescents ranging in age from birth th...

Background Data from the NHANES indicate that BMI has increased in some subgroups of children and adolescents in the United States over the past 20 y; however, BMI is an indirect measure of body fatness. Objectives We assessed changes in DXA-derived measures of adiposity in a nationally representative population of US children and adolescents aged...

Objective: The purpose of this study was to investigate the association of sodium intake with obesity in US children and adolescents. Methods: Cross-sectional data were analyzed for 9,026 children and adolescents in the National Health and Nutrition Examination Survey (NHANES) 2009-2016. Usual sodium intake was estimated from 24-hour dietary rec...

Based on nationally representative anthropometric data, the National Center for Health Statistics (NCHS) has published reference tables on the distribution of various body measurements for the U.S. population (1-5). National Health and Nutrition Examination Survey (NHANES) data are the primary source of body measurement information for the U.S. pop...

Over the past two decades, a steady decline in response rates on national face-to-face surveys has been documented, with steeper declines observed in recent years. The impact of nonresponse on survey estimates is inconsistent and depends on the correlation between response propensity and the survey estimates. To better understand the impact of decl...

Background: The 2000 CDC growth charts are based on national data collected between 1963 and 1994 and include a set of selected percentiles between the 3rd and 97th and LMS parameters that can be used to obtain other percentiles and associated z-scores. Obesity is defined as a sex- and age-specific body mass index (BMI) at or above the 95th percen...

Beverages play a substantial role in meeting total water intake needs and are a major contributor to overall nutrient and caloric intake for the U.S. population (1,2). The 2015-2020 Dietary Guidelines for Americans recommend that water, fat-free and low-fat milk, and 100% juice be the primary beverages consumed (2). This report provides estimates o...

Public health surveillance of obesity describes changes over time and identifies subgroups at risk of obesity-related consequences. We analyzed trends, stratified by race and Hispanic origin, in high weight for length, obesity, and severe obesity in the US from 1999 to 2018.

Fast food has been associated with higher caloric intake and poorer diet quality in children and adolescents (1). In 2011-2012, children and adolescents aged 2-19 years consumed on average 12.4% of their daily calories from fast food on a given day (2). This report presents 2015-2018 estimates of the percentage of calories consumed from fast food o...

Obesity is associated with serious health risks (1). Severe obesity further increases the risk of obesity-related complications, such as coronary heart disease and end-stage renal disease (2,3). From 1999-2000 through 2015-2016, a significantly increasing trend in obesity was observed (4). This report provides the most recent national data for 2017...

Nutrition surveillance includes assessment of physical size and growth (anthropometry), biological samples (e.g., saliva, blood, and urine), and dietary intake. The target group may be individuals, households, schools, communities, or even a nation. Nutrition surveillance serves many purposes: monitoring nutritional status or changes in the food su...

Differences by nativity status for cardiovascular disease (CVD) risk factors have been previously reported. Recent research has focused on understanding how other acculturation factors, such as length of residence, affect health behaviors and outcomes. This study examines the association between CVD risk factors and nativity/length of US residence....

Background: Limited information is available on added sugars consumption in US infants and toddlers. Objectives: To present national estimates of added sugars intake among US infants and toddlers by sociodemographic characteristics, to identify top sources of added sugars, and to examine trends in added sugars intake. Design: Cross-sectional a...

Objective: The aim of this study was to compare national estimates of self-reported and measured height and weight, BMI, and obesity prevalence among adults from US surveys. Methods: Self-reported height and weight data came from the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey, and the Behavior...

Body mass index z-score (BMIz) based on the CDC growth charts is widely used, but it is inaccurate above the 97th percentile. We explored the performance of alternative metrics based on the absolute distance or % distance of a child’s BMI from the median BMI for sex and age. We used longitudinal data from 5628 children who were first examined < 12...

Monitoring prescription drug use patterns at the population level (1) can inform research and clinical practice. These patterns may shift over time in response to changing health needs, updated clinical guidelines (2), policy changes, and other factors (1,3). The percentage of the U.S. population that used one or more prescription drugs increased f...

Background: Both excessive sodium intake and obesity are risk factors for hypertension and cardiovascular disease. The association between sodium intake and obesity is unclear, with few studies assessing sodium intake using 24-h urine collection. Objectives: Our objective was to assess the association between usual 24-h sodium excretion and meas...

Objectives-This report presents trends in mean weight, height, waist circumference, and body mass index (BMI) among adults in the United States from 1999-2000 through 2015-2016. Methods-Data were obtained from physical examinations of a nationally representative sample of adults aged 20 and over in the National Health and Nutrition Examination Surv...

