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Chronic Kidney Disease (CKD) Surveillance System

Indicator Details: Percentage with Abdominal Obesity by Survey Year
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Abdominal obesity, as measured by waist circumference, was found in 59% of U.S. adults in 2015-2016.

The prevalence of abdominal obesity has significantly increased over the previous 18-year period (p<.001).
Chart Explanation: Prevalence of abdominal obesity continues to be high in the general U.S. population, with an overall prevalence ranging being greater than 50% since 2003-2004. Across the previous 18-years, the prevalence has increased by 28% from 45.9% in 1999-2000 to 58.9% in 2015-2016 (p<.001).
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 MeasurePrevalence of overweight and obesity in the general adult population
Data SourceNCHS
Type of Data SourcePublic
Health Care System DataNo
Regional or National?National
Demographic GroupNon-institutionalized U.S. residents aged 20+ years
NumeratorNon-pregnant participants 20+ with measured BMI (kg/m²) >25 [overweight] or >30 [obese], or waist circumference>102 cm (males) and >88 cm (females)
DenominatorNon-pregnant participants 20+ with measured BMI or waist circumference
Primary Data Source Indicatorbmxbmi: measured BMI
Primary Indicator Method of MeasurementMEC exam anthropometric protocol; ages 2+
Secondary Data Source Indicatorbmiwaist: measured waist circumference (cm)
Secondary Indicator Method of MeasurementMEC exam anthropometric protocol; ages 2+
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available1999–2016
Pending Data2017-2018
Additional Data Items of Intereststratification variables of interest (age, gender, race/ethnicity)
Limitations of IndicatorBMI 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 ConsiderationsAppropriate 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.
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.