This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (1851)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Nutritional and Metabolic Disorders  • Lipids and Lipid Disorders  • Metabolic Diseases  • Nutritional and Metabolic Disorders, Other  • Obesity  • Hypertension  • Alert me on articles by topic  Social Bookmarking   What's this?

Findings From the Third National Health and Nutrition Examination Survey

Earl S. Ford, MD,MPH; Wayne H. Giles, MD,MSc; William H. Dietz, MD,PhD

JAMA. 2002;287:356-359.

Context  The Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) highlights the importance of treating patients with the metabolic syndrome to prevent cardiovascular disease. Limited information is available about the prevalence of the metabolic syndrome in the United States, however.

Objective  To estimate the prevalence of the metabolic syndrome in the United States as defined by the ATP III report.

Design, Setting, and Participants  Analysis of data on 8814 men and women aged 20 years or older from the Third National Health and Nutrition Examination Survey (1988-1994), a cross-sectional health survey of a nationally representative sample of the noninstitutionalized civilian US population.

Main Outcome Measures  Prevalence of the metabolic syndrome as defined by ATP III (3 of the following abnormalities): waist circumference greater than 102 cm in men and 88 cm in women; serum triglycerides level of at least 150 mg/dL (1.69 mmol/L); high-density lipoprotein cholesterol level of less than 40 mg/dL (1.04 mmol/L) in men and 50 mg/dL (1.29 mmol/L) in women; blood pressure of at least 130/85 mm Hg; or serum glucose level of at least 110 mg/dL (6.1 mmol/L).

Results  The unadjusted and age-adjusted prevalences of the metabolic syndrome were 21.8% and 23.7%, respectively. The prevalence increased from 6.7% among participants aged 20 through 29 years to 43.5% and 42.0% for participants aged 60 through 69 years and aged at least 70 years, respectively. Mexican Americans had the highest age-adjusted prevalence of the metabolic syndrome (31.9%). The age-adjusted prevalence was similar for men (24.0%) and women (23.4%). However, among African Americans, women had about a 57% higher prevalence than men did and among Mexican Americans, women had about a 26% higher prevalence than men did. Using 2000 census data, about 47 million US residents have the metabolic syndrome.

Conclusions  These results from a representative sample of US adults show that the metabolic syndrome is highly prevalent. The large numbers of US residents with the metabolic syndrome may have important implications for the health care sector.

Author Affiliations: Division of Nutrition and Physical Activity (Drs Ford and Dietz) and the Division of Adult and Community Health (Dr Giles), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga.

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

RELATED ARTICLE

January 16, 2002
JAMA. 2002;287(3):387-388.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort
Rumawas et al.
Am. J. Clin. Nutr. 2009;90:1608-1614.
ABSTRACT | FULL TEXT  

Trajectories of Entering the Metabolic Syndrome: The Framingham Heart Study
Franco et al.
Circulation 2009;120:1943-1950.
ABSTRACT | FULL TEXT  

Metabolic Syndrome and Weight Gain in Adulthood
Alley and Chang
J Gerontol A Biol Sci Med Sci 2009;0:glp177v1-glp177.
ABSTRACT | FULL TEXT  

Risk of dementia hospitalisation associated with cardiovascular risk factors in midlife and older age: the Atherosclerosis Risk in Communities (ARIC) study
Alonso et al.
J. Neurol. Neurosurg. Psychiatry 2009;80:1194-1201.
ABSTRACT | FULL TEXT  

How to Define Prehypertension in Diabetes/Metabolic Syndrome
Leibowitz and Grossman
Diabetes Care 2009;32:S275-S279.
FULL TEXT  

Should All Diabetic Patients Be Treated With a Statin?
Kamari et al.
Diabetes Care 2009;32:S378-S383.
FULL TEXT  

Women and ischemic heart disease: evolving knowledge.
Shaw et al.
J Am Coll Cardiol 2009;54:1561-1575.
ABSTRACT | FULL TEXT  

Hypothalamic proopiomelanocortin promoter methylation becomes altered by early overfeeding: an epigenetic model of obesity and the metabolic syndrome
Plagemann et al.
J. Physiol. 2009;587:4963-4976.
ABSTRACT | FULL TEXT  

Creation of a Metabolic Monitoring Program for Second-Generation (Atypical) Antipsychotics
Reeves et al.
J Correct Health Care 2009;15:292-301.
ABSTRACT  

