Total,Added, and Free Sugars: Are Restrictive Guidelines Science-Based or Achievable?

Sugar consumption, especially added sugars, is under attack. Various government and health authorities have suggested new sugar recommendations and guidelines as low as 5% of total calories from free sugars. Definitions for total sugars, free sugars, and added sugars are not standardized, nor are there accepted nutrient databases for this information. Our objective was to measure total sugars and added sugars in sample meal plans created by the United States Department of Agriculture (USDA) and the Academy of Nutrition and Dietetics (AND). Utilizing the Nutrition Data System for Research (NDSR) nutritional database, results found that plans created by the USDA and AND averaged 5.1% and 3.1% calories from added sugar, 8.7% and 3.1% from free sugar, and 23.3% and 21.1% as total sugars respectively. Compliance with proposed added sugar recommendations would require strict dietary compliance and may not be sustainable for many Americans. Without an accepted definition and equation for calculating added sugar, added sugar recommendations are arbitrary and may reduce intakes of nutrient-rich, recommended foods, such as yogurt, whole grains, and tart fruits including cranberries, cherries, and grapefruit. Added sugars are one part of excess calorie intake; however, compliance with low added sugar recommendations may not be achievable for the general public.     

The 2006–2007 Food Label and Package Survey (FLAPS): Nutrition labeling,trans fat labeling

Since the 1970s, the Center for Food Safety and Applied Nutrition at the United States (US) Food and Drug Administration (FDA) has studied product labels from the US food supply through the Food Label and Package Survey (FLAPS). The sampling frame for the latest survey, FLAPS 2006–2007, was the ACNielsen Strategic Planner food sales database. As the newest addition to the Nutrition Facts label, this latest FLAPS included trans fat and was utilized to characterize the prevalence of foods reporting trans fat information. For this survey, FDA used a new probability-based sample design to draw a list of food products. Products were purchased from retail stores across the US, and label information was recorded to create the FLAPS 2006–2007 database. Results of initial data analyses show that an estimated 96.3% of FDA-regulated processed, packaged foods have nutrition labeling, with an additional 3.7% exempt from mandatory nutrition labeling requirements. FLAPS data show that 12% of products provide a nutrient content claim about the amount of trans fat on the principal display panel, with over 75% displaying “0 g trans fat.” FDA will continue to analyze FLAPS data as a tracking mechanism to monitor the market response to food label regulations and to support policy, regulatory, economic, and food safety decisions.     

Food Sources of Total Energy and Nutrients among U.S. Infants and Toddlers: National Health and Nutrition Examination Survey 2005–2012

Understanding the dietary intakes of infants and toddlers is important because early life nutrition influences future health outcomes. The aim of this study was to determine the dietary sources of total energy and 16 nutrients in a nationally representative sample of U.S. infants and toddlers aged 0–24 months. Data from the 2005–2012 National Health and Nutrition Examination Survey were analyzed. Dietary intake was assessed in 2740 subjects using one 24-h dietary recall. The population proportion was used to determine the contribution of foods and beverages to nutrient intakes. Overall infant formulas and baby foods were the leading sources of total energy and nutrients in infants aged 0–11.9 months. In toddlers, the diversity of food groups contributing to nutrient intakes was much greater. Important sources of total energy included milk, 100% juice and grain based mixed dishes. A number of foods of low nutritional quality also contributed to energy intakes including sweet bakery products, sugar-sweetened beverages and savory snacks. Overall non-flavored milks and ready-to-eat cereals were the most important contributors to micronutrient intakes. In conclusion this information can be used to guide parents regarding appropriate food selection as well as inform targeted dietary strategies within public health initiatives to improve the diets of infants and toddlers.     

Socioeconomic status and dyslipidemia in Korean adults: The 2008–2010 Korea National Health and Nutrition Examination Survey

Objective

This study investigated the relationship between socioeconomic status (SES) and dyslipidemia and various parameters of dyslipidemia among Korean adults.

Methods

Data from the 2008–2010 Korea National Health and Nutrition Examination Survey were used in this study. A total of 19,041 Korean adults greater than 19 years old participated in the study. The SES was assessed by monthly household income and education level. The relationship of SES to the risk of dyslipidemia was assessed with multivariate logistic regression analysis after adjusting for potential confounders.

