Obesity and diabetes in the United States - Obesity - Brief Article

Nutrition Research Newsletter, Nov, 2001

Obesity and diabetes are major causes of morbidity and mortality in the United States. In fact, evidence shows that obesity and weight gain are associated with an increased risk of diabetes. A recent study showed that the prevalence of obesity and diabetes, separately, increased from 1990 to 1999 (a growth over years, to what extent? Is it possible to give either percentage growth or numbers? Without them, the statement is too general and somewhat incomplete!).

Along with the increasing prevalence of these two diseases, come increasing health care costs. Therefore, researchers used data from the Behavioral Risk Factor Surveillance System (BRFSS) in 2000 to examine whether these increases in obesity and diabetes are continuing, the prevalence of attempting to lose or maintain weight and the strategies used by US adults to lose or maintain weight

The BRFSS is a cross-sectional telephone survey conducted by the Centers for Disease Control and Prevention and state health departments of 184,450 adults aged 18 years or older. The BRFSS consists primarily of questions about personal behaviors that increase risk for one or more of the 10 leading causes of death in the United States. For the purpose of this study, body mass index (BMI) was calculated by self-reported weight and height and participants were asked if they had ever been diagnosed with diabetes. The subjects were then asked to report type, duration, and frequency of the two leisure-time physical activities they had participated in most frequently in the past month. It was then assessed whether the subjects were trying to lose or maintain their weight and if they were trying to lose weight, how they were going about it. Fruit and vegetable intake was also assessed.

In 2000, the prevalence of obesity was 19.8 percent among US adults, which shows a 61 percent increase since 1991. Approximately 2.1 percent of the subjects had a BMI greater than or equal to 40 kg/sq m (extreme obesity), compared with 0.9 percent in 1991. In 2000, approximately 56.4 percent of the subjects were overweight (BMI greater than or equal to 25), compared with 45 percent in 1991. Mississippi had the highest rates of obesity and of diabetes, while Colorado had the lowest rate of obesity and Alaska had the lowest rate of diabetes. Twenty-seven percent of US adults did not engage in any physical activity and 28.2 percent were not regularly active. However, weight control practices varied by BMI. While most subjects were trying to lose or maintain weight, 20.1 percent and 13.5 percent of overweight and obese subjects, respectively, were not trying to lose or maintain weight. Among obese participants who were trying to lose weight, only 42.8 percent had been advised by a health professional. Among those subjects trying to lose or maintain weight, 17.5 percent were following recommendations to eat fewer calories and increase physical activity to 30 minutes of moderate activity five times a week. Similarly, only 24.9 percent of these participants were consuming the recommended five servings of fruits and vegetables.

The data clearly shows that the prevalence of obesity and diabetes continues to increase among US adults. In fact, Mokdad et al., realize that these numbers are conservative due to the subjects underestimating their weight and overestimating their height. To prevent these two chronic diseases from increasing even more, interventions are needed to improve physical activity and diet in the United States.

Ali H. Mokdad, Barbara A. Bowman, Earl S. Ford, et al. The continuing epidemics of obesity and diabetes in the United States. Journal of the American Medical Association 286: 1195-1200 (September 12, 2001) [Corresponding author and reprints: Ali H. Mokdad, PhD, Data Management Division, National Immunization Program, Centers for Disease Control and Prevention, MS E62, 1600 Clifton Rd, NE, Atlanta, GA 30333. E-mail: ahml@cdc.gov.]