Assessing the nutritional health of populations
This presentation is the property of its rightful owner.
Sponsored Links
1 / 72

Assessing the Nutritional Health of Populations PowerPoint PPT Presentation


  • 94 Views
  • Uploaded on
  • Presentation posted in: General

Assessing the Nutritional Health of Populations. Some Definitions. Joint Nutrition Monitoring Evaluation Committee, 1986 Expert Panel on Nutrition Monitoring, 1989. Dietary Status. The condition of a population’s or an individual’s intake of foods and food components, especially nutrients.

Download Presentation

Assessing the Nutritional Health of Populations

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Assessing the nutritional health of populations

Assessing the Nutritional Health of Populations


Some definitions

Some Definitions

Joint Nutrition Monitoring Evaluation Committee, 1986

Expert Panel on Nutrition Monitoring, 1989


Dietary status

Dietary Status

  • The condition of a population’s or an individual’s intake of foods and food components, especially nutrients.


Nutrition assessment

Nutrition Assessment

  • Measurement of indicators of dietary status and nutrition related health status to identify the possible occurrence, nature, and extent of impaired nutritional status.


Nutrition monitoring

Nutrition Monitoring

  • Assessment of dietary or nutrition status at intermittent times with the aim of detecting changes in the dietary or nutritional status of a population


Nutrition surveillance

Nutrition Surveillance

  • Continuous assessment of nutritional status for the purpose of detecting changes in trend or distribution in order to initiate corrective measures


Nutrition monitoring in the united states

Nutrition Monitoring in the United States


Public health revolutions

Public Health “Revolutions”


Brief chronology

Brief Chronology


Goals of nnms

Goals of NNMS

  • Provide foundations for improvement of nutritional status and quality and healthfulness of food supply

  • Collect, analyze, and disseminate timely data on nutrition and dietary status, quality of food supply, food consumption patterns, consumer knowledge and attitudes


Nnms goals cont

NNMS Goals, cont...

ID high risk groups and geographic areas and trends

Establish national baseline data and develop standards for monitoring

Provide data for evaluating implications of changes in agricultural policy


Nnms some agencies

NNMS - Some Agencies

  • USDA

    • Food and Nutrition Service

    • Food Safety and Inspection Service

    • Agricultural Research Service

    • Economic Research Service

    • Extension Service

    • Cooperative State Research Service


Assessing the nutritional health of populations

  • Department of Health and Human Services

    • National Center for Health Statistics

    • CDC-National Center for Chronic Disease Prevention and Health Promotion

    • Food and Drug Administration

    • Heath Resources and Services Administration

    • Indian Health Services

    • National Institutes of Health

    • Substance Abuse and Mental Health Services Administration


Assessing the nutritional health of populations

  • Others:

    • Department of Defense

    • Department of Education

    • Agency for International Development

    • Department of Veterans Affairs

    • Census Bureau

    • Bureau of Labor Statistics

    • National Marine Fisheries Service


Nutrition and related health measurements

Nutrition and Related Health Measurements

  • National Health and Nutrition Examination Surveys (I-V, and continuous)

  • National Health Interview Survey

  • National Hospital Discharge Survey

  • Pediatric Nutrition Surveillance System


Food and nutrient composition

Food and Nutrient Composition

  • Nationwide Food Consumption Survey

  • Continuing Survey of Food Intakes by Individuals – now integrated into What We Eat in America


Knowledge attitudes and behavior

Knowledge, Attitudes, and Behavior

  • Behavioral Risk Factor Surveillance System

  • Youth Risk Behavior Survey

  • Diet and Health Knowledge Survey


Food composition and nutrient data bases

Food Composition and Nutrient Data Bases

  • National Nutrient Data Bank (NNDB)


Food supply determinations

Food Supply Determinations

  • US Food and Nutrition Supply Series

    • Interactive web site for nutrient content of the US food supply from 1909 to 2006: http://65.216.150.146/

    • Gerrior & Bente. Dietary Guidance, 1970 to 1999: Does the U.S. Food Supply Support It? Family Economics and Nutrition Review. 2002


Assessing the nutritional health of populations

Gerrior & Bente, 2002


Assessing the nutritional health of populations

Gerrior & Bente, 2002


Federal assessment of policies and practices

Federal Assessment of Policies and Practices


Major public health surveys with nutrition content

Major Public Health Surveys with Nutrition Content


Behavioral risk factor surveillance system brfss

Behavioral Risk Factor Surveillance System (BRFSS)

  • CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)

  • Annually since 1984 (not all states at first)

  • Telephone interview

  • Data collection is conducted separately by each State. Sample design uses State-level, random-digit-dialed probability samples of the adult (aged 18 years and over) population.

  • State-specific sample sizes ranged from 1,499 to 6,005


Brfss questions

BRFSS - Questions

  • Behavioral risk factors (for example, alcohol and tobacco use), preventive health measures, HIV/AIDS, health status, limitation of activity, and health care access and utilization

  • Core of questions asked in all States

  • Standardized optional questions on selected topics administered at the State’s discretion

  • Rotating core of questions asked every other year in all States

  • State-added questions developed to address State-specific needs


Brfss data

BRFSS - Data

  • National

  • State

  • Smaller units when local agencies pay for additional surveys

  • Data system homepage: http://www.cdc.gov/brfss/


Brfss nutrition

BRFSS - Nutrition

  • Self reported height and weight

  • Trying to loose weight?

