This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

The National Health and Nutrition Examination Surveys, 1960 to 1991

Robert J. Kuczmarski, DrPH, RD; Katherine M. Flegal, PhD; Stephen M. Campbell, MHS; Clifford L. Johnson, MSPH

JAMA. 1994;272(3):205-211.

Abstract
Objective.
—To examine trends in overweight prevalence and body mass index of the US adult population.

Design.
—Nationally representative cross-sectional surveys with an in-person interview and a medical examination, including measurement of height and weight.

Setting/Participants.
—Between 6000 and 13000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 to 1962 (the first National Health Examination Survey [NHES I]), 1971 to 1974 (the first National Health and Nutrition Examination Survey [NHANES I]), 1976 to 1980 (NHANESII), and 1988 to 1991 (NHANES III phase 1).

Results.
—In the period 1988 to 1991,33.4% of US adults 20 years of age or older were estimated to be overweight. Comparisons of the 1988 to 1991 overweight prevalence estimates with data from earlier surveys indicate dramatic increases in all race/sex groups. Overweight prevalence increased 8% between the 1976 to 1980 and 1988 to 1991 surveys. During this period, for adult men and women aged 20 through 74 years, mean body mass index increased from 25.3 to 26.3; mean body weight increased 3.6 kg.

Conclusions.
—These nationally representative data document a substantial increase in overweight among US adults and support the findings of other investigations that show notable increases in overweight during the past decade. These observations suggest that the Healthy People 2000 objective of reducing the prevalence of overweight US adults to no more than 20% may not be met by the year 2000. Understanding the reasons underlying the increase in the prevalence of overweight in the United States and elucidating the potential consequences in terms of morbidity and mortality present a challenge to our understanding of the etiology, treatment, and prevention of overweight.

(JAMA. 1994;272:205-211)

Author Affiliations
From the Division of Health Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.

Footnotes
Reprint requests to 6525 Belcrest Rd, Room 900, Hyattsville, MD 20782 (Dr Kuczmarski).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Differential Trends in Weight-Related Health Behaviors Among American Young Adults by Gender, Race/Ethnicity, and Socioeconomic Status: 1984-2006
Clarke et al.
AJPH 2009;99:1893-1901.
ABSTRACT | FULL TEXT  

Trends in 10-Year Predicted Risk of Cardiovascular Disease in the United States, 1976 to 2004
Lopez-Jimenez et al.
Circ Cardiovasc Qual Outcomes 2009;2:443-450.
ABSTRACT | FULL TEXT  

Mortality, Health Outcomes, and Body Mass Index in the Overweight Range: A Science Advisory From the American Heart Association
Lewis et al.
Circulation 2009;119:3263-3271.
FULL TEXT  

Social disparities in BMI trajectories across adulthood by gender, race/ethnicity and lifetime socio-economic position: 1986-2004
Clarke et al.
Int J Epidemiol 2009;38:499-509.
ABSTRACT | FULL TEXT  

From observation to experimentation: leptin action in the mediobasal hypothalamus
Williams et al.
Am. J. Clin. Nutr. 2009;89:985S-990S.
ABSTRACT | FULL TEXT  

Obesity: Effects on Cardiovascular Disease and its Diagnosis
Mathew et al.
J Am Board Fam Med 2008;21:562-568.
ABSTRACT | FULL TEXT  

Obesity and Pulmonary Complications in Critically Injured Adults
Dossett et al.
Chest 2008;134:974-980.
ABSTRACT | FULL TEXT  

Epidemiology of Obesity in the Western Hemisphere
Ford and Mokdad
J. Clin. Endocrinol. Metab. 2008;93:s1-s8.
ABSTRACT | FULL TEXT  

Design considerations and rationale of a multi-center trial to sustain weight loss: the weight loss maintenance trial
Brantley et al.
Clin Trials 2008;5:546-556.
ABSTRACT  

Optimal Intramuscular Needle-Penetration Depth
Lippert and Wall
Pediatrics 2008;122:e556-e563.
ABSTRACT | FULL TEXT  

Habitual physical activity in daily life correlates positively with markers for mitochondrial capacity
den Hoed et al.
J. Appl. Physiol. 2008;105:561-568.
ABSTRACT | FULL TEXT  

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
Shai et al.
NEJM 2008;359:229-241.
ABSTRACT | FULL TEXT  