The Metabolic Syndrome in Patients With Chronic Bronchitis and COPD: Frequency and Associated Consequences for Systemic Inflammation and Physical Inactivity
Watz et al.
Chest 2009;136:1039-1046.
ABSTRACT | FULL TEXT  

Cardiorespiratory fitness and the metabolic syndrome in firefighters
Donovan et al.
Occup Med (Lond) 2009;59:487-492.
ABSTRACT | FULL TEXT  

Clinical implication of metabolic syndrome on chronic kidney disease depends on gender and menopausal status: results from the Korean National Health and Nutrition Examination Survey
Yu et al.
Nephrol Dial Transplant 2009;0:gfp483v2-gfp483.
ABSTRACT | FULL TEXT  

Resistance Training Does Not Contribute to Improving the Metabolic Profile after a 6-Month Weight Loss Program in Overweight and Obese Postmenopausal Women
Brochu et al.
J. Clin. Endocrinol. Metab. 2009;94:3226-3233.
ABSTRACT | FULL TEXT  

Myocardial lysyl oxidase regulation of cardiac remodeling in a murine model of diet-induced metabolic syndrome
Zibadi et al.
Am. J. Physiol. Heart Circ. Physiol. 2009;297:H976-H982.
ABSTRACT | FULL TEXT  

Microstructural white matter changes in metabolic syndrome: A diffusion tensor imaging study
Segura et al.
Neurology 2009;73:438-444.
ABSTRACT | FULL TEXT  

Effects of long-term antioxidant supplementation and association of serum antioxidant concentrations with risk of metabolic syndrome in adults
Czernichow et al.
Am. J. Clin. Nutr. 2009;90:329-335.
ABSTRACT | FULL TEXT  

A new mouse model of metabolic syndrome and associated complications
Wang et al.
J Endocrinol 2009;202:17-28.
ABSTRACT | FULL TEXT  

Genetic and Environmental Risks for High Blood Pressure Among African American Mothers and Daughters
Taylor et al.
Biol Res Nurs 2009;11:53-65.
ABSTRACT  

Association of the Metabolic Syndrome With Pulmonary Venous Hypertension
Robbins et al.
Chest 2009;136:31-36.
ABSTRACT | FULL TEXT  

The Emerging Link Between Hypogonadism and Metabolic Syndrome
Guay
J Androl 2009;30:370-376.
ABSTRACT | FULL TEXT  

Metabolic Syndrome and Diabetes, Alone and in Combination, as Predictors of Cardiovascular Disease Mortality Among Men
Church et al.
Diabetes Care 2009;32:1289-1294.
ABSTRACT | FULL TEXT  

Genome-wide linkage scan for plasma high density lipoprotein cholesterol, apolipoprotein A-1 and triglyceride variation among American Indian populations: the Strong Heart Family Study
Li et al.
J. Med. Genet. 2009;46:472-479.
ABSTRACT | FULL TEXT  

A Traditional Rice and Beans Pattern Is Associated with Metabolic Syndrome in Puerto Rican Older Adults
Noel et al.
J. Nutr. 2009;139:1360-1367.
ABSTRACT | FULL TEXT  

Genetic locus on rat chromosome 20 regulates diet-induced adipocyte hypertrophy: a microarray gene expression study
Bourdon et al.
Physiol. Genomics 2009;38:63-72.
ABSTRACT | FULL TEXT  

Prevalence and Incidence of Endocrine and Metabolic Disorders in the United States: A Comprehensive Review
Golden et al.
J. Clin. Endocrinol. Metab. 2009;94:1853-1878.
ABSTRACT | FULL TEXT  

National Heart, Lung, and Blood Institute-Initiated Program "Interventions to Improve Hypertension Control Rates in African Americans": Background and Implementation
Einhorn
Circ Cardiovasc Qual Outcomes 2009;2:236-240.
FULL TEXT  

Phosphodiesterase 5 Inhibition Improves {beta}-Cell Function in Metabolic Syndrome
Hill et al.
Diabetes Care 2009;32:857-859.
ABSTRACT | FULL TEXT  

Longitudinal Paths to the Metabolic Syndrome: Can the Incidence of the Metabolic Syndrome Be Predicted? The Baltimore Longitudinal Study of Aging
Scuteri et al.
J Gerontol A Biol Sci Med Sci 2009;64A:590-598.
ABSTRACT | FULL TEXT  

