QuickStats: Prevalence of Complete Tooth Loss Among Adults Aged 65 Years or Older by Federal Poverty Level — National Health and Nutrition Examination Survey, United States, 1999–2018

September 18, 2020

The age-adjusted prevalence of complete tooth loss among adults aged 65 years or older decreased from 29.3% during 1999–2000 to 12.6% during 2017–2018.

For the same period, the prevalence decreased from 42.1% to 23.5% for adults living at less than 200% of the federal poverty level and from 17.7% to 8.5% for adults living at more than 200% of the federal poverty level.

Throughout the period, the prevalence of complete tooth loss was higher among those living at less than 200% of the federal poverty level.

Sources: Fleming E, Afful J, Griffin SO. Prevalence of tooth loss among older adults: United States, 2015–2018. NCHS data brief, no. 368. https://www.cdc.gov/nchs/products/databriefs/db368.htm. National Center for Health Statistics, National Health and Nutrition Examination Survey, 2015–2018. https://www.cdc.gov/nchs/nhanes.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a8.htm


QuickStats: Prevalence of Past or Present Infection with Hepatitis B Virus Among Adults Aged 18 Years or Older, by Race and Hispanic Origin — National Health and Nutrition Examination Survey, 1999–2018

September 4, 2020

The prevalence of past or present infection with hepatitis B virus among adults aged 18 years or older declined from 5.7% in 1999–2002 to 4.3% in 2015–2018.

A decline among non-Hispanic White (3.5% to 2.1%), non-Hispanic Black (15.6% to 10.8%), and Mexican American (3.5% to 1.8%) adults also occurred over the same period.

Prevalence was higher among non-Hispanic Black adults than among both non-Hispanic White and Mexican American adults for all periods.

Sources: Kruszon-Moran D, Paulose-Ram R, Martin CB, Barker L, McQuillan G. Prevalence and trends in hepatitis B virus infection in the United States, 2015–2018. NCHS Data Brief, no 361. https://www.cdc.gov/nchs/products/databriefs/db361.htm; National Center for Health Statistics, National Health and Nutrition Examination Survey, 1999–2002 to 2015-2018. https://www.cdc.gov/nchs/nhanes/index.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6935a8.htm


Nonalcoholic Beverage Consumption Among Adults: United States, 2015–2018

September 3, 2020

Questions for Crescent Martin, Health Statistician and Lead Author of “Nonalcoholic Beverage Consumption Among Adults: United States, 2015–2018.”

Q: Why did you decide to look at non-alcoholic beverage consumption for this report?

CM: Beverages help meet total water intake needs, and also are a major contributor to overall nutrient and caloric intake in the United States.

A previous analysis had looked at beverage consumption among youth (2013-2016), decided to conduct a similar analysis for adults.


Q: Was there a specific finding in the data that surprised you from this report?

CM: Water contributed substantially more to total non-alcoholic beverages consumption in grams, compared to other beverages.

Men consumed a lower percentage of their total beverages as water and tea, compared to women.

The contribution of coffee to total beverage consumption increased with age


Q: How did the data vary by different beverage types to total non-alcoholic beverage consumption among adults?

CM: By sex: Men consumed a lower percentage of their total beverages as water and tea, compared to women.

Men consumed a higher percentage of their total beverage intake as: coffee, sweetened beverages, fruit beverages, compared to women.

By age: The contributions of several beverages to total beverage consumption decreased with age: water, sweetened beverages, fruit beverages.

Others increased with age: coffee, tea, milk, diet beverages

By race and Hispanic origin:

For non-Hispanic Asian adults: water and tea contributed a higher percentage, sweetened beverages a lower percentage compared to other groups

For non-Hispanic white adults: coffee and diet beverages both contributed a higher percentage than for other groups

For non-Hispanic black and Hispanic adults: sweetened beverages were higher than for NH Asian and NH white adults

For Non-Hispanic black adults: fruit beverages higher than for other groups


Q: What is the take home message for this report?

CM: Water accounted for over half (51.2%) of total non-alcoholic beverage consumption on a given day for US adults in 2015–2018.