Physical fitness, BMI and sickness absence in male military personnel
Kyrolainen et al.
Occup Med (Lond) 2008;58:251-256.
ABSTRACT | FULL TEXT  

Relations of Thyroid Function to Body Weight: Cross-sectional and Longitudinal Observations in a Community-Based Sample
Fox et al.
Arch Intern Med 2008;168:587-592.
ABSTRACT | FULL TEXT  

Quality of life in obese postmenopausal women
Jones and Sutton
Menopause Int 2008;14:26-32.
ABSTRACT | FULL TEXT  

Immigration and Generational Trends in Body Mass Index and Obesity in the United States: Results of the National Latino and Asian American Survey, 2002-2003
Bates et al.
AJPH 2008;98:70-77.
ABSTRACT | FULL TEXT  

Laparoscopic Adjustable Gastric Bandings: A Prospective Randomized Study of 400 Operations Performed With 2 Different Devices
Gravante et al.
Arch Surg 2007;142:958-961.
ABSTRACT | FULL TEXT  

Inhibitory effects of intestinal electrical stimulation on food intake, weight loss and gastric emptying in rats
Yin et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2007;293:R78-R82.
ABSTRACT | FULL TEXT  

Longitudinal Study of Racial and Ethnic Differences in Developing End-Stage Renal Disease among Aged Medicare Beneficiaries
Xue et al.
J. Am. Soc. Nephrol. 2007;18:1299-1306.
ABSTRACT | FULL TEXT  

Increasing Cardiovascular Disease Burden Due to Diabetes Mellitus: The Framingham Heart Study
Fox et al.
Circulation 2007;115:1544-1550.
ABSTRACT | FULL TEXT  

Coaching Process Outcomes of a Family Visit Nutrition and Physical Activity Intervention
Heimendinger et al.
Health Educ Behav 2007;34:71-89.
ABSTRACT  

Increasing Body Mass Index z-Score Is Continuously Associated with Complications of Overweight in Children, Even in the Healthy Weight Range
Bell et al.
J. Clin. Endocrinol. Metab. 2007;92:517-522.
ABSTRACT | FULL TEXT  

Patterns in food intake correlate with body mass index
Periwal and Chow
Am. J. Physiol. Endocrinol. Metab. 2006;291:E929-E936.
ABSTRACT | FULL TEXT  

The Relation between Perceived Unfair Treatment and Blood Pressure in a Racially/Ethnically Diverse Sample of Women
Brown et al.
Am J Epidemiol 2006;164:257-262.
ABSTRACT | FULL TEXT  

Secular Trends in Incidence of Atrial Fibrillation in Olmsted County, Minnesota, 1980 to 2000, and Implications on the Projections for Future Prevalence
Miyasaka et al.
Circulation 2006;114:119-125.
ABSTRACT | FULL TEXT  

Trends in the Incidence of Type 2 Diabetes Mellitus From the 1970s to the 1990s: The Framingham Heart Study
Fox et al.
Circulation 2006;113:2914-2918.
ABSTRACT | FULL TEXT  

Consumption of Both Resistant Starch and {beta}-Glucan Improves Postprandial Plasma Glucose and Insulin in Women
Behall et al.
Diabetes Care 2006;29:976-981.
ABSTRACT | FULL TEXT  

Glucose Abnormalities in Patients with Hepatitis C Virus Infection: Epidemiology and pathogenesis
Lecube et al.
Diabetes Care 2006;29:1140-1149.
FULL TEXT  

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss: An Update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease From the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism
Poirier et al.
Circulation 2006;113:898-918.
ABSTRACT | FULL TEXT  

Commentary: The epidemic of obesity--what's in a name?
Flegal
Int J Epidemiol 2006;35:72-74.
FULL TEXT  

Associations of Changes in Exercise Level With Subsequent Disability Among Seniors: A 16-Year Longitudinal Study
Berk et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2006;61:97-102.
ABSTRACT | FULL TEXT  

Differences in transport of fatty acids and expression of fatty acid transporting proteins in adipose tissue of obese black and white women
Bower et al.
Am. J. Physiol. Endocrinol. Metab. 2006;290:E87-E91.
ABSTRACT | FULL TEXT  

Roux-en-Y Gastric Bypass Surgery for Morbid Obesity: Evaluation of Postoperative Extraluminal Leaks with Upper Gastrointestinal Series
Carucci et al.
Radiology 2006;238:119-127.
ABSTRACT | FULL TEXT  

Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society
Villareal et al.
Am. J. Clin. Nutr. 2005;82:923-934.
ABSTRACT | FULL TEXT  

Estimated Risks for Developing Obesity in the Framingham Heart Study
Vasan et al.
ANN INTERN MED 2005;143:473-480.
ABSTRACT | FULL TEXT  

Weighing both sides: morality, mortality, and framing contests over obesity.
Saguy and Riley
Journal of Health Politics, Policy and Law 2005;30:869-921.
ABSTRACT  

Anorectics on Trial: A Half Century of Federal Regulation of Prescription Appetite Suppressants
Colman
ANN INTERN MED 2005;143:380-385.
ABSTRACT | FULL TEXT  

Obesity and Mortality in Elderly Nursing Home Residents
Grabowski et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2005;60:1184-1189.
ABSTRACT | FULL TEXT  

Race/Ethnicity, Life-Course Socioeconomic Position, and Body Weight Trajectories Over 34 years: The Alameda County Study
Baltrus et al.
AJPH 2005;95:1595-1601.
ABSTRACT | FULL TEXT  

The impact of country of birth and time in Sweden on overweight and obesity: A population-based study
Lindstrom and Sundquist
Scand J Public Health 2005;33:276-284.
ABSTRACT  

Severe Obesity: A Growing Health Concern A.S.P.E.N. Should Not Ignore
Shikora
JPEN J Parenter Enteral Nutr 2005;29:288-297.
ABSTRACT | FULL TEXT  

Comparison of Hormone and Glucose Responses of Overweight Women to Barley and Oats
Behall et al.
J. Am. Coll. Nutr. 2005;24:182-188.
ABSTRACT | FULL TEXT  

Hispanic and Non-Hispanic White Elders from Massachusetts Have Different Patterns of Carotenoid Intake and Plasma Concentrations
Bermudez et al.
J. Nutr. 2005;135:1496-1502.
ABSTRACT | FULL TEXT  

Influence of Excess Adiposity on Exercise Fitness and Performance in Overweight Children and Adolescents
Norman et al.
Pediatrics 2005;115:e690-e696.
ABSTRACT | FULL TEXT  

Diet-induced obesity impairs mammary development and lactogenesis in murine mammary gland
Flint et al.
Am. J. Physiol. Endocrinol. Metab. 2005;288:E1179-E1187.
ABSTRACT | FULL TEXT  

Onset of Overweight during Childhood and Adolescence in Relation to Race and Sex
Saha et al.
J. Clin. Endocrinol. Metab. 2005;90:2648-2652.
ABSTRACT | FULL TEXT  

Meta-Analysis: Pharmacologic Treatment of Obesity
Li et al.
ANN INTERN MED 2005;142:532-546.
ABSTRACT | FULL TEXT  

Healthy Eating and Exercising to Reduce Diabetes: Exploring the Potential of Social Determinants of Health Frameworks Within the Context of Community-Based Participatory Diabetes Prevention
Schulz et al.
AJPH 2005;95:645-651.
ABSTRACT | FULL TEXT  

Suppression of Hepatic Cholesteryl Ester Transfer Protein Expression in Obese Humans with the Development of Type 2 Diabetes Mellitus
MacLean et al.
J. Clin. Endocrinol. Metab. 2005;90:2250-2258.
ABSTRACT | FULL TEXT  

Public Health Strategies for Dietary Change: Schools and Workplaces
French
J. Nutr. 2005;135:910-912.
ABSTRACT | FULL TEXT  

Rimonabant--A Selective CB1 Antagonist
Boyd and Fremming
The Annals of Pharmacotherapy 2005;39:684-690.
ABSTRACT | FULL TEXT  

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Report of the Outcomes Writing Group
Benjamin et al.
Circulation 2005;111:e124-e133.
FULL TEXT  

Survival advantages of obesity in dialysis patients
Kalantar-Zadeh et al.
Am. J. Clin. Nutr. 2005;81:543-554.
ABSTRACT | FULL TEXT  

Adenocarcinoma of oesophagus: what exactly is the size of the problem and who is at risk?
Lagergren
Gut 2005;54:i1-i5.
ABSTRACT | FULL TEXT  

Biographic and Psychobehavioral Influences on Body Mass Index in a Nursing Sample
Allison
West J Nurs Res 2005;27:7-20.
ABSTRACT  