Results

The prevalence of dyslipidemia was 37.4% among Korean adults. In men, household income level was positively associated with prevalence and risks of several parameters of dyslipidemia, and education level had positive associations with the risks of dyslipidemia and parameters of dyslipidemia. However, low SES was linked to increased prevalence and risks of dyslipidemia (P for trend < 0.05) and parameters of dyslipidemia in women.

Conclusions

Socioeconomic disparities in dyslipidemia were found in the Korean population. Also, there were gender differences in the relationship between SES and dyslipidemia. These disparities should be considered when performing risk calculations and screening for dyslipidemia, which will ultimately help prevent cardiovascular disease.     

The French National Nutrition and Health Program: 2001–2006–2010

Summary Objectives: Established in 2001–2005 then extended to 2010, the French National Nutrition and Health Program (PNNS) is a nutrition policy whose objective is to improve the health status of the population by acting on one of its major determinants, nutrition. Methods: Nine priority objectives focusing on diet, physical activity and nutritional status were determined. Program strategies are based on fundamental principles including food culture, pleasure, and gastronomy. This multidisciplinary program involves stakeholders from ministries, research and educational institutions, food industry, healthcare, and consumers. Results: More than 75 % of the public health actions planned were accomplished or in progress by the end of 2005, particularly those concerning nutrition communication, education, research and nutritional surveillance. Dietary guidelines were established and are now considered the official reference in France. Actions focusing on the healthcare system, economic actors and players and specific population groups need further development. Conclusions: The success of a public health program like the PNNS requires a combination of synergistic and complementary actions, measures, regulations and laws. A national study at the end of the PNNS will determine if objectives were achieved. Submitted: 28 February 2007; Revised: 05 July 2007, 10 December 2007; Accepted: 21 December 2007     

Association between Rice Consumption and Selected Indicators of Dietary and Nutritional Status using National Health and Nutrition Examination Survey 2007–2008

The present study was aimed at evaluating whether white rice, brown rice, and rice flour consumption has any association with selected measures of dietary intake and nutritional status, including various variables of energy intake, major vitamin and mineral intakes, weigh status, blood pressure, cholesterol level, and serum folate level for adults 20 years and older. Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2008 and the Food Commodity Intake Database were used. Rice consumers had a significantly higher energy intake, yet they had lower percentage calorie intake from fat and saturated fat. Rice consumers also had significantly higher intakes of a range of nutrients. Rice consumers had lower waist circumference, triceps skinfold, and were significantly more likely to have a body mass index less than or equal to 25.     

Socioeconomic Status,Food Security,and Dental Caries in US Children: Mediation Analyses of Data From the National Health and Nutrition Examination Survey, 2007–2008

Objectives. We examined associations of household socioeconomic status (SES) and food security with children’s oral health outcomes.Methods. We analyzed 2007 and 2008 US National Health and Nutrition Examination Survey data for children aged 5 to 17 years (n = 2206) to examine the relationship between food security and untreated dental caries and to assess whether food security mediates the SES–caries relationship.Results. About 20.1% of children had untreated caries. Most households had full food security (62%); 13% had marginal, 17% had low, and 8% had very low food security. Higher SES was associated with significantly lower caries prevalence (prevalence ratio [PR] = 0.77; 95% confidence interval = 0.63, 0.94; P = .01). Children from households with low or very low food security had significantly higher caries prevalence (PR = 2.00 and PR = 1.70, respectively) than did children living in fully food-secure households. Caries prevalence did not differ among children from fully and marginally food-secure households (P = .17). Food insecurity did not appear to mediate the SES–caries relationship.Conclusions. Interventions and policies to ensure food security may help address the US pediatric caries epidemic.Tooth decay (dental caries) is the most prevalent disease worldwide and the most common pediatric disease in the United States.1,2 From 1999 to 2004, the prevalence of untreated tooth decay was 24.5% for children aged 6 to 11 years and 19.6% for adolescents aged 12 to 19 years.3 Untreated tooth decay can lead to difficulties eating and sleeping, pain, the need for invasive restorative treatment, emergency department visits and inpatient hospitalizations, poor quality of life, systemic health problems, and, in rare cases, death.4–7 To date, most public health efforts aimed at addressing the pediatric caries epidemic have focused on tooth-level interventions (e.g., topical fluorides, dental sealants). Although disparities in oral health are considered a measure of social injustice,8 comparatively less research has been conducted on the social determinants of pediatric oral health.9Low socioeconomic status (SES), one of the strongest determinants of caries in children,10–12 is associated with food insecurity,10–17 defined as inadequate access to food resulting in food shortages, disrupted eating patterns, and hunger.18 Food insecurity, in turn, is associated with oral health–related behaviors, including increased fermentable carbohydrate intake,19,20 a risk factor for dental caries.21,22 The American Dietetic Association recognizes the link between nutrition and oral health,23 and numerous studies have drawn associations between dietary factors and disparities in dental caries.24 Collectively, these studies suggest that food insecurity is related to caries and is a potential mechanism linking SES and caries, but these relationships have not yet been evaluated empirically. We used nationally representative data from the United States to test 3 hypotheses: (1) food insecurity is positively associated with untreated dental caries, (2) food insecurity mediates the SES–caries relationship, and (3) food insecurity mediates the SES–caries relationship differentially for children from higher- versus lower-SES households.     