  • 6 fruit and vegetable intake questions

  • Activity

  • Food security


Brfss 2008 percentage of respondents reporting bmi 24 9

BRFSS 2008 – percentage of respondents reporting BMI < 24.9


Assessing the nutritional health of populations

The Youth Risk Behavior Surveillance System (YRBSS)

National, State, and Local Data


Purposes of the yrbss

Purposes of the YRBSS

  • Focus the nation on behaviors among youth causing the most important health problems

  • Assess how risk behaviors change over time

  • Provide comparable data


Behaviors that contribute to the leading causes of morbidity and mortality

Behaviors That Contribute to the Leading Causes of Morbidity and Mortality

  • Behaviors that contribute to unintentional injuries and violence

  • Tobacco use

  • Alcohol and other drug use

  • Sexual behaviors

  • Unhealthy dietary behaviors

  • Inadequate physical activity


Characteristics of the national state and local school based yrbs

Characteristics of the National, State, and Local School-Based YRBS

  • 2007 sample was 14,041, 9th – 12th grade students

  • 2007 response rates

    • School = 81%

    • Student = 84%

    • Overall 68%

  • Anonymous, computer-scannable questionnaire or answer sheet

  • Completed in one class period (45 minutes)

  • Conducted biennially usually during the spring


Policy and program applications

Policy and Program Applications

  • Describe risk behaviors

  • Create awareness

  • Set program goals

  • Develop programs and policies

  • Support health-related legislation

  • Seek funding


Yrbs nutrition

YRBS - Nutrition

  • Self reported weight and height

  • Dieting behaviors

  • Eating disorder behaviors

  • Fruit and vegetable intake

  • Fat intake


Assessing the nutritional health of populations

Percentage of High School Students Who Ate Fruits and Vegetables Five or More Times/Day,* by Sex** and Race/Ethnicity,*** 2007

* 100% fruit juices, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables during the 7 days before the survey.

** M > F*** B, H > W

National Youth Risk Behavior Survey, 2007


Percentage of high school students who ate fruits and vegetables five or more times day 1999 2007

Percentage of High School Students Who Ate Fruits and Vegetables Five or More Times/Day,* 1999 – 2007

* 100% fruit juices, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables during the 7 days before the survey.

1 Decreased 1999-2007, p < .05

National Youth Risk Behavior Surveys, 1999 – 2007


Assessing the nutritional health of populations

Percentage of High School Students Who Drank Three or More Glasses/Day of Milk,* by Sex** and Race/Ethnicity,*** 2007

* During the 7 days before the survey.

** M > F*** W > H > B

National Youth Risk Behavior Survey, 2007


Percentage of high school students who drank three or more glasses day of milk 1999 2007

Percentage of High School Students Who Drank Three or More Glasses/Day of Milk,* 1999 – 2007

* During the 7 days before the survey.

1 Decreased 1999-2007, p < .05

National Youth Risk Behavior Surveys, 1999 – 2007


Assessing the nutritional health of populations

Percentage of High School Students Who Drank a Can, Bottle, or Glass of Soda or Pop at Least One Time/Day,* by Sex** and Race/Ethnicity,*** 2007

* Not including diet soda or diet pop, during the 7 days before the survey.

** M > F*** B > H

National Youth Risk Behavior Survey, 2007


Assessing the nutritional health of populations

Percentage of High School Students Who Did Not Eat for 24 or More Hours to Lose Weight or to Keep From Gaining Weight,* by Sex** and Race/Ethnicity,*** 2007

* During the 30 days before the survey.

** F > M

*** H > W, B

National Youth Risk Behavior Survey, 2007


Assessing the nutritional health of populations

Percentage of High School Students Who Vomited or Took Laxatives to Lose Weight or to Keep From Gaining Weight,* by Sex** and Race/Ethnicity,*** 2007

* During the 30 days before the survey.

** F > M*** H > B

National Youth Risk Behavior Survey, 2007


Assessing the nutritional health of populations

Percentage of High School Students Who Vomited or Took Laxatives to Lose Weight or to Keep From Gaining Weight,* 1995 – 2007

* During the 30 days before the survey.

1 No change 1995-2003, decreased 2003-2007, p < .05

National Youth Risk Behavior Surveys, 1995 – 2007


Rising rates of childhood overweight in lewis county

Rising Rates of Childhood Overweight in Lewis County


Continuing survey of food intake by individuals csfii

Continuing Survey of Food Intake by Individuals (CSFII)

  • USDA

  • 1994-1996

  • in-person interviews

  • 24-hour dietary recall: 2 nonconsecutive days of food intake data collected 3-10 days apart

  • 2 weeks later, one adult from each household asked questions about knowledge and attitudes toward dietary guidance, health, and use of food labels.


Cfsii sample

CFSII - Sample

  • Nationally representative stratified multistage area probability sample of U.S. noninstitutionalized civilian population, all ages.

  • Oversampling of low-income households

  • For 1994–96, sample size for 1-day dietary data was 16,103; for 2-day dietary data, it was 15,303.


Cfsii data

CFSII - Data

  • kinds and amounts of foods consumed

  • sources of foods

  • time, name of each eating occasion

  • food expenditures, shopping practices

  • pregnancy, lactation, nursing status,

  • height and weight

  • income, poverty status, household size,

  • participation in Food Stamp and WIC programs


Cfsii data availability

CFSII - Data Availability

  • National; four U.S. Census Bureau regions; Standard Metropolitan Statistical Areas

  • http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm


Cfsii nutrition

CFSII - Nutrition

  • food intakes in grams of 71 USDA-defined food groups and subgroups

  • nutrient intakes of 28 nutrients and food components

  • nutrient intakes expressed as percentages of the 1989 Recommended Dietary Allowance

  • Pyramid servings from 30 food groups


Trends in beverage consumption youth aged 11 18 years

Trends in Beverage Consumption – Youth aged 11-18 years


Assessing the nutritional health of populations

Consumption of cereals, added sugars and fats has gone up (lb per capita)

Note that the major increases was in the cereals category

Source: ERS/USDA FoodReview 2002


Assessing the nutritional health of populations

Corn sweeteners have overtaken cane and beet sugar (lb per capita)

Sucrose = 50% fructose; 50% glucose; HFCS = 55% fructose; 45% glucose

Source: ERS/USDA FoodReview 2002


Assessing the nutritional health of populations

Less red meat, fewer eggs, and more poultry and fish (lb per capita, edible weight)

Source: ERS/USDA FoodReview 2002


Assessing the nutritional health of populations

Oranges, apples, and bananas account for 50% of all fruit servings (lb per capita)

Source: ERS/USDA FoodReview 2002


Assessing the nutritional health of populations

Iceberg lettuce, frozen potatoes, and potato chips account for 33% of vegetable servings

(lb per capita)

Starchy vegetables: corn, carrots, peas, sweet potatoes, beans

Fresh vegetables: tomatoes, onions, cucumbers, peppers, cabbage, celery

Dark green leafy: Leaf lettuce, broccoli, spinach, squash

Source: ERS/USDA FoodReview 2002


National health and nutrition examination survey nhanes

National Health and Nutrition Examination Survey (NHANES)

  • CDC, National Center for Health Statistics (NCHS)

  • In-person interview in household and mobile examination center

  • stratified multistage probability sample, nationally representative of the U.S. civilian noninstitutionalized population

  • Approximately 5,000 people are examined at 15 locations each year

  • All ages beginning in 1999


Nhanes continuous

NHANES - Continuous

  • Periodic (1960–94);

  • annual beginning in 1999

  • after 1999 annual sample size too small to provide reliable estimates for many measures and for most subgroups. Most analyses require 3 years of data for reliable estimates.


Nhanes content

NHANES - Content

  • Chronic disease prevalence and conditions (including undiagnosed conditions

  • immunization status

  • infectious disease prevalence

  • health insurance

  • measures of environmental exposures

  • hearing

  • vision

  • mental health


Nhanes content1

NHANES - Content

  • anemia

  • diabetes

  • cardiovascular disease

  • osteoporosis

  • obesity

  • oral health

  • physical fitness


Nhanes data

NHANES - Data

  • National; four U.S. Census Bureau regions

  • Demographics: Gender, age, education, race/ethnicity, place of birth, income, occupation, and industry

  • http://www.cdc.gov/nchs/nhanes.htm


Nhanes nutrition

NHANES - Nutrition

  • Food Security

  • Dietary supplements

  • Weight history

  • Dietary Recall - one 24 hour


Nhanes iii anthropometric procedures video

Body weight

Standing height

Sitting height

Upper leg length

Recumbent length

Upper arm length

Knee height

Arm circumference

Waist circumference

Buttocks circumference

Thigh circumference

Head circumference

Skinfolds (including thighs, triceps, subscapular, and suprailiac)

Wrist breadth

Elbow breadth

NHANES III Anthropometric Procedures Video


What we eat in america nhanes cfsii integration

WHAT WE EAT IN AMERICA: NHANES-CFSII Integration

  • Staged integration of the two surveys

  • 2001 a year of testing, 2002 full integration

  • Goals: continuous data collection, linkage of diet and health data, 2 days of dietary data collection (second day by phone 3 to 10 days after initial exam)

  • DHKS not part of integrated efforts at this time, but under consideration


What we eat in america

What We Eat in America

  • Food intake data can be linked to health status data from other NHANES components

  • HHS is responsible for the sample design and data and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the database used to code and process the data, and data review and processing


History of the food security measurement project

History of the Food Security Measurement Project


Sample of other population surveillance systems with nutrition components

Sample of Other Population Surveillance Systems with Nutrition Components

  • Breastfeeding: National Immunization Survey

  • Growth in Low Income Children: Pediatric Nutrition Surveillance System

  • Pregnancy Risk Assessment Monitoring System


  • Login