Genetic Variants at the PDZ-Interacting Domain of the Scavenger Receptor Class B Type I Interact with Diet to Influence the Risk of Metabolic Syndrome in Obese Men and Women
Junyent et al.
J. Nutr. 2009;139:842-848.
ABSTRACT | FULL TEXT  

High-Density Lipoprotein Modulates Glucose Metabolism in Patients With Type 2 Diabetes Mellitus
Drew et al.
Circulation 2009;119:2103-2111.
ABSTRACT | FULL TEXT  

Heart failure in hispanics.
Vivo et al.
J Am Coll Cardiol 2009;53:1167-1175.
ABSTRACT | FULL TEXT  

Long-term effect of metformin on metabolic parameters in the polycystic ovary syndrome
Cheang et al.
Diabetes and Vascular Disease Research 2009;6:110-119.
ABSTRACT  

Relationship of Metabolic Syndrome With Incident Aortic Valve Calcium and Aortic Valve Calcium Progression: The Multi-Ethnic Study of Atherosclerosis (MESA)
Katz et al.
Diabetes 2009;58:813-819.
ABSTRACT | FULL TEXT  

Abundance of the Na-K-2Cl cotransporter NKCC2 is increased by high-fat feeding in Fischer 344 X Brown Norway (F1) rats
Riazi et al.
Am. J. Physiol. Renal Physiol. 2009;296:F762-F770.
ABSTRACT | FULL TEXT  

Commentary: Risk/Benefit Ratio of Androgen Deprivation Treatment for Sex Offenders
Berlin
J Am Acad Psychiatry Law 2009;37:59-62.
ABSTRACT | FULL TEXT  

Metabolic syndrome is an independent risk factor for stroke and acute renal failure after coronary artery bypass grafting.
Kajimoto et al.
J. Thorac. Cardiovasc. Surg. 2009;137:658-663.
ABSTRACT | FULL TEXT  

The Metabolic Syndrome and Development of Cognitive Impairment Among Older Women
Yaffe et al.
Arch Neurol 2009;66:324-328.
ABSTRACT | FULL TEXT  

The Not-so-Sweet Side of Fructose
Choi
J. Am. Soc. Nephrol. 2009;20:457-459.
FULL TEXT  

Diabetes in African American Youth: Prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study
Mayer-Davis et al.
Diabetes Care 2009;32:S112-S122.
ABSTRACT | FULL TEXT  

Cardiovascular therapies and associated glucose homeostasis: implications across the dysglycemia continuum.
Cooper-DeHoff et al.
J Am Coll Cardiol 2009;53:S28-S34.
ABSTRACT | FULL TEXT  

Progress and Challenges in Metabolic Syndrome in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism
Steinberger et al.
Circulation 2009;119:628-647.
FULL TEXT  

Vitamin B-12 and neural tube defects: the Canadian experience
Thompson et al.
Am. J. Clin. Nutr. 2009;89:697S-701S.
ABSTRACT | FULL TEXT  

Metabolic Syndrome and Physical Decline in Older Persons: Results from the Health, Aging and Body Composition Study
Penninx et al.
J Gerontol A Biol Sci Med Sci 2009;0:gln005v2-gln005.
ABSTRACT | FULL TEXT  

Effects of Exercise and Caloric Restriction on Insulin Resistance and Cardiometabolic Risk Factors in Older Obese Adults--A Randomized Clinical Trial
Yassine et al.
J Gerontol A Biol Sci Med Sci 2009;0:gln032v1-gln032.
ABSTRACT | FULL TEXT  

The clinical impact of identifying metabolic syndrome in patients with diabetes: a cross-sectional study
Bulugahapitiya et al.
Diabetes and Vascular Disease Research 2009;6:21-24.
ABSTRACT  

The limited role of midnight salivary cortisol levels in the diagnosis of subclinical hypercortisolism in patients with adrenal incidentaloma
Masserini et al.
Eur J Endocrinol 2009;160:87-92.
ABSTRACT | FULL TEXT  

Metabolic Syndrome Pathophysiology and Clinical Presentation
Handelsman
Toxicol Pathol 2009;37:18-20.
ABSTRACT | FULL TEXT  

The Dark Side of Testosterone Deficiency: I. Metabolic Syndrome and Erectile Dysfunction
Traish et al.
J Androl 2009;30:10-22.
ABSTRACT | FULL TEXT  