Almost 40% of adults in the United States had obesity in 2015-2016 (1). Obesity is associated with a range of serious health risks (2). Individuals may have multiple motivations for trying to losing weight, including health and appearance reasons (3). This report describes the percentage of U.S. adults who tried to lose weight in the past year by s...

Importance Differences in obesity by sex, age group, race and Hispanic origin among US adults have been reported, but differences by urbanization level have been less studied. Objectives To provide estimates of obesity by demographic characteristics and urbanization level and to examine trends in obesity prevalence by urbanization level. Design,...

Importance Differences in childhood obesity by demographics and urbanization have been reported. Objective To present data on obesity and severe obesity among US youth by demographics and urbanization and to investigate trends by urbanization. Design, Setting, and Participants Measured weight and height among youth aged 2 to 19 years in the 2001-...

Importance Access to appropriate prescription medications, use of inappropriate or ineffective treatments, and adverse drug events are public health concerns among US children and adolescents. Objective To evaluate trends in use of prescription medications among US children and adolescents. Design, Setting, and Participants US children and adoles...

Obesity prevalence has been increasing since the 1980s among adults, but among youth, prevalence plateaued between 2005-2006 and 2013-2014.¹,2 We analyzed trends in obesity prevalence among US youth and adults between 2007-2008 and 2015-2016 in order to determine recent changes.

Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nu...

Objective Differences in bottled v. tap water intake may provide insights into health disparities, like risk of dental caries and inadequate hydration. We examined differences in plain, tap and bottled water consumption among US adults by sociodemographic characteristics. Design Cross-sectional analysis. We used 24 h dietary recall data to test di...

Studies have suggested that obesity prevalence varies by income and educational level, although patterns might differ between high-income and low-income countries (1-3). Previous analyses of U.S. data have shown that the prevalence of obesity varied by income and education, but results were not consistent by sex and race/Hispanic origin (4). Using...

Obesity is associated with serious health risks. Monitoring obesity prevalence is relevant for public health programs that focus on reducing or preventing obesity. Between 2003–2004 and 2013–2014, there were no significant changes in childhood obesity prevalence, but adults showed an increasing trend. This report provides the most recent national e...

What is already known about this topic? Approximately one third of U.S. adults have hypertension, and only about half of these adults have their hypertension under control. Hypertension is an important and common risk factor for heart disease and stroke, two of the leading causes of death in adults. What is added by this report? The examination com...

Objective: To examine the associations among several body mass index (BMI) metrics (z-scores, percent of the 95th percentile (%BMIp95) and BMI minus 95th percentile (ΔBMIp95) as calculated in the growth charts from the Centers for Disease Control and Prevention (CDC). It is known that the widely used BMI z-scores (BMIz) and percentiles calculated...

Background and objectives: The surveillance of children's growth reflects a population's nutritional status and risk for adverse outcomes. This study aimed to describe trends in length-for-age, weight-for-age, weight-for-length, and early childhood weight gain among US children aged 6 to 23 months. Methods: We analyzed NHANES data from 1976-1980...

Objective: Although the Centers for Disease Control and Prevention (CDC) growth charts are widely used, BMI-for-age z-Scores (BMIz) are known to be uninformative above the 97th percentile. This study compared the relations of BMIz and other BMI metrics (%BMIp95 , percent of 95th percentile, and ΔBMIp95 , BMI minus 95th percentile) to circumference...

Total cholesterol (TC) levels, triglyceride levels, and low-density lipoprotein cholesterol (LDL-C) levels are linked to coronary heart disease.¹ Between 1999 and 2010, mean TC, triglycerides, and LDL-C levels declined in the United States, regardless of cholesterol-lowering medication use.² We used 2013/2014 National Health and Nutrition Examinati...

Background: Adequate water intake is critical to physiologic and cognitive functioning. Although water requirements increase with body size, it remains unclear whether weight status modifies the relation between water intake and hydration status. Objective: We examined how the association between water intake and urine osmolality, which is a hydr...

Background: Although the prevalence of a body mass index [BMI (in kg/m(2))] ≥30 has tripled among US adults since the 1960s, BMI is only moderately correlated with body fatness. Because skinfolds can more accurately estimate body fatness than can BMI, it is possible that skinfolds could be useful in monitoring secular trends in body fatness. Obje...

In Reply The intent of our comments was not to dismiss projection analyses but rather to point out that it may be difficult to extrapolate accurately from past data to future trends in obesity. Changes in obesity prevalence over time have not followed a readily predictable pattern. Projections can vary according to the starting time point chosen an...

Objective: Previous research has not investigated the role of prescription medication in sleep-obesity associations despite the fact that 56% of U.S. adults take at least one prescription medication. Methods: Data from n = 16,622 adults in the National Health and Nutrition Examination Survey (2007-2012) were used to examine how the association b...

This study reports on the secular trends of breastfeeding initiation and duration by birth weight using nationally representative data from the National Health and Nutrition Examination Survey. In the United States, breastfeeding initiation rates have risen to 80%.1 We report secular trends of breastfeeding initiation and duration by birth weight u...

Importance Previous analyses of obesity trends among children and adolescents showed an increase between 1988-1994 and 1999-2000, but no change between 2003-2004 and 2011-2012, except for a significant decline among children aged 2 to 5 years. Objectives To provide estimates of obesity and extreme obesity prevalence for children and adolescents for...

Importance Between 1980 and 2000, the prevalence of obesity increased significantly among adult men and women in the United States; further significant increases were observed through 2003-2004 for men but not women. Subsequent comparisons of data from 2003-2004 with data through 2011-2012 showed no significant increases for men or women. Objective...

Key findings: Data from the National Health and Nutrition Examination Survey •During 2009-2012, 32.4% of youth consumed nuts (including seeds and nut butters) on a given day. •A higher percentage of non-Hispanic white youth (37.6%) than non-Hispanic black (24.3%) or Hispanic (25.0%) youth consumed nuts. •Almost 44.0% of youth in households at or a...

• In the late 1970s, the prevalence of childhood obesity was the same in Canada and the United States, but recently the prevalence is 4.5 percentage points higher in the United States than in Canada. • No change has been seen over the last decade in the prevalence of obesity among children and adolescents in Canada or the United States. • The preva...

Key findings: Obesity is associated with health risks (1,2). Monitoring the prevalence of obesity is relevant for public health programs that focus on reducing or preventing obesity. No significant changes were seen in either adult or childhood obesity prevalence in the United States between 2003-2004 and 2011-2012 (3). This report provides the mo...

Introduction: Although decline in muscle mass and quality and resulting declines in muscle strength are associated with aging, more research is needed in general populations to assess the utility of handgrip strength as an indicator of muscle strength and cardiovascular disease risk. Methods: Data from 4,221 participants aged ≥20 years in the 20...

Background: Although the estimation of body fatness by Slaughter skinfold thickness equations (PBFSlaughter) has been widely used, the accuracy of this method is uncertain. We have previously examined the interrelationships among the body mass index (BMI), PBFSlaughter, percent body fat from dual energy X-ray absorptiometry (PBFDXA) and CVD risk f...

Objectives: To describe the contribution of whole fruit, including discrete types of fruit, to total fruit consumption and to investigate differences in consumption by sociodemographic characteristics. Methods: We analyzed data from 3129 youth aged 2 to 19 years from the National Health and Nutrition Examination Survey, 2011 to 2012. Using the F...

Key findings: Consumption of fast food has been linked to weight gain in adults (1). Fast food has also been associated with higher caloric intake and poorer diet quality in children and adolescents (2). From 1994 through 2006, caloric intake from fast food increased from 10% to 13% among children aged 2-18 years (3). This report presents the most...

Background: The WHO cutoffs to classify biologically implausible values (BIVs) for weight, height, and weight-for-height in children and adolescents are widely used in data cleaning. Objectives: We assess 1) the prevalence of these BIVs, 2) whether they were consistent with information on waist circumference, arm circumference, and leg lengths,...

Cardiovascular disease remains an important cause of death in the U.S. where veterans of the U.S. Armed Forces represent a significant segment of the population. Limited national estimates of cardiovascular disease risk factors using physical measurements and reported veteran status in the U.S. civilian population have been reported. The purpose of...

As more epidemiologic data on childhood obesity become available, researchers are faced with decisions regarding how to determine biologically implausible values (BIVs) in height, weight, and body mass index. The purpose of the current study was 1) to track how often large, epidemiologic studies address BIVs, 2) to review BIV identification methods...

Food insecurity can put children at greater risk of obesity because of altered food choices and nonuniform consumption patterns. We examined the association between obesity and both child-level food insecurity and personal food insecurity in US children. Data from 9,701 participants in the National Health and Nutrition Examination Survey, 2001-2010...

