Importance More than one-third of adults and 17% of youth in the United States are obese, although the prevalence remained stable between 2003-2004 and 2009-2010. Objective To provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults. Design, Setting, and Participants Weight and height or recumbent length were measured in 9120 participants in the 2011-2012 nationally representative National Health and Nutrition Examination Survey. Main Outcomes and Measures In infants and toddlers from birth to 2 years, high weight for recumbent length was defined as weight for length at or above the 95th percentile of the sex-specific Centers for Disease Control and Prevention (CDC) growth charts. In children and adolescents aged 2 to 19 years, obesity was defined as a body mass index (BMI) at or above the 95th percentile of the sex-specific CDC BMI-for-age growth charts. In adults, obesity was defined as a BMI greater than or equal to 30. Analyses of trends in high weight for recumbent length or obesity prevalence were conducted overall and separately by age across 5 periods (2003-2004, 2005-2006, 2007-2008, 2009-2010, and 2011-2012). Results In 2011-2012, 8.1% (95% CI, 5.8%-11.1%) of infants and toddlers had high weight for recumbent length, and 16.9% (95% CI, 14.9%-19.2%) of 2- to 19-year-olds and 34.9% (95% CI, 32.0%-37.9%) of adults (age-adjusted) aged 20 years or older were obese. Overall, there was no significant change from 2003-2004 through 2011-2012 in high weight for recumbent length among infants and toddlers, obesity in 2- to 19-year-olds, or obesity in adults. Tests for an interaction between survey period and age found an interaction in children ( P  = .03) and women ( P  = .02). There was a significant decrease in obesity among 2- to 5-year-old children (from 13.9% to 8.4%; P  = .03) and a significant increase in obesity among women aged 60 years and older (from 31.5% to 38.1%; P  = .006). Conclusions and Relevance Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012. Obesity prevalence remains high and thus it is important to continue surveillance.

/pdf/prevalence-of-childhood-and-adult-obesity-in-the-united-1gon174hws.pdf

Prevalence of childhood and adult obesity in the United States, 2011-2012.

The purpose of this Position Stand is to provide guidance to professionals who counsel and prescribe individualized exercise to apparently healthy adults of all ages. These recommendations also may apply to adults with certain chronic diseases or disabilities, when appropriately evaluated and advised by a health professional. This document supersedes the 1998 American College of Sports Medicine (ACSM) Position Stand, "The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults." The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults. The ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. The exercise program should be modified according to an individual's habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. Behaviorally based exercise interventions, the use of behavior change strategies, supervision by an experienced fitness instructor, and exercise that is pleasant and enjoyable can improve adoption and adherence to prescribed exercise programs. Educating adults about and screening for signs and symptoms of CHD and gradual progression of exercise intensity and volume may reduce the risks of exercise. Consultations with a medical professional and diagnostic exercise testing for CHD are useful when clinically indicated but are not recommended for universal screening to enhance the safety of exercise.

/pdf/quantity-and-quality-of-exercise-for-developing-and-1fohxlhqop.pdf

Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise

Author(s): Go, Alan S; Mozaffarian, Dariush; Roger, Veronique L; Benjamin, Emelia J; Berry, Jarett D; Borden, William B; Bravata, Dawn M; Dai, Shifan; Ford, Earl S; Fox, Caroline S; Franco, Sheila; Fullerton, Heather J; Gillespie, Cathleen; Hailpern, Susan M; Heit, John A; Howard, Virginia J; Huffman, Mark D; Kissela, Brett M; Kittner, Steven J; Lackland, Daniel T; Lichtman, Judith H; Lisabeth, Lynda D; Magid, David; Marcus, Gregory M; Marelli, Ariane; Matchar, David B; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Mussolino, Michael E; Nichol, Graham; Paynter, Nina P; Schreiner, Pamela J; Sorlie, Paul D; Stein, Joel; Turan, Tanya N; Virani, Salim S; Wong, Nathan D; Woo, Daniel; Turner, Melanie B; American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2013 Update A Report From the American Heart Association

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e3

1. About These Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e7

2. American Heart Association's 2020 Impact Goals. . . . . . . . . . . . . . . . .e10

3. Cardiovascular Diseases . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .e21

4. Subclinical Atherosclerosis . . . . . . . . . . . . . . . . . . . . .e45

5. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris . . . . . . . . .e54

6. Stroke (Cerebrovascular Disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . .e68

7. High Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .e88

8. Congenital Cardiovascular Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . .e97

9. Cardiomyopathy and Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . .e102

10. Disorders …

Heart Disease and Stroke Statistics—2012 Update A Report From the American Heart Association

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovas...

Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association

ContextImplementation of the National Institutes of Health's 1998 guidelines,
which recommended that health care professionals advise obese patients to
lose weight, required baseline data for evaluation.ObjectivesTo describe the proportion and characteristics of obese persons advised
to lose weight by their health care professional during the previous 12 months
and to determine whether the advice was associated with reported attempts
to lose weight.DesignThe Behavioral Risk Factor Surveillance System, a random-digit telephone
survey conducted in 1996 by state health departments.SettingPopulation-based sample from 50 states and the District of Columbia.ParticipantsA total of 12,835 adults, 18 years and older, classified as obese (body
mass index ≥30 kg/m2), who had visited their physician for a
routine checkup during the previous 12 months.Main Outcome MeasuresReported advice from a health care professional to lose weight, and
reported attempts to lose weight.ResultsForty-two percent of participants reported that their health care professional
advised them to lose weight. Using multivariate logistic regression analysis,
we found that the persons who were more likely to receive advice were female,
middle aged, had higher levels of education, lived in the northeast, reported
poorer perceived health, were more obese, and had diabetes mellitus. Persons
who reported receiving advice to lose weight were significantly more likely
to report trying to lose weight than those who did not (OR, 2.79; 95% CI,
2.53-3.08).ConclusionsLess than half of obese adults report being advised to lose weight by
health care professionals. Barriers to counseling need to be identified and
addressed.

https://jamanetwork.com/journals/jama/articlepdf/192021/jbr90268.pdf

Are health care professionals advising obese patients to lose weight

Reliability and validity of self-reported height and weight among high school students.

ContextOverweight and obesity are increasing in the United States. Changes
in diet and physical activity are important for weight control.ObjectivesTo examine the prevalence of attempting to lose or to maintain weight
and to describe weight control strategies among US adults.DesignThe Behavioral Risk Factor Surveillance System, a random-digit telephone
survey conducted in 1996 by state health departments.SettingThe 49 states (and the District of Columbia) that participated in the
survey.ParticipantsAdults aged 18 years and older (N=107,804).Main Outcome MeasuresReported current weights and goal weights, prevalence of weight loss
or maintenance attempts, and strategies used to control weight (eating fewer
calories, eating less fat, or using physical activity) by population subgroup.ResultsThe prevalence of attempting to lose and maintain weight was 28.8% and
35.1% among men and 43.6% and 34.4% among women, respectively. Among those
attempting to lose weight, a common strategy was to consume less fat but not
fewer calories (34.9% of men and 40.0% of women); only 21.5% of men and 19.4%
of women reported using the recommended combination of eating fewer calories
and engaging in at least 150 minutes of leisure-time physical activity per
week. Among men trying to lose weight, the median weight was 90.4 kg with
a goal weight of 81.4 kg. Among women, the median weight was 70.3 kg with
a goal weight of 59.0 kg.ConclusionsWeight loss and weight maintenance are common concerns for US men and
women. Most persons trying to lose weight are not using the recommended combination
of reducing calorie intake and engaging in leisure-time physical activity
150 minutes or more per week.

https://jamanetwork.com/journals/jama/articlepdf/191986/JOC90559.pdf

Prevalence of attempting weight loss and strategies for controlling weight.

Physical activity, food choice, and weight management goals and practices among U.S. college students

ContextAlthough the prevalence of obesity has markedly increased among US adults,
health risks vary according to the severity of obesity. Persons with class
3 obesity (body mass index [BMI] ≥40) are at greatest risk, but there is
little information about this subgroup.ObjectiveTo examine correlates of class 3 obesity and secular trends.Design, Setting, and ParticipantsAdults (aged ≥18 years) in the United States who participated in
the Behavioral Risk Factor Surveillance System telephone survey between 1990
(75 600 persons) and 2000 (164 250 persons).Main Outcome MeasureBody mass index calculated from self-reported weight and height.ResultsThe prevalence of class 3 obesity increased from 0.78% (1990) to 2.2%
(2000). In 2000, class 3 obesity was highest among black women (6.0%), persons
who had not completed high school (3.4%), and persons who are short. During
the 11-year period, the median BMI level increased by 1.2 units and the 95th
percentile increased by 3.2 units.ConclusionThe prevalence of class 3 obesity is increasing rapidly among adults.
Because these extreme BMI levels are associated with the most severe health
complications, the incidence of various diseases will increase substantially
in the future.

https://jamanetwork.com/journals/jama/articlepdf/195356/JBR20139.pdf

Deborah A. Galuska

Papers

Are health care professionals advising obese patients to lose weight

Reliability and validity of self-reported height and weight among high school students.

Prevalence of attempting weight loss and strategies for controlling weight.

Physical activity, food choice, and weight management goals and practices among U.S. college students

Trends and Correlates of Class 3 Obesity in the United States From 1990 Through 2000