CDC Surveillance System: Overweight or Obese U.S. Residents

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Prevalence of CKD in the General Population

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Prevalence of CKD Towards Tracking Healthy People 2030 Goals

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Indicator Details: Crude Percentage with Overweight or Obesity

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Crude Percentage with Overweight or Obesity by BMI and Year and Age National Health and Nutrition Examination Survey
Year	Age	Overweight	Obese	Total
1999–2000	20–39 years	31.9% (CI 27.1-36.8)	26.2% (CI 22.9-29.5)	58.1% (CI 54.4-61.8)
1999–2000	40–59 years	34.1% (CI 30.9-37.4)	33.3% (CI 26.9-39.7)	67.4% (CI 61.5-73.3)
1999–2000	60–69 years	35.8% (CI 32.8-38.8)	35.8% (CI 32.8-38.4)	75.8% (CI 72.4-79.2)
1999–2000	70+ years	38.7% (CI 34.0-43.4)	26.1% (CI 20.2-32.1)	64.8% (CI 60.5-69.1)
2001–2002	20–39 years	31.5% (CI 28.6-34.5)	25.9% (CI 22.9-28.9)	57.4% (CI 54.1-60.7)
2001–2002	40–59 years	36.9% (CI 34.0-39.8)	33.5% (CI 30.2-36.7)	70.4% (CI 67.7-73.0)
2001–2002	60–69 years	36.5% (CI 30.9-42.1)	38.8% (CI 34.6-43.0)	75.2% (CI 69.9-80.5)
2001–2002	70+ years	42.4% (CI 36.6-48.2)	24.5% (CI 20.6-28.4)	66.9% (CI 61.4-72.4)
2003–2004	20–39 years	28.6% (CI 25.3-31.8)	28.8% (CI 25.4-32.1)	57.4% (CI 54.0-60.7)
2003–2004	40–59 years	36.4% (CI 32.8-40.0)	36.4% (CI 32.6-40.2)	72.8% (CI 69.0-76.6)
2003–2004	60–69 years	39.8% (CI 34.8-44.7)	35.9% (CI 32.5-39.3)	75.7% (CI 71.8-79.5)
2003–2004	70+ years	39.7% (CI 35.4-44.0)	26.4% (CI 22.8-30.0)	66.1% (CI 61.2-71.1)
2005–2006	20–39 years	31.2% (CI 27.9-34.5)	29.1% (CI 25.1-33.2)	60.4% (CI 56.0-64.8)
2005–2006	40–59 years	31.7% (CI 28.0-35.4)	39.9% (CI 35.4-44.4)	71.6% (CI 68.3-75.0)
2005–2006	60–69 years	37.0% (CI 32.5-41.4)	40.0% (CI 34.6-45.4)	76.9% (CI 71.1-82.8)
2005–2006	70+ years	37.5% (CI 34.3-40.8)	26.6% (CI 21.9-31.3)	64.1% (CI 60.1-68.1)
2007–2008	20–39 years	30.9% (CI 27.6-34.1)	30.5% (CI 25.9-35.0)	61.3% (CI 58.1-64.6)
2007–2008	40–59 years	35.8% (CI 32.7-38.8)	36.0% (CI 32.5-39.6)	71.8% (CI 68.9-74.7)
2007–2008	60–69 years	36.6% (CI 33.0-40.2)	38.7% (CI 35.0-42.4)	75.3% (CI 71.3-79.3)
2007–2008	70+ years	38.9% (CI 34.8-43.0)	31.0% (CI 27.1-34.9)	69.9% (CI 66.5-73.2)
2009–2010	20–39 years	29.5% (CI 27.2-31.7)	32.8% (CI 29.2-36.5)	62.3% (CI 57.3-67.3)
2009–2010	40–59 years	35.9% (CI 32.7-39.1)	36.4% (CI 34.3-38.6)	72.3% (CI 68.9-75.6)
2009–2010	60–69 years	33.5% (CI 28.5-38.5)	43.7% (CI 39.2-48.2)	77.1% (CI 73.8-80.5)
2009–2010	70+ years	37.1% (CI 32.8-41.4)	34.9% (CI 30.7-39.0)	72.0% (CI 69.1-74.9)
2011–2012	20–39 years	29.9% (CI 25.7-34.2)	30.4% (CI 26.5-34.3)	60.3% (CI 54.4-66.2)
2011–2012	40–59 years	35.9% (CI 31.8-39.9)	39.4% (CI 36.0-42.9)	75.3% (CI 72.2-78.3)
2011–2012	60–69 years	35.7% (CI 30.4-40.9)	38.4% (CI 32.9-43.9)	74.0% (CI 67.2-80.8)
2011–2012	70+ years	37.0% (CI 34.1-39.8)	32.0% (CI 27.6-36.4)	68.9% (CI 64.9-73.0)
2013–2014	20–39 years	29.5% (CI 27.6-31.4)	34.3% (CI 30.7-37.9)	63.8% (CI 60.5-67.1)
2013–2014	40–59 years	33.6% (CI 30.4-36.8)	41.0% (CI 36.6-45.4)	74.6% (CI 71.6-77.5)
2013–2014	60–69 years	33.6% (CI 29.2-37.9)	43.2% (CI 38.3-48.1)	76.8% (CI 73.3-80.2)
2013–2014	70+ years	38.6% (CI 35.2-42.0)	33.0% (CI 29.2-36.8)	71.6% (CI 69.0-74.3)
2015–2016	20–39 years	29.2% (CI 26.8-31.6)	35.7% (CI 31.7-39.6)	64.9% (CI 61.0-68.7)
2015–2016	40–59 years	32.1% (CI 28.9-35.3)	42.7% (CI 37.3-48.2)	74.8% (CI 70.4-79.2)
2015–2016	60–69 years	31.5% (CI 25.9-37.1)	45.3% (CI 38.1-52.5)	76.8% (CI 70.2-83.4)
2015–2016	70+ years	39.0% (CI 34.9-43.1)	36.1% (CI 30.9-41.3)	75.1% (CI 71.2-79.0)

Notes:

* Indicates that the result for this cell was suppressed because of imprecision due to a sample size that was too small or the standard error of the result being too large (>30% of the estimate).
95% confidence intervals, when available, are shown in parentheses.