Blood Pressure and Fasting Plasma Glucose Rather Than Metabolic Syndrome Predict Coronary Artery Calcium Progression: The Rancho Bernardo Study
Kramer et al.
Diabetes Care 2009;32:141-146.
ABSTRACT | FULL TEXT  

Metabolic Syndrome and All-Cause and Cardiovascular Mortality in an Italian Elderly Population: The Progetto Veneto Anziani (Pro.V.A.) Study
Zambon et al.
Diabetes Care 2009;32:153-159.
ABSTRACT | FULL TEXT  

Stroke and the Metabolic Syndrome in Populations: The Challenge Ahead
Cronin and Kelly
Stroke 2009;40:3-4.
FULL TEXT  

Mouse breast cancer model-dependent changes in metabolic syndrome-associated phenotypes caused by maternal dioxin exposure and dietary fat
La Merrill et al.
Am. J. Physiol. Endocrinol. Metab. 2009;296:E203-E210.
ABSTRACT | FULL TEXT  

Metabolic Syndrome Clusters and the Risk of Incident Stroke: The Atherosclerosis Risk in Communities (ARIC) Study
Rodriguez-Colon et al.
Stroke 2009;40:200-205.
ABSTRACT | FULL TEXT  

ABT-335, the Choline Salt of Fenofibric Acid, Does Not Have a Clinically Significant Pharmacokinetic Interaction With Rosuvastatin in Humans
Zhu et al.
J Clin Pharmacol 2009;49:63-71.
ABSTRACT | FULL TEXT  

Structural and functional changes in the kidneys of high-fat diet-induced obese mice
Deji et al.
Am. J. Physiol. Renal Physiol. 2009;296:F118-F126.
ABSTRACT | FULL TEXT  

CHAPTER 12 Prevention of Cardiovascular Disease
Rosengren et al.
ESC Textbook of Cardiovascular Medicine 2009;2:med-9780199566990-chapter-med-9780199566990-chapter.
ABSTRACT | FULL TEXT  

The Metabolic Syndrome
Cornier et al.
Endocr. Rev. 2008;29:777-822.
ABSTRACT | FULL TEXT  

Mitochondrial apoptotic signaling is elevated in cardiac but not skeletal muscle in the obese Zucker rat and is reduced with aerobic exercise
Peterson et al.
J. Appl. Physiol. 2008;105:1934-1943.
ABSTRACT | FULL TEXT  

Review of the Effect of Dairy Products on Non-Lipid Risk Factors for Cardiovascular Disease
Lamarche
J. Am. Coll. Nutr. 2008;27:741S-746S.
ABSTRACT | FULL TEXT  

Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study
Aijaz et al.
Mayo Clin Proc. 2008;83:1350-1357.
ABSTRACT | FULL TEXT  

Endothelial progenitor cell levels in obese men with the metabolic syndrome and the effect of simvastatin monotherapy vs. simvastatin/ezetimibe combination therapy
Westerweel et al.
Eur Heart J 2008;29:2808-2817.
ABSTRACT | FULL TEXT  

Investigation and management of hypertriglyceridaemia
Ferns et al.
J. Clin. Pathol. 2008;61:1174-1183.
ABSTRACT | FULL TEXT  

Individual and Neighborhood Socioeconomic Status Characteristics and Prevalence of Metabolic Syndrome: The Atherosclerosis Risk in Communities (ARIC) Study
Chichlowska et al.
Psychosom. Med. 2008;70:986-992.
ABSTRACT | FULL TEXT  

Endurance Exercise as a Countermeasure for Aging
Lanza et al.
Diabetes 2008;57:2933-2942.
ABSTRACT | FULL TEXT  

Intact renal afferent arteriolar autoregulatory responsiveness in db/db mice
Park et al.
Am. J. Physiol. Renal Physiol. 2008;295:F1504-F1511.
ABSTRACT | FULL TEXT  

Interplay of Vascular Phenotype and Metabolic Phenotype in Populations With or Without Type 2 Diabetes
Bosevski
Stroke 2008;39:e175-e175.
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  

Nonalcoholic fatty liver disease: A manifestation of the metabolic syndrome
KIM and YOUNOSSI
Cleveland Clinic Journal of Medicine 2008;75:721-728.
ABSTRACT | FULL TEXT  