Tree Nut Consumption Is Associated with Better Nutrient Adequacy and Diet Quality in Adults: National Health and Nutrition Examination Survey 2005–2010

Nutrient adequacy of tree nut consumers has not been examined. The National Health and Nutrition Examination Survey 2005–2010 data were used to assess the association of tree nut consumption by adults 19+ years (n = 14,386) with nutrient adequacy and diet quality. Covariate adjusted usual intake was determined using two 24-h dietary recalls and the National Cancer Institute method. Percentages of the consumption groups below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was determined using the Healthy Eating Index-2005 (HEI) score. Usual intake data showed consumers of tree nuts had a lower percentage (p < 0.0001) of the population below the EAR for vitamins A (22 ± 5 vs. 49 ± 1), E (38 ± 4 vs. 94 ± 0.4) and C (17 ± 4 vs. 44 ± 1); folate (2.5 ± 1.5 vs. 12 ± 0.6); calcium (26 ± 3 vs. 44 ± 1); iron (3 ± 0.6 vs. 9 ± 0.4); magnesium (8 ± 1 vs. 60 ± 1); and zinc (1.5 ± 1 vs. 13 ± 1). Tree nut consumers had a higher percentage (p < 0.0001) of the population above the AI for fiber (33 ± 3 vs. 4 ± 0.3) and potassium (12 ± 3 mg vs. 2 ± 0.2 mg). HEI-2005 total score was higher (p < 0.0001) in tree nut consumers (61 ± 0.7 vs. 52 ± 0.3) than non-consumers. Health professionals should encourage the use of tree nuts as part of a dietary approach to healthy eating.     

Family Consumer Behaviors,Adolescent Prediabetes and Diabetes in the National Health and Nutrition Examination Survey (2007–2010)

Background: Prediabetes or diabetes (characterized by hemoglobin A1c [HbA1c] levels ≥ 5.7 gm%) has been associated with numerous long-term complications. Family consumer behaviors are important risk factors that lead to impaired glucose tolerance or diabetes. However, few studies have studied the association between the family consumer environment and prediabetes and diabetes in adolescents.

Objective: The aim of this study was to examine the association between family consumer behaviors (healthy food availability and supermarket spending) and adolescent prediabetes and diabetes (ClinicalTrials.gov identifier #NCT03136289.)

Methods: Data from a nationwide survey conducted by the Centers for Disease Control and Prevention (National Health and Nutrition Examination Survey [NHANES] 2007–2010 data) were used for these analyses. Adolescents aged 12–19 years were selected for this study. Bivariate analyses and logistic regression models assessed the relationship between family consumer behaviors and the prevalence of adolescent prediabetes and diabetes. Multivariable models adjusted for age, gender, ethnicity, physical activity, education, income, and household size.

Results: A total of 2520 adolescents were eligible for this study. Adolescents with healthier household food availability had negative odds (odds ratio [OR] = 0.74, 95% confidence interval [CI], 0.55–1.00), as did higher log supermarket spending (OR = 0.69; 95% CI, 0.57–0.85). Interaction models demonstrated that adolescent females had more negative odds of prediabetes/diabetes for both healthier food availability (OR = 0.79, 95% CI, 0.39–1.29) and for greater log supermarket spending (OR = 0.69, 95% CI, 0.57–0.85).

Conclusion: This study shows that both healthy food availability and an increase in supermarket spending were associated with a decreased adjusted prevalence of prediabetes and diabetes in adolescents, with a greater effect in females. These results suggest the need for policy and dietary interventions targeting the consumer environment.     

