Cognitive Performance in Adults Aged 60 and Over, NHANES 2011-2014

September 18, 2019

Questions for Debra Brody, Lead Author of ”Cognitive Performance in Adults Aged 60 and Over, NHANES 2011-2014.”

Q: What was your objective in conducting this study?

DB: Our objective was to describe the cognitive performance, based on objective assessments, of U.S. adults aged 60 and over. We examined selected areas of cognition such as language, memory, attention, reasoning, and processing speed.

Q: Is this a topic you have looked at before?

DB: Cognitive performance has been evaluated periodically in the National Health and Nutrition Examination Survey, but the assessment method and age group has not always been the same.  Of the assessments conducted during 2011-2014, only one had been administered previously.

Q: Which cognitive tests were administered?

DB: Cognitive performance was evaluated with selected standardized instruments, including a 10 word list learning test consisting of 3 immediate recalls, and a delayed recall; a 1 minute animal naming test, and the digit symbol substitution test that required matching numbers with symbols.  There are other subdomains of cognitive ability that were not assessed. The tests were administered during the examination portion of the survey.

Q:  What are your most important findings from this study?

DB: Cognitive assessment scores varied by sociodemographic characteristics.  Overall, mean scores decreased with increasing age; for example, persons 80 years and older, on average, named 5 fewer animals  and remembered 2 fewer words than persons in the 60-69 year old category.   We also found that mean scores were lower for persons with less education and income, for persons reporting fair or poor health status, and for those who were aware of a change in their memory over the past year.  These results are generally consistent with other published studies.

Q: What is the main point you want people to take away from this study?

DB: The report showed the wide range of cognitive performance among adults 60 and older in the U.S.  Further examination of these data in relation to other medical conditions may provide insight in understanding how cognition changes as we age.


Attempts to Lose Weight Among Adolescents Aged 16–19 in the United States, 2013–2016

July 17, 2019

Questions for Lead Author Kendra McDow, Health Statistician, of “Attempts to Lose Weight Among Adolescents Aged 16–19 in the United States, 2013–2016.”

Q: What was the most significant finding in your report?

KM: Almost 40% of adolescents 16-19 years old tried to lose weight in the past year and the groups with the highest percentages were girls, Hispanic teens and teens with obesity.

Q: Why do more Hispanic teens attempt to lose weight than other race/ethnic groups?

KM: Yes, that was an interesting finding. Data from another source – the Youth Behavioral Risk Surveillance System (YBRSS) support this finding. In 2017 YBRSS also found that Hispanic teens were more likely to try to lose weight compared to other racial/Hispanic-origin groups. Our study did not look at motivations or the reason why adolescents attempt to lose weight. This a great area for further study!

Q: Do we have any sense of whether the number/percent of teens trying to lose weight has increased or declined over time?

KM: Our study period was from 2013-2016. For this analysis we didn’t look at trends but we started to look into this and found some changes in the way the data were collected over time. We need to explore this more fully. Trend analysis using YRBSS (9th through 12th graders) showed a significant increase in weight loss attempts from 1991 through 2017 (41.8% to 47.1%).

Q: What type of exercising do teens do to lose weight?

KM: Exercise was the most commonly reported method to lose weight. Our study did not specifically look at the type or intensity of exercise adolescents are doing to lose weight. Regular physical activity among adolescents is important for life-long health.

Q: Is there a public health “take home message” here?

KM: Teens are employing multiple methods to lose weight. The vast majority, over 83%, of teens trying to lose weight were exercising. Over half were drinking water and almost half were eating less. And certain populations are more likely to attempt to lose weight, including girls, Hispanic adolescents and adolescents with obesity. The American Academy of Pediatrics recommends the promotion of healthy weight loss and adoption of healthy eating and physical activity.

Q: Anything else you’d like to add?

KM: We saw that the majority of adolescents who attempted to lose weight used recommended lifestyle modification strategies of healthy eating and exercise. In addition to exercise, drinking more water and eating less, 44.7% of adolescents reported they ate less junk food or fast food and 44.6% ate more fruits, vegetables and salads. This is promising! Of note, 16.5% (1 in 6 adolescents) reported skipping meals as a weight loss method. The American Academy of Pediatrics discourages unhealthy weight loss strategies, such as skipping meals and dieting, and encourages healthy eating and physical activity behaviors for adolescents

Contribution of Whole Grains to Total Grains Intake Among Adults Aged 20 and Over: United States, 2013–2016

July 9, 2019

New NCHS report provides estimates of the percentage of total grains intake consumed from whole grains sources, for U.S. adults aged 20 and over who reported consumption of grains (98.6%) on a given day during 2013–2016.