Cardiovascular Fitness and Exercise as Determinants of Insulin Resistance in Postpubertal Adolescent Females
Kasa-Vubu et al.
J. Clin. Endocrinol. Metab. 2005;90:849-854.
ABSTRACT | FULL TEXT  

Effect of obesity and thoracic epidural analgesia on perioperative spirometry
von Ungern-Sternberg et al.
Br J Anaesth 2005;94:121-127.
ABSTRACT | FULL TEXT  

A controlled study of peripheral neuropathy after bariatric surgery
Thaisetthawatkul et al.
Neurology 2004;63:1462-1470.
ABSTRACT | FULL TEXT  

Associations between Food Variety and Body Fatness in Hong Kong Chinese Adults
Sea et al.
J. Am. Coll. Nutr. 2004;23:404-413.
ABSTRACT | FULL TEXT  

The More Food Young Adults Are Served, the More They Overeat
Levitsky and Youn
J. Nutr. 2004;134:2546-2549.
ABSTRACT | FULL TEXT  

Urban Sprawl and Risk for Being Overweight or Obese
Lopez
AJPH 2004;94:1574-1579.
ABSTRACT | FULL TEXT  

Length of Hospital Stays Among Obese Individuals
Zizza et al.
AJPH 2004;94:1587-1591.
ABSTRACT | FULL TEXT  

Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms
Gunnbjornsdottir et al.
Eur Respir J 2004;24:116-121.
ABSTRACT | FULL TEXT  

Body mass index and short-term weight change in relation to mortality in Dutch women after age 50 y
Maru et al.
Am. J. Clin. Nutr. 2004;80:231-236.
ABSTRACT | FULL TEXT  

Plasma Ghrelin in Obesity before and after Weight Loss after Laparoscopical Adjustable Gastric Banding
Hanusch-Enserer et al.
J. Clin. Endocrinol. Metab. 2004;89:3352-3358.
ABSTRACT | FULL TEXT  

High Energy Flux Mediates the Tonically Augmented {beta}-Adrenergic Support of Resting Metabolic Rate in Habitually Exercising Older Adults
Bell et al.
J. Clin. Endocrinol. Metab. 2004;89:3573-3578.
ABSTRACT | FULL TEXT  

Overweight Children and Adolescents: A Risk Group for Iron Deficiency
Nead et al.
Pediatrics 2004;114:104-108.
ABSTRACT | FULL TEXT  

Stearoyl-CoA Desaturase 1 Gene Expression Is Necessary for Fructose-mediated Induction of Lipogenic Gene Expression by Sterol Regulatory Element-binding Protein-1c-dependent and -independent Mechanisms
Miyazaki et al.
J. Biol. Chem. 2004;279:25164-25171.
ABSTRACT | FULL TEXT  

Dietary Fructose Reduces Circulating Insulin and Leptin, Attenuates Postprandial Suppression of Ghrelin, and Increases Triglycerides in Women
Teff et al.
J. Clin. Endocrinol. Metab. 2004;89:2963-2972.
ABSTRACT | FULL TEXT  

p53 Involvement in the Pathogenesis of Fatty Liver Disease
Yahagi et al.
J. Biol. Chem. 2004;279:20571-20575.
ABSTRACT | FULL TEXT  

Analytical and Clinical Evaluation of the Bayer ADVIA Centaur Automated B-Type Natriuretic Peptide Assay in Patients with Heart Failure: A Multisite Study
Wu et al.
Clin. Chem. 2004;50:867-873.
ABSTRACT | FULL TEXT  

Influence of Overweight on ICU Mortality: A Prospective Study
Goulenok et al.
Chest 2004;125:1441-1445.
ABSTRACT | FULL TEXT  

Underweight rather than overweight is associated with higher prevalence of hypertension: BP vs BMI in haemodialysis population
Salahudeen et al.
Nephrol Dial Transplant 2004;19:427-432.
ABSTRACT | FULL TEXT  

Energy requirements in the eighth decade of life
Blanc et al.
Am. J. Clin. Nutr. 2004;79:303-310.
ABSTRACT | FULL TEXT  

Effect of obesity and site of surgery on perioperative lung volumes
von Ungern-Sternberg et al.
Br J Anaesth 2004;92:202-207.
ABSTRACT | FULL TEXT  

Body Mass Index in Middle Age and Health-Related Quality of Life in Older Age: The Chicago Heart Association Detection Project in Industry Study
Daviglus et al.
Arch Intern Med 2003;163:2448-2455.
ABSTRACT | FULL TEXT  

Rising caesarean section rates: can evolution and ecology explain some of the difficulties of modern childbirth?
Liston
JRSM 2003;96:559-561.
FULL TEXT  

Diabetes and obesity in Northern Sweden: occurrence and risk factors for stroke and myocardial infarction
Eliasson et al.
Scand J Public Health 2003;31:70-77.
ABSTRACT  

Circle of Willis Atherosclerosis Is a Risk Factor for Sporadic Alzheimer's Disease
Roher et al.
Arterioscler. Thromb. Vasc. Bio. 2003;23:2055-2062.
ABSTRACT | FULL TEXT  

The Timing of Normal Puberty and the Age Limits of Sexual Precocity: Variations around the World, Secular Trends, and Changes after Migration
Parent et al.
Endocr. Rev. 2003;24:668-693.
ABSTRACT | FULL TEXT  

The Long-term Results of Gastric Bypass on Indexes of Sleep Apnea
Guardiano et al.
Chest 2003;124:1615-1619.
ABSTRACT | FULL TEXT  

Calcium Intake Trends and Health Consequences from Childhood through Adulthood
Nicklas
J. Am. Coll. Nutr. 2003;22:340-356.
ABSTRACT | FULL TEXT  

Body Mass Index and Asthma Severity Among Adults Presenting to the Emergency Department
Thomson et al.
Chest 2003;124:795-802.
ABSTRACT | FULL TEXT  

Trait Impressions as Overgeneralized Responses to Adaptively Significant Facial Qualities: Evidence from Connectionist Modeling
Zebrowitz et al.
Pers Soc Psychol Rev 2003;7:194-215.
ABSTRACT  

Weight gain among women in the late reproductive years
Sammel et al.
Fam Pract 2003;20:401-409.
ABSTRACT | FULL TEXT  

p53 Activation in Adipocytes of Obese Mice
Yahagi et al.
J. Biol. Chem. 2003;278:25395-25400.
ABSTRACT | FULL TEXT  

Obesity and Estrogen as Risk Factors for Gastroesophageal Reflux Symptoms
Nilsson et al.
JAMA 2003;290:66-72.
ABSTRACT | FULL TEXT  

Association between Eating Patterns and Obesity in a Free-living US Adult Population
Ma et al.
Am J Epidemiol 2003;158:85-92.
ABSTRACT | FULL TEXT  

A Population Perspective on Diabetes Prevention: Whom should we target for preventing weight gain?
Burke et al.
Diabetes Care 2003;26:1999-2004.
ABSTRACT | FULL TEXT  

Influence of distribution of lean body mass on resting metabolic rate after weight loss and weight regain: comparison of responses in white and black women
Byrne et al.
Am. J. Clin. Nutr. 2003;77:1368-1373.
ABSTRACT | FULL TEXT  

Relative influence of diet and physical activity on body composition in urban Chinese adults
Yao et al.
Am. J. Clin. Nutr. 2003;77:1409-1416.
ABSTRACT | FULL TEXT  

Diacylglycerols affect substrate oxidation and appetite in humans
Kamphuis et al.
Am. J. Clin. Nutr. 2003;77:1133-1139.
ABSTRACT | FULL TEXT  

Coronary Heart Disease Death and Sudden Cardiac Death: A 20-Year Population-based Study
Goraya et al.
Am J Epidemiol 2003;157:763-770.
ABSTRACT | FULL TEXT  

Predictors of Hemoglobin A1c in a National Sample of Nondiabetic Children: The Third National Health and Nutrition Examination Survey, 1988-1994
Eldeirawi and Lipton
Am J Epidemiol 2003;157:624-632.
ABSTRACT | FULL TEXT  

Overview of the Epidemiology of Obesity and the Early History of Procedures to Remedy Morbid Obesity
MacDonald
Arch Surg 2003;138:357-360.
FULL TEXT  

Skeletal muscle lipid metabolism with obesity
Hulver et al.
Am. J. Physiol. Endocrinol. Metab. 2003;284:E741-E747.
ABSTRACT | FULL TEXT  

The Life Course of Severe Obesity: Does Childhood Overweight Matter?
Ferraro et al.
Journals of Gerontology Series B: Psychological Sciences and Social Science 2003;58:S110-119.
ABSTRACT | FULL TEXT