Next highest: coffee (14.9%); Sweetened beverages (10.2%); Tea (8.7%)


Q: Does NHANES or NCHS have any data on alcoholic beverage consumption?

CM: An NHANES report from 2012: Calories Consumed From Alcoholic Beverages by U.S. Adults, 2007–2010. https://www.cdc.gov/nchs/products/databriefs/db110.htm

Main findings – Men and younger adults consume more calories from alcoholic beverages. And men consume more beer than other types of alcohol.

Alcohol use (not calories) is also reported using the National Health Interview Survey


Fast Food Intake Among Children and Adolescents in the United States, 2015–2018

August 14, 2020

Questions for Cheryl Fryar, Health Statistician and Lead Author of “Fast Food Intake Among Children and Adolescents in the United States, 2015–2018.”

Q: Why does NCHS conduct studies on fast food consumption among children and adolescents?

CF: We focus on fast food for this report because fast food continues to play an important role in the American diet. Fast food has been associated with poor diet and increased risk of obesity. In a previous report, we described the percentage of calories consumed from fast food among children and adolescents during 201-2012. This report provides an update on the daily percentage of calories consumed from fast food by children and adolescents aged 2-19 years during 2015-2018 and trends since 2003.


Q: How did the data vary by age groups, sex and race?

CF: There were some demographic differences in the daily percentage of calories consumed from fast food. Adolescents aged 12–19 consumed a higher percentage of calories (16.7%) from fast food than younger children (11.4%) aged 2-11 years. Girls consumed a higher percentage than boys and non-Hispanic white adolescents consumed a lower percentage than the other race and Hispanic origin groups. This brief report did not examine confounders that may possibly explain demographic differences.


Q: Was there a specific finding in the data that surprised you from this report?

CF: While there really wasn’t anything in this report that I hadn’t expected to see or that was surprising to me, this report’s trends analysis is of interest. The daily percentage of calories from fast food in children and adolescents decreased from 14.1% in 2003–2004 to 10.6% in 2009–2010, and then increased to 14.4% in 2017-2018.


Q: How did you obtain this data for this report?

CF: The National Health and Nutrition Examination Survey (NHANES) is the source of the data.  Since 1999, NHANES has been conducted on a continuous basis, and visits approximately 15 counties each year of various population size.  The survey conducts at home health interviews and health examinations in mobile examination centers (MEC) with nearly 5000 people each year.   Information on nutrient intake was obtained from one 24-hour dietary recall interview administered in-person at the MEC.  Specifically, anyone who reported obtaining any food or beverage from “restaurant fast food/pizza” was someone who consumed fast food on a given day.  Dietary recalls cover intake for any given day, specifically the 24-hour period prior to the dietary recall interview (midnight to midnight).

For survey participants < 6 years of age a proxy was used (who was generally the person most knowledgeable about the child’s food intake). For children ages 6- 8, interviews were conducted with a proxy and with the child present to assist in reporting intake information. Interviews of children ages 9-11, were conducted with the child and the assistance of an adult familiar with the child’s intake. Adolescents 12 years or older answered for themselves.


Q: What is the take home message for this report?

CF: The take-home message for this report is that more than one-third (36.3%) of U.S. children and adolescents consume fast food on a given day. Overall, children and adolescents consume, on average, 13.8% of their daily calories from fast food.  And, on a given day, over 11% of children and adolescents consume more than 45% of their daily calories from fast food.

Diet and exercise play important roles in helping individuals achieve and maintain their health.  The USDA/HHS’ Dietary Guidelines for Americans 2015 provides guidance in healthy food choices.  In addition, HHS’ 2018 Physical Activity Guidelines for Americans provides guidance for all ages in improving health through physical activity.


Prevalence of Prescription Pain Medication Use Among Adults: United States, 2015–2018

June 24, 2020

FROM THE AUTHOR

In 2015–2018, 10.7% of U.S. adults used one or more prescription pain medications in the past 30 days.  Prescription pain medication use was higher among women than men overall and within each age category. Use increased with age overall and among men and women. Prescription pain medication use was lowest among non-Hispanic Asian adults, and use among Hispanic adults was lower than among non-Hispanic white adults. This same pattern of prescription pain medication use was observed among both men and women.