  • During 2013–2016, whole grains accounted for 15.8% of total grains intake among adults on a given day. This percentage increased with age from 12.9% among adults aged 20–39 to 19.7% for adults 60 and over.
  • Overall, the contribution of whole grains to total grains intake was lower among men (14.8%) than women (16.7%).
  • The contribution of whole grains to total grains intake was lowest among Hispanic adults (11.1%) compared with non-Hispanic white (16.5%), non-Hispanic black (13.7%), and non-Hispanic Asian (18.3%) adults.
  • The contribution of whole grains to total grains intake on a given day increased with increasing family income.
  • From 2005–2006 to 2015–2016, the contribution of whole grains to total grains intake increased for adults overall, and for men and women.

Prescription Drug Use in the United States, 2015–2016

May 8, 2019

Questions for Lead Author Crescent Martin, Health Statistician, of “Prescription Drug Use in the United States, 2015–2016.”

Q: Why did you decide to do a report on prescription drug use in the United States?

CM: We wanted to update a previous report that found an increase in prescription drug use from 1999–2000 through 2007–2008, using the latest available data from 2015–2016.

Q: Do you have data for the years between 2007-2008 and 2015-2016 on prescription drug use?

CM: Yes, the trends analysis (shown in Figure 4) includes an estimate for each two-year survey cycle from 2007–2008 through 2015–2016 (i.e. 5 time points over the decade.)

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

CM: The percentage of the population that used prescription drugs increased with age among every group we looked at: overall, among both males and females, and among each race and Hispanic origin group.

By sex, prescription drug use was higher among females than males, though this overall difference was primarily driven by the difference observed among adults aged 20–59. Among children age 11 and younger, a higher percentage of boys than girls used prescription drugs.

Prescription drug use was highest among Non-Hispanic white persons, followed by non-Hispanic black persons, and was lowest among non-Hispanic Asian and Hispanic persons. This pattern also varied by age, and among adults aged 60 and over no differences were observed between race and Hispanic origin groups.

Q: Was there a specific finding in your report that surprised you?

CM: I was interested to see the different types of prescription drugs that were most commonly used within each age group. The most commonly used types of prescription drugs were bronchodilators (such as asthma rescue inhalers) for children aged 11 and under, central nervous system stimulants for adolescents aged 12-19, antidepressants for adults aged 20-59, and cholesterol-lowering drugs for adults aged 60 and over.

The top drug type for each age group was actually the same drug type that was most commonly used in 2007–2008, from the earlier report.

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

CM: Overall, almost half of the U.S. population took one or more prescription drugs in the past 30 days during 2015–2016.

When we look at trends over time and take into account how the age distribution of the US population has gotten older over this decade, we see a decline in the use of prescription drugs from 2007–2008 through 2015–2016.

QuickStats: Percentage of Youths Aged 2–19 Years Consuming Any Fast Food on a Given Day, by Race and Hispanic Origin — National Health and Nutrition Examination Survey, 2013–2016

October 15, 2018

During 2013–2016, 36.0% of youths aged 2–19 consumed fast food on a given day.

Non-Hispanic Asian youths (27.3%) had a lower percentage of fast food consumption on a given day, compared with non-Hispanic black (39.6%), Hispanic (36.6%), and non-Hispanic white (35.4%) youths.

There were no significant differences in fast food consumption on a given day among non-Hispanic white, non-Hispanic black, and Hispanic youths.

Source: National Center for Health Statistics Data Brief No. 322.; National Center for Health Statistics, National Health and Nutrition Examination Survey Data, 2013–2016.

Fast Food Consumption Among Adults in the United States, 2013-2016

October 3, 2018

Questions for Cheryl Fryar, M.S.P.H., Health Statistician and Lead Author of “Fast Food Consumption Among Adults in the United States, 2013-2016

Q: Of all the types of food that Americans eat, what made you decide to focus on fast food for this study?

