In 2015-2016, abdominal obesity was more prevalent among those who were either older (72% in those aged 70-years or older vs. 46% in those aged 20-39-years); who were female (70% vs. 47%); or those who were Mexican-American (64% vs. 61% and 58% in non-Hispanic whites and non-Hispanic blacks).
Crude prevalence of abdominal obesity during 2015-2016, among U.S. adults, was greater for those who were in the oldest age category (71.7% in 70-years or older) compared to adults in the lower age category (46.2% for those aged 20-39-years). Females had the highest crude prevalence of abdominal obesity compared to males (69.9% vs. 47.5%). Mexican Americans (63.9%) and non-Hispanic whites (61.3%) had roughly the same percentage of persons with abdominal obesity. Both groups had a higher crude prevalence compared to their non-Hispanic black counterparts (58.5%). Comparisons across groups were significant for age and gender (X2 test p<.001), but not for race/ethnicity.
The NHANES (National Health and Nutrition Examination Survey) 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.
|Description of Measure||Prevalence of overweight and obesity in the general adult population|
|Type of Data Source||Public|
|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|
|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.
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.
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.
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.
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.