Additionally, this report estimated the percentage of adults who used one or more opioid prescription pain medications (with or without use of non-opioid prescription pain medications) and the percentage who used one ore more non-opioid prescription pain medication (without use of prescription opioids).  In 2015–2018, 5.7% of U.S. adults used prescription opioids and 5.0% used non-opioid prescription pain medications (without prescription opioids) in the past 30 days. Use of one or more prescription opioids and use of non-opioid prescription pain medications (without prescription opioids) were higher among women than men, and increased with age, and were lowest among non-Hispanic Asian adults.  Use of one or more prescription opioids among Hispanic adults was lower than among non-Hispanic white adults.

From 2009–2010 to 2017–2018, there was no significant increase in use of prescription opioids, but use of non-opioid prescription pain medications (without prescription opioids) increased.

Source: National Health and Nutrition Examination Survey, 2015–2018.


Prevalence of Tooth Loss Among Older Adults: United States, 2015–2018

June 17, 2020

Questions for Eleanor Fleming, Health Statistician and Lead Author of “Prevalence of Tooth Loss Among Older Adults: United States, 2015–2018.”

Q: Why did you decide to do a report on tooth loss among older U.S. adults?

EF: Tooth loss among older U.S. adults is an important public health issue. Reducing complete tooth loss is a national health goal monitored by Healthy People. From a health perspective, tooth loss diminishes quality of life, impacts nutrition as food choices are limited, and can impede social interactions. Tooth loss is also preventable.


Q: Can you summarize how the data varied by sex, age, race and Hispanic origin, and education?

EF: While the prevalence of complete tooth loss has been diminishing since the 1960s, in other words, older adults are retaining their teeth; in 2015-2018, disparities continue to persist. Overall, the prevalence of complete tooth loss was 12.9%. We found differences in the prevalence of complete tooth loss by sex, age, race and Hispanic origin, and education.

The prevalence of complete tooth loss among adults aged 65 and over and increased with age: 8.9% (aged 65–69), 10.6% (70–74), and 17.8% (75 and over). There were also differences among women and men by age. Among women, prevalence increased in a similar pattern with age (6.9% for adults aged 65–69, 11.7% for 70–74, and 16.6% for 75 and over). There was a different pattern among men. Among men, complete tooth loss was higher in the oldest age group (19.5% for 75 and over) compared with the two younger groups (11.1% and 9.4%, respectively, for those aged 65–69 and 70–74). There were no observed significant differences in the prevalence between men and women.

By race and Hispanic origin, the prevalence of complete tooth loss is similar to patterns that we see in other oral health and health outcomes. There are differences among race and Hispanic and origin. Non-Hispanic black older adults (25.4%) had the highest prevalence of complete tooth loss compared with other race and Hispanic-origin groups. Among men, prevalence was also higher among non-Hispanic black men (23.4%) compared with non-Hispanic white (12.5%) and Hispanic (11.9%) men. Among women, prevalence of complete tooth loss was higher in non-Hispanic black women (26.8%) compared with Hispanic (17.8%) and non-Hispanic white (9.5%) women.

We also found differences in the prevalence of complete tooth loss among older adults by education level. We defined education in terms of less than a high education and a high school education or greater. Adults with less than a high school education had a higher prevalence of complete tooth loss (31.9%) compared with adults with a high school education of greater (9.5%).


Q: Was there a specific finding in the data that surprised you from this report?

EF: The statistical difference between Hispanic men and women was the most surprising finding in this report. It was not surprising that we observed the prevalence of complete tooth loss to be higher among Hispanic women (17.8%) compared to non-Hispanic women (9.5%). Nor, was it surprising that the prevalence of complete tooth loss among Hispanic men (11.9%) was lower compared to non-Hispanic white men (12.5%). However, a statistical difference Hispanic men and women was not expected.