Consuming seafood has health benefits, but seafood can also contain methylmercury, a neurotoxicant. Exposure to methylmercury affects children at different stages of brain development, including during adolescence. The objective was to examine seafood consumption and blood mercury concentrations in US youth. In the 2009-2012 NHANES, a cross-section...

Recent national data suggest there were improvements in serum lipid concentrations among US children and adolescents between 1988 and 2010 but an increase in or stable blood pressure (BP) during a similar period. To describe the prevalence of and trends in dyslipidemia and adverse BP among US children and adolescents. The National Health and Nutrit...

Background Few studies have assessed how well body mass index (BMI), waist circumference (WC), or waist to height ratio (WtHR) perform in identifying cardio-metabolic risk among youth.Objective The objective of this study was to evaluate the utility of BMI and WC percentiles and WtHR to distinguish adolescents with and without cardio-metabolic risk...

Data from the National Health and Nutrition Examination Survey, 2009-2010. Almost 40% (38.2%) of adults consumed nuts on a given day. More non-Hispanic white (43.6%) than non-Hispanic black (23.7%) or Hispanic (25.5%) adults consumed nuts. Approximately 80% of nuts consumed (84.0% by men and 79.7% by women) were nuts or seeds as single-item foods o...

The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, pro...

Background and objectives: Regular aerobic and muscle-strengthening physical activity in youth has been positively associated with health and may help prevent obesity. The purpose of this study is to provide reference values on 4 core, upper, and lower body measures of muscle strength among US children and adolescents and to investigate the associ...

More than one-third of adults and 17% of youth in the United States are obese, although the prevalence remained stable between 2003-2004 and 2009-2010. To provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults. Weight and he...

Seafood is part of a healthy diet, but seafood can also contain methyl mercury-a neurotoxin. The objective was to describe seafood consumption in US adults and to explore the relation between seafood consumption and blood mercury. Seafood consumption, obtained from a food-frequency questionnaire, and blood mercury data were available for 10,673 adu...

The prevalence of obesity among adults in the United States doubled between 1980 and 2000 and the prevalence remains high at over one third of the population. Obesity has been linked to increased morbidity and mortality in the USA and globally. In 2008, an estimated 502 million adults worldwide were obese. Obesity is estimated based on body mass in...

Key findings: Data from the combined National Health and Nutrition Examination Survey (NHANES) and the NHANES National Youth Fitness Survey, 2012. In 2012, about one-quarter of U.S. youth aged 12-15 years engaged in moderate-to-vigorous physical activity for at least 60 minutes daily. Basketball was the most common activity reported among active b...

Obesity results from an imbalance between energy intake and energy expenditure. Factors that influence energy intake include the quantity and quality of foods and beverages consumed, while physical activity levels influence energy expenditure. Energy balance is further influenced by genetic, metabolic, and environmental factors.

Between 2010 and 2050, the American older adult population aged 65 years and older is projected to grow from 40.2 million to 88.5 million. Similar to estimates in the entire adult population, in 2007-2010 over a third of adults aged 65 years and older were obese, which represents over 13 million adults. Because both aging and obesity contribute to...

Key findings: Data from the National Health and Nutrition Examination Survey, National Youth Fitness Survey. There were no significant differences by sex in core, lower, or upper body measures of strength for younger boys and girls. In contrast, adolescent boys had higher values than adolescent girls on all measures of strength. Adolescent boys an...

Key findings: Data from the National Health and Nutrition Examination Survey, 2011-2012. More than one-third (34.9%) of adults were obese in 2011-2012. In 2011-2012, the prevalence of obesity was higher among middle-aged adults (39.5%) than among younger (30.3%) or older (35.4%) adults. The overall prevalence of obesity did not differ between men...

Background-Analytic guide lines were first created in 1996 to assist data users in analyzing data from the Third National Health and Nutrition Examination Survey (NHANES III),conducted from 1988 to 1994 by the Centers for Disease Control and Prevention's National Center for Health Statistics. NHANES became a continuous annual survey in 1999, with d...

Background: Reducing sugar-sweetened beverage (SSB) consumption is a recommended strategy to promote optimal health. Objective: The objective was to describe trends in SSB consumption among youth and adults in the United States. Design: We analyzed energy intake from SSBs among 22,367 youth aged 2-19 y and 29,133 adults aged ≥20 y who particip...

Data from the National Health and Nutrition Examination Survey, 2005-2010 The mean percentage of total calories from added sugars decreased with increasing age and increasing income. Non-Hispanic black men and women consumed a larger percentage of their total calories from added sugars than non-Hispanic white and Mexican-American men and women. Mor...