Patterns of Alcohol Consumption and Suicidal Behavior: Findings From the Fourth and Fifth Korea National Health and Nutritional Examination Survey (2007–2011)

Objectives:

The purpose of this study was to investigate the association between suicidal behavior and patterns of alcohol consumption in Korean adults.

Methods:

This study was based on data provided by the Korea National Health and Nutritional Examination Survey from 2007 to 2011. A total of 42 347 subjects were included in the study, of whom 19 292 were male and 23 055 were female. Logistic regression analysis was performed to assess the association between patterns of alcohol consumption and suicidal behavior.

Results:

Among the study subjects, 1426 males (11.3%) and 3599 females (21.2%) had experienced suicidal ideation, and 106 males (0.8%) and 190 females (1.1%) had attempted suicide during the previous 12 months. Alcohol Use Disorders Identification Test (AUDIT) scores were found to be associated with suicidal ideation in males and associated with both suicidal ideation and suicide attempts in females. Alcoholic blackouts were associated with suicidal ideation and suicide attempts in males, and were also associated with suicidal ideation in females.

Conclusions:

In this study, we found that certain patterns of alcohol consumption were associated with suicidal behaviors. In particular, only alcoholic blackouts and categorized AUDIT scores were found to be associated with suicidal behavior in males. We therefore suggest that further research is needed to examine this relationship prospectively and in other settings.     

Thyroid Hormones in Relation to Lead,Mercury, and Cadmium Exposure in the National Health and Nutrition Examination Survey, 2007–2008

Background: Heavy metals, such as lead (Pb), mercury (Hg), and cadmium (Cd), are known toxicants, but their associations with the thyroid axis have not been well quantified at U.S. background levels.Objectives: We investigated the relationships between thyroid hormones (total and free thyroxine [TT₄ and FT₄], total and free triiodothyronine [TT₃ and FT₃], thyroid-stimulating hormone [TSH], and thyroglobulin [Tg]) and levels of Pb, Hg, and Cd in blood and Cd in urine.Methods: We separately analyzed a sample of 1,109 adolescents (12–19 years of age) and a sample of 4,409 adults from the U.S. National Health and Nutrition Examination Survey (NHANES) 2007–2008. We estimated associations after adjusting for age, sex, race, urinary iodine, body mass index, and serum cotinine.Results: The geometric mean (GM) levels of blood Pb (BPb), total Hg, and Cd were 0.81 µg/dL, 0.47 µg/L, and 0.21 µg/L in adolescents and 1.43 µg/dL, 0.96 µg/L, and 0.38 µg/L in adults, respectively. The GMs of urinary Cd were 0.07 and 0.25 µg/g creatinine in adolescents and adults, respectively. No consistent pattern of metal and thyroid hormone associations was observed in adolescents. In adults, blood Hg was inversely related to TT₄, TT₃, and FT₃ and urinary Cd was positively associated with TT₄, TT₃, FT₃, and Tg, but there were no associations with Pb. Associations were relatively weak at an individual level, with about 1–4% change in thyroid hormones per interquartile range increase in Hg or Cd.Conclusions: Our analysis suggests an inverse association between Hg exposure and thyroid hormones, and a positive association between Cd exposure and thyroid hormones in adults.     

Ten-Year Trends in Fiber and Whole Grain Intakes and Food Sources for the United States Population: National Health and Nutrition Examination Survey 2001–2010

Current U.S. dietary guidance includes recommendations to increase intakes of both dietary fiber and whole grain (WG). This study examines fiber and WG intakes, food sources and trends from 2001 to 2010 based on National Health and Nutrition Examination Survey (NHANES) data for children/adolescents (n = 14,973) and adults (n = 24,809). Mean fiber intake for children/adolescents was 13.2 (±0.1) g/day. Mean fiber intake for adults 19–50 years (y) was 16.1 (±0.2) g/day and for adults 51+ was 16.1 (±0.2) g/day. There were significant increases in fiber intake from 2001–2010 for children/adolescents and for adults 51+ y. Mean WG intake for children/adolescents was 0.52 (±0.01) oz eq/day. Mean WG intake for adults 19–50 y was 0.61 (±0.02) oz eq/day and for adults 51+ 0.86 (±0.02) oz eq/day. There were no significant changes in WG intake for any age group from 2001–2010. The main food groups contributing to dietary fiber intake for children/adolescents were vegetables (16.6%), grain mixtures (16.3%), other foods (15.8%) and fruits (11.3%). For adults 19+ y, the main sources of dietary fiber were vegetables (22.6%), other foods (14.3%), grain mixtures (12.0%) and fruits (11.1%). Major WG sources for children/adolescents included ready-to-eat cereals (RTEC) (31%), yeast breads/rolls (21%) and crackers and salty grain snacks (21%). The main sources of WG for adults 19+ were yeast breads/rolls (27%), RTEC (23%) and pastas/cooked cereals/rice (21%). Recommending cereals, breads and grain mixtures with higher contents of both dietary fiber and WG, along with consumer education, could increase intakes among the United States (U.S.) population.     

Temporal Trends in Phthalate Exposures: Findings from the National Health and Nutrition Examination Survey, 2001–2010

Background: Phthalates are ubiquitous environmental contaminants. Because of potential adverse effects on human health, butylbenzyl phthalate [BBzP; metabolite, monobenzyl phthalate (MBzP)], di-n-butyl phthalate [DnBP; metabolite, mono-n-butyl phthalate (MnBP)], and di(2-ethylhexyl) phthalate (DEHP) are being replaced by substitutes including other phthalates; however, little is known about consequent trends in population-level exposures.Objective: We examined temporal trends in urinary concentrations of phthalate metabolites in the general U.S. population and whether trends vary by sociodemographic characteristics.Methods: We combined data on 11 phthalate metabolites for 11,071 participants from five cycles of the National Health and Nutrition Examination Survey (2001–2010). Percent changes and least square geometric means (LSGMs) were calculated from multivariate regression models.Results: LSGM concentrations of monoethyl phthalate, MnBP, MBzP, and ΣDEHP metabolites decreased between 2001–2002 and 2009–2010 [percent change (95% CI): –42% (–49, –34); –17% (–23, –9); –32% (–39, –23) and –37% (–46, –26), respectively]. In contrast, LSGM concentrations of monoisobutyl phthalate, mono(3-carboxypropyl) phthalate (MCPP), monocarboxyoctyl phthalate, and monocarboxynonyl phthalate (MCNP) increased over the study period [percent change (95% CI): 206% (178, 236); 25% (8, 45); 149% (102, 207); and 15% (1, 30), respectively]. Trends varied by subpopulations for certain phthalates. For example, LSGM concentrations of ΣDEHP metabolites, MCPP, and MCNP were higher in children than adults, but the gap between groups narrowed over time (p_interaction < 0.01).Conclusions: Exposure of the U.S. population to phthalates has changed in the last decade. Data gaps make it difficult to explain trends, but legislative activity and advocacy campaigns by nongovernmental organizations may play a role in changing trends.Citation: Zota AZ, Calafat AM, Woodruff TJ. 2014. Temporal trends in phthalate exposures: findings from the National Health and Nutrition Examination Survey, 2001–2010. Environ Health Perspect 122:235–241; http://dx.doi.org/10.1289/ehp.1306681     

Human papillomavirus vaccination coverage among females and males,National Health and Nutrition Examination Survey,United States, 2007–2016

BackgroundHuman papillomavirus (HPV) vaccination has been routinely recommended at age 11–12 years in the United States for females since 2006 and males since 2011. Coverage can be estimated using self/parent-reported HPV vaccination collected in the National Health and Nutrition Examination Survey (NHANES) for a wider age range than other national surveys. We assessed vaccination coverage in 2015–2016, temporal trends by age, and the validity of self/parent-reported vaccination status.MethodsParticipants aged 9–59 years completed an interview collecting demographic and vaccination information. Weighted coverage was estimated for two-year NHANES cycles by age group for 2007–2008 to 2015–2016 for females (N = 14318) and 2011–2012 to 2015–2016 for males (N = 7847). Temporal trends in coverage were assessed from 2007–2008 to 2011–2012 for females and from 2011–2012 to 2015–2016 for both sexes. Sensitivity and specificity of self/parent-reported vaccination were assessed using provider-verified vaccination records from a pilot study in 14–29 year-olds.ResultsIn 2015–2016, ≥1 dose coverage among females was highest in 14–19 (54.7%) and 20–24 (56.0%) year-olds and lower in successively older age groups. Among males, ≥1 dose coverage was highest in 14–19 year-olds (39.5%) and lower at older ages. Coverage was similar in 9–13 year-old females and males. Between 2007–2008 and 2011–2012, there were increases among females younger than 30 years. Between 2011–2012 and 2015–2016, there were increases among female age groups including 20–39 year-olds; male coverage increased among ages 9–13, 14–19, and 20–24 years. Self/parent-reported receipt of ≥1 dose had a sensitivity and specificity of 87.0% and 83.3%. Performance was lower for 3 doses.ConclusionsWhile overall HPV vaccination coverage remains low, it is higher in females than males, except in 9–13 year-olds. There have been increases in coverage among many age groups, but coverage has stalled in younger females. Adequate validity was demonstrated for self/parent-reported vaccination of ≥1 dose, but not 3 doses, in a pilot study.     