When you look at the prevalence tooth loss by age among men and women, it is also striking that there were no statistical differences between men and women. While the pattern of estimates with age was difference, none of these differences were statistically different. One would hope to see either a similar pattern or statistical differences. Finding neither is striking.


Q: How did you obtain this data for this report?

EF: This report used National Health and Nutrition Examination Survey data, survey years 1999-2000 to 2017-2018. The survey includes an oral health examination, where dental examiners who are trained and licensed to practice in the United States conduct a tooth count. They assess whether a tooth is present or absence or all 32 teeth. We used these data to assess the absence of teeth in all teeth. Because the protocol for assess tooth count was similar in the survey years, we could combine the data. It should be noted, however, that protocols for the tooth count were similar, the dental examiners were not always dentists; licensed dental hygienists collected data for certain survey cycles.


Q: Is there any trend data that goes back further than 1999?

EF: This report includes trend data starting at 1999 with continuous data, meaning that survey has collected data continuously. While the oral health component has been part of the survey since its inception in 1959, we focused on these more recent, continuous data.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of complete tooth loss decreased from 29.9% to 13.1%. The prevalence has decreased for both men and women.


Q: What is the take home message for this report?

EF: Overall, the prevalence of complete tooth loss among adults aged 65 and over was 12.9%, and the age-adjusted prevalence has decreased since 1999-2000. This is great news, as more older adults are retaining their teeth. However, for 12.9% of older adults to be without their teeth has tremendously public health importance and signals that additional work is needed.


QuickStats: Prevalence of High Total Cholesterol Among Adults Aged 20 Years or Older by Age Group and Sex

June 5, 2020

During 2015–2018, the prevalence of high total cholesterol among adults aged 20 years or older was 11.4%, with no significant difference between men (10.5%) and women (12.1%). Prevalence was highest among adults aged 40–59 years (15.7%), followed by those aged 60 years or older (11.4%), and lowest among those aged 20–39 years (7.5%).

Among men, the prevalence was highest among those aged 40–59 years (14.5%), followed by those aged 20–39 years (9.5%), and lowest among those aged 60 years or older (6.0%).

Among women, the pattern was different, with women aged 20–39 years (5.5%) having a lower prevalence than either women aged 40–59 years (16.9%) or women aged 60 years or older (15.9%).

Prevalence among women aged 20–39 years was lower than that among men in this age group, but prevalence was higher among women aged 60 years or older than it was among men of that age group. There was no significant difference between men and women for adults aged 40–59 years.

Sources: Carroll MD, Fryar CD. Total and high-density lipoprotein cholesterol in adults: United States, 2015–2018. NCHS Data Brief, no 363. https://www.cdc.gov/nchs/products/databriefs/db363.htm. National Center for Health Statistics, National Health and Nutrition Examination Survey, 2015–2018. https://www.cdc.gov/nchs/nhanes.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6922a5.htm


Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2018

April 22, 2020

Questions for Margaret Carroll, Health Statistician and Lead Author of “Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2018.”

Q: How has the prevalence of high total cholesterol among US adults changed since 1999-2000 data and and low high-density lipoprotein cholesterol (HDL-C) since 2007-2008?

MC: There has been a declining trend in the prevalence of high total cholesterol since 1999-2000 and a declining trend in the prevalence of low HDL-C since 2007-2008.


Q: Can you summarize how the data varied by sex, age groups and race?

MC: The prevalence of high total cholesterol:

  • Higher in adults aged 40-59 than in adults aged 20-39 and those aged 60 and over
  • Not significantly different between men and women aged 20 and older
  • Not significantly different among non-Hispanic white, non-Hispanic black, non-Hispanic Asians and Hispanics

The prevalence of low HDL-C:

  • Higher in men than in women overall, within each age group and within each race and Hispanic origin group.
  • lower among NH black adults than in non-Hispanic white adults, non-Hispanic Asian adults and Hispanic adults over all and in men.
  • Higher among Hispanic adults than among non-Hispanic white, non-Hispanic black and non-Hispanic Asian adults overall, among men and among women.

Q: Was there a specific finding in the data that surprised you from this report?