CF: We focused on fast food for this report because fast food has played an important role in the American diet in recent decades. Fast food has been associated with poor diet and increased risk of obesity. In a previous report, we analyzed and described the percentage of calories consumed from fast food among adults. This current study looks at fast food consumption in a different way. We describe who is eating fast food on a given day. Specifically in this new report, we look at the percentage of adults who consume fast food overall as well as by sex, age group, race and Hispanic origin, family income level and eating occasion.

Q: Your new report measures fast food consumption “on a given day.” What does that mean exactly?

CF: Fast food consumption “on a given day” reflects the way respondents in the National Health and Nutrition Examination Survey reported all the foods and beverages they consumed in the previous 24 hours. The survey is designed to be representative of people anywhere in the United States at any time of the year, so “on a given day” refers to any day—so for example, on any day in the United States, approximately 37% of U.S. adults consume some fast food.

“Fast food” is defined as any food a respondent reported getting from a “restaurant fast food/pizza” outlet in the 2013-2016 National Health and Nutrition Examination Survey – often known as NHANES.

Q: What type of trend data do you have on eating fast food in the United States; for example, how has the consumption of fast food changed in the United States over the last 10 to 20 years?

CF: While we did not look at trend data for this report, dietary data collected from the National Health and Nutrition Examination Survey is a joint effort between the U.S. Department of Health and Human Services and the U.S. Department of Agriculture (USDA). The USDA has tables with calories (or energy) consumed from quick service restaurants – which includes fast food along with cafeterias and food trucks. These tables show that in 2015-2016, 15% of calories was from quick service restaurants compared to 16% in 2011-2012.

Q: Was there a finding in this new report on fast food that you hadn’t expected and that really surprised you?

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 analysis does offer some new information. Results from this study were similar to what we found for youth in 2011-2012, where 34% of youth consumed fast food. A new contribution from this new research is reporting fast food consumption among non-Hispanic Asian American adults in comparison to other groups. A notable finding is that non-Hispanic Asian American adults consumed a lower percentage of fast food (30.6%) compared to non-Hispanic white (37.6%) and non-Hispanic black (42.4%) adults.

Q: What differences or similarities did you see between or among various demographic groups in this analysis of fast food consumption?

CF: We found some differences in the percentage of U.S. adults who consume fast food. For example, fast food consumption decreased with age and increased with increasing income. About 45% of young adults consumed fast food compared to just over 24% of older adults. About 32% of adults in the lowest income group consumed fast food compared to 42% of adults in the highest income group. And a lower percentage of non-Hispanic Asian adults (30.6%) consumed fast food compared to non-Hispanic white (37.6%) and non-Hispanic black (42.4%) adults.

Also, among those who consumed fast food, men were more likely than women to eat fast food at lunch, but women were more likely than men to report eating fast food as a snack.

Q: What would you say is the take-home message of this report?

CF: The take-home message of this report is that overall more than one-third of U.S. adults and 45% of young adults consume fast food on a given day. Fast food restaurants can vary, though consumers can find nutritional information, such as calories, on the menu in most fast food establishments and restaurants.

Fact or Fiction: Do One in Three U.S. Adults Eat Seafood at Least Two Times Per Week?

September 28, 2018

SOURCE: National Health and Nutrition Examination Survey, 2013–2016.

Seafood Consumption in the United States, 2013–2016

September 28, 2018

Questions for Ana Terry, Health Statistician and Lead Author of “Seafood Consumption in the United States, 2013–2016

Q: What surprised you most about the findings in your report?

AT: Although the findings were not necessarily surprising, we found that seafood consumption was more than twice as high among non-Hispanic Asian adults compared with adults of other race and Hispanic-origin groups.  More than 40% of non-Hispanic Asian adults consumed seafood at least twice per week compared to about 19% of non-Hispanic white, 23% of non-Hispanic black, and 15% of Hispanic  adults.  This is consistent with other studies, which have found that people of Asian descent living in the U.S. consume seafood more frequently, in greater variety, and in greater quantity than non-Asian Americans (Liu et al, Environmental Research, October 2017).

Q: Do we know why there is such a disparity between US Asians and other race/ethnic groups when it comes to consuming the recommended amount of seafood?

AT: We analyzed data from the 2013-2016 National Health and Nutrition Examination Survey that was collected by a food frequency questionnaire in which persons were asked about the frequency and type of fish and shellfish they consumed in the previous 30 days.  The questionnaire did not ask for the reasons why individuals consumed or did not consume seafood. Other studies have