In 2015-2016, the crude prevalence of overweight and obesity was high for all age groups, with prevalence being 65% or greater across all categories. However, crude prevalence was highest in adults aged 60-69-years (77%).

Males were more likely than females to be overweight or have obesity (75% vs. 69%); Mexican-Americans (83% respectively) were more likely than non-Hispanic blacks (75%) and non-Hispanic whites (71%) to be overweight or have obesity.

Chart Explanation: In 2015-2016, crude prevalence of overweight and obesity was high for all age groups, with adults aged 60-69-years having the highest prevalence (76.8%). Males had a higher prevalence of being overweight (36.8% vs. 27.3% in females), but had a lower percentage of obesity than females (38.0% vs. 41.4%). Mexican-Americans and non-Hispanic blacks had higher prevalences of obesity (49.3% and 46.8%) compared to non-Hispanic whites (38.6%). As well, Mexican-Americans had the highest prevalence for overweight adults (33.8%) when compared to non-Hispanic white (32.6%) and non-Hispanic black (28.2%) adults. The crude prevalence of overweight and obesity varied by age (P<.001), but not by gender and race/ethnicity.

The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the Centers for Disease Control and Prevention's National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.

Obesity is a risk factor for both diabetes and hypertension, the two main causes of CKD among adults in the United States. Additionally, there is some evidence that obesity is an independent risk factor for CKD (Eknoyan, 2011; Hsu et al., 2006; Gelber et al., 2005; Foster et al., 2008), although some of the risk may be explained by shared CVD risk factors (Sowers et al., 2011). Particularly, abdominal obesity has been shown to be associated with increased prevalence of proteinuria but not necessarily associated with CKD progression or decline in renal function (Bonnet et al., 2006; Lea et al., 2008; deBoer et al., 2007). Since obesity appears to increase the likelihood of both CKD and CKD risk factors, assessing the burden of this risk factor is important in CKD surveillance. The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from the 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016 NHANES. Both body mass index (BMI) and waist circumference were measured in non-pregnant adult (20+) participants. Overweight and obesity were defined by BMI ≥25 and ≥30 kg/m². Abdominal obesity were defined by waist circumference measurements of >102 cm (~40 inches) and >88 cm (~35 inches) for men and women, respectively.

Field	Data
Description of Measure	Prevalence of overweight and obesity in the general adult population
Data Source	NCHS
Type of Data Source	Public
Data Set	NHANES
Health Care System Data	No
Regional or National?	National
Demographic Group	Non-institutionalized U.S. residents aged 20+ years
Numerator	Non-pregnant participants 20+ with measured BMI (kg/m²) >25 [overweight] or >30 [obese], or waist circumference>102 cm (males) and >88 cm (females)
Denominator	Non-pregnant participants 20+ with measured BMI or waist circumference
Primary Data Source Indicator	bmxbmi: measured BMI
Primary Indicator Method of Measurement	MEC exam anthropometric protocol; ages 2+
Secondary Data Source Indicator	bmiwaist: measured waist circumference (cm)
Secondary Indicator Method of Measurement	MEC exam anthropometric protocol; ages 2+
Frequency of Measurement (Primary)	Once (cross-sectional)
U.S. Region Covered by Primary Variable	All
Period Currently Available	1999–2016
Pending Data	2017-2018
Additional Data Items of Interest	stratification variables of interest (age, gender, race/ethnicity)
Limitations of Indicator	BMI limited in those with high muscle mass; no waist:hip ratio or body fat % measurement (except triceps skin fold, which is not widely accepted)
Analytic Considerations	Appropriate NHANES survey weights must be used for all analyses

References and Sources:

Eknoyan G. Obesity and chronic kidney disease. Nefrologia. 2011;31(4):397-403.
Sowers JR, Whaley-Connell A, Hayden MR. The Role of Overweight and Obesity in the Cardiorenal Syndrome. Cardiorenal Med. 2011;1(1):5-12.
Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006;144(1):21-8.
http://www.ncbi.nlm.nih.gov/pubmed/16389251
Gelber RP, Kurth T, Kausz AT, et al. Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis. 2005;46(5):871-80.
http://www.ncbi.nlm.nih.gov/pubmed/16253727
Foster MC, Hwang SJ, Larson MG, et al. Overweight, obesity, and the development of stage 3 CKD: The Framingham Heart Study. Am J Kidney Dis. 2008;52(1):39-48.
http://www.ncbi.nlm.nih.gov/pubmed/18440684
Lea J, Cheek D, Thornley-Brown D, et al. Metabolic syndrome, proteinuria, and the risk of progressive CKD in hypertensive African-Americans. Am J Kidney Dis. 2008;51(5):732-40.
http://www.ncbi.nlm.nih.gov/pubmed/16685216
de Boer IH, Sibley SD, Kestenbaum B, et al. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study Research Group. Central obesity, incident microalbuminuria, and change in creatinine clearance in the epidemiology of diabetes interventions and complications study. J Am Soc Nephrol. 2007;18(1):235-43.
http://www.ncbi.nlm.nih.gov/pubmed/18436083

Suggested Citation:

Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd