Over the time period, 1999 to 2016, the prevalence of overweight and obesity combined, signifcantly increased (p<.001) from 64% to 72%.
In 2015-2016, 71% of U.S. adults were either overweight (32%) or had obesity (40%), according to their measured body mass index (BMI).
Chart Explanation: Over the entire 18-year period, the total percentage of U.S. adults with overweight or obesity gradually increased by 12% from 63.7% in 1999-2000 to 71.6% in 2015-2016 (p<.001). During 2015-2016, U.S. adults were either overweight (31.9%) or had obesity (39.8%), according to their measured body mass index (BMI). Although percentages for overweight adults have been gradually decreasing (p<.001), rates of adults with obesity perisist with a 33% increase over the previous 18-years (p=0.02).
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.
|Description of Measure||Percentage with Overweight or Obesity by Survey Year|
|Type of Data Source||Public|
|Health Care System Data||No|
|Regional or National?||National|
|Demographic Group||Noninstitutionalized 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.