Frequency and determinants of the metabolic syndrome in apparently healthy adult Nigerians
Wahab et al.
Trop Doct 2008;38:224-226.
ABSTRACT | FULL TEXT  

Association of the Metabolic Syndrome with Severe Periodontitis in a Large U.S. Population-Based Survey
D'Aiuto et al.
J. Clin. Endocrinol. Metab. 2008;93:3989-3994.
ABSTRACT | FULL TEXT  

Metabolic and Cardiovascular Adverse Events Associated With Antipsychotic Treatment in Children and Adolescents
McIntyre and Jerrell
Arch Pediatr Adolesc Med 2008;162:929-935.
ABSTRACT | FULL TEXT  

Changes in Risk Variables of Metabolic Syndrome Since Childhood in Pre-Diabetic and Type 2 Diabetic Subjects: The Bogalusa Heart Study
Nguyen et al.
Diabetes Care 2008;31:2044-2049.
ABSTRACT | FULL TEXT  

Gout and the risk of type 2 diabetes among men with a high cardiovascular risk profile
Choi et al.
Rheumatology (Oxford) 2008;47:1567-1570.
ABSTRACT | FULL TEXT  

Prioritization of candidate disease genes for metabolic syndrome by computational analysis of its defining phenotypes
Tiffin et al.
Physiol. Genomics 2008;35:55-64.
ABSTRACT | FULL TEXT  

Is LDL-C Passed Its Prime?: The Emerging Role of Non-HDL, LDL-P, and ApoB in CHD Risk Assessment
Davidson
Arterioscler. Thromb. Vasc. Bio. 2008;28:1582-1583.
FULL TEXT  

Surrogate Markers for Atherosclerosis in Overweight Subjects With Atherogenic Dyslipidemia: The GEMS Project
Genoud et al.
ANGIOLOGY 2008;59:484-492.
ABSTRACT  

Metabolic syndrome in peritoneal dialysis patients
Li et al.
NDT Plus 2008;1:206-214.
ABSTRACT | FULL TEXT  

Food Intake Patterns May Explain the High Prevalence of Cardiovascular Risk Factors among Iranian Women
Esmaillzadeh and Azadbakht
J. Nutr. 2008;138:1469-1475.
ABSTRACT | FULL TEXT  

Effect of Bariatric Surgery on the Metabolic Syndrome: A Population-Based, Long-term Controlled Study
Batsis et al.
Mayo Clin Proc. 2008;83:897-906.
ABSTRACT | FULL TEXT  

A Practical 'ABCDE' Approach to the Metabolic Syndrome
Blaha et al.
Mayo Clin Proc. 2008;83:932-943.
ABSTRACT | FULL TEXT  

Menopause and the Metabolic Syndrome: The Study of Women's Health Across the Nation
Janssen et al.
Arch Intern Med 2008;168:1568-1575.
ABSTRACT | FULL TEXT  

Relation between alanine aminotransferase concentrations and visceral fat accumulation among nondiabetic overweight Korean women
Song et al.
Am. J. Clin. Nutr. 2008;88:16-21.
ABSTRACT | FULL TEXT  

Ocular Vascular Thrombotic Events: Central Retinal Vein and Central Retinal Artery Occlusions
Glueck et al.
CLIN APPL THROMB HEMOST 2008;14:286-294.
ABSTRACT  

Interaction of Age With Lipoproteins as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis
Owens et al.
Arch Intern Med 2008;168:1200-1207.
ABSTRACT | FULL TEXT  

Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart Study
Chen et al.
Diabetes and Vascular Disease Research 2008;5:96-101.
ABSTRACT  

Physical Activity Belief Scales for Diabetes Risk: Development and Psychometric Testing
Blue et al.
Health Educ Behav 2008;35:316-331.
ABSTRACT  

Variants in the CD36 gene associate with the metabolic syndrome and high-density lipoprotein cholesterol
Love-Gregory et al.
Hum Mol Genet 2008;17:1695-1704.
ABSTRACT | FULL TEXT  

The Prevalence of Metabolic Syndrome Among US Women of Childbearing Age
Ramos and Olden
AJPH 2008;98:1122-1127.
ABSTRACT | FULL TEXT  

Association Between Circulating Oxidized Low-Density Lipoprotein and Incidence of the Metabolic Syndrome
Holvoet et al.
JAMA 2008;299:2287-2293.
ABSTRACT | FULL TEXT