Food Sources of Energy and Nutrients among Children in the United States: National Health and Nutrition Examination Survey 2003–2006

Background: Recent detailed analyses of data on dietary sources of energy and nutrients in US children are lacking. The objective of this study was to identify food sources of energy and 28 nutrients for children in the United States. Methods: Analyses of food sources were conducted using a single 24-h recall collected from children 2 to 18 years old (n = 7332) in the 2003–2006 National Health and Nutrition Examination Survey. Sources of nutrients contained in foods were determined using nutrient composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from the total diet and from each food group were adjusted for the sample design using appropriate weights. Percentages of the total dietary intake that food sources contributed were tabulated by rank order. Results: The two top ranked food/food group sources of energy and nutrients were: energy—milk (7% of energy) and cake/cookies/quick bread/pastry/pie (7%); protein—milk (13.2%) and poultry (12.8%); total carbohydrate—soft drinks/soda (10.5%) and yeast bread/rolls (9.1%); total sugars—soft drinks/soda (19.2%) and yeast breads and rolls (12.7%); added sugars—soft drinks/soda (29.7%) and candy/sugar/sugary foods (18.6%); dietary fiber—fruit (10.4%) and yeast bread/rolls (10.3%); total fat—cheese (9.3%) and crackers/popcorn/pretzels/chips (8.4%); saturated fatty acids—cheese (16.3%) and milk (13.3%); cholesterol—eggs (24.2%) and poultry (13.2%); vitamin D—milk (60.4%) and milk drinks (8.3%); calcium—milk (33.2%) and cheese (19.4%); potassium—milk (18.8%) and fruit juice (8.0%); and sodium—salt (18.5%) and yeast bread and rolls (8.4%). Conclusions: Results suggest that many foods/food groupings consumed by children were energy dense, nutrient poor. Awareness of dietary sources of energy and nutrients can help health professionals design effective strategies to reduce energy consumption and increase the nutrient density of children’s diets.     

Oral Health Need and Access to Dental Services: Evidence from the National Survey of Children’s Health, 2007

This study examines associations between parents’ report of their children’s oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1–17 years, using data from the 2007 National Survey of Children’s Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.     

Trends in Prevalence of Overweight and Obesity in Korean Adults, 1998–2009: The Korean National Health and Nutrition Examination Survey

Background

Although obesity is increasing worldwide and becoming a major public health problem, some countries report a trend toward stabilization. We investigated prevalence trends in overweight/obesity and obesity among Korean adults during a 12-year period.

Methods

This study was based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), and IV (2007–2009). The χ² and ANOVA tests were used to compare the prevalence and mean values for age and BMI, respectively. P-values for trends were determined by linear and logistic regression analyses, with KNHANES phase as the continuous variable.

Results

The prevalences of overweight/obesity in KNHANES I through IV were 50.8%, 57.4%, 62.5%, and 62.6%, respectively, among men (P for trend = 0.002, β = 0.021) and 47.3%, 51.9%, 50.0%, and 48.9% among women (P for trend = 0.017, β = −0.015). The respective prevalences of obesity were 26.0%, 32.4%, 35.1%, and 36.3% among men (P for trend = 0.006, β = 0.018) and 26.5%, 29.3%, 28.0%, and 27.6% among women (P for trend = 0.143, β = −0.008). During the same period, the respective prevalences of grade 2 obesity (BMI ≥30 kg/m²) were 1.7%, 2.8%, 3.6%, and 3.8% among men (P for trend = 0.075, β = 0.005) and 3.0%, 3.5%, 3.4%, and 4.0% among women (P for trend = 0.398, β = 0.003).

Conclusions

The prevalences of overweight/obesity and obesity showed an upward trend among men during the 12-year period, whereas the prevalence of overweight/obesity slightly decreased among women from 2001.Key words: obesity, overweight, prevalence, trend