MC: Although we weren’t surprised because the results have been seen in the past, men continue to have a much higher prevalence of low HDL-C compared to women.


Q: How did you obtain this data for this report?

MC: Results presented in this report are based on data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross sectional, probability survey representative of the United States non-institutionalized population.  Beginning in 1999 NHANES became a continuous survey and data have been released in 2-year cycles.  Data from 2015-2016 and 2017-2018 were used to test differences in the prevalence of high total and low HDL-C cholesterol between subgroups. Trends in the prevalence of high total cholesterol are based on data from ten 2-year cycles from 1999-2000 through 2017-2018. Trends in the prevalence of low HDL-C are based on six 2-year cycles from 2007-2008 through 2017-2018


Q: What is the take home message for this report?

MC: Over 1 in ten (11%) adults have high total cholesterol and over 17% have low HDL-C. The prevalence of high total cholesterol has declined since 1999-2000; the prevalence of low HDL-C has declined since 2007-2008.


QuickStats: Prevalence of Obesity and Severe Obesity Among Persons Aged 2–19 Years — National Health and Nutrition Examination Survey, 1999–2000 through 2017–2018

April 3, 2020

From 1999–2000 to 2017–2018, the prevalence of obesity among persons aged 2–19 years increased from 13.9% to 19.3%, and the prevalence of severe obesity increased from 3.6% to 6.1%.

Source: National Center for Health Statistics, National Health and Nutrition Examination Survey, 1999–2000 to 2017–2018. https://www.cdc.gov/nchs/nhanes.htm.


Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018

February 27, 2020

Questions for Craig Hales, Health Statistician and Lead Author of “Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018.”

Q: How has the prevalence of obesity and severe obesity in U.S. adults changed since 1999-2000?

CH: The prevalence of obesity and severe obesity among U.S. adults increased since 1999-2000.  The prevalence of obesity was 30.5% among adults in 1999-2000 and increased more than 10 percentage points to 42.4% in 2017-2018.  The prevalence of severe obesity among adults almost doubled from 4.7% in 1999-2000 to 9.2% in 2017-2018.  The prevalence for obesity and severe obesity in 2017-2018 is the highest ever reported among all U.S. adults.


Q: Can you explain the differences between obesity and severe obesity?

CH: The definitions of obesity and severe obesity are based on the body mass index, or BMI, which is based on your weight and your height.  Obesity is defined as having a BMI of 30 or higher, and severe obesity is defined as having a BMI of 40 or higher.


Q: How far back do you have obesity trend data?

CH: The trends reported in this data brief go back to 1999-2000, which is when NHANES began running as a continuous survey.  However, NHANES began collecting height and weight data among adults aged 20-74 in 1960-1962.  At that time, obesity prevalence was 13.4% and severe obesity prevalence was 0.9%.


Q: Was there a specific finding in the data that surprised you?

CH:  What I found most striking is that more than 40% of adults in the US had obesity in 2017-2018, which is more than 10 percentage points higher than the prevalence was in 1999-2000.  The prevalence of severe obesity among adults has almost doubled from 4.7% in 1999-2000 to 9.2% in 2017-2018.  The prevalence of obesity and severe obesity in 2017-2018 is the highest ever reported among all U.S. adults.


Q: When will you have 2017-2018 children’s obesity data available?

CH:  NHANES height and weight data for children and adolescents are currently available on the NHANES website.  Estimates for obesity and severe obesity among children and adolescents will be published in the near future.


Q:  Anything else you’d like to note about the new report?

CH:  Measured height and weight is the gold standard for generating accurate estimates of obesity prevalence.  The National Health and Nutrition Examination Survey is unique in that it combines both interviews in the home and physical examinations in mobile examination centers, and it is the only national survey where people’s height and weight are physically measured.

Other surveys report obesity prevalence based on self-reported height and weight, but several studies have found serious inaccuracies with self-reported or proxy-reported height and weight.  Among adults, self-reported height tends to be overreported and weight is underreported, although misreporting can vary among subgroups of the population – but this misreporting leads to underestimates of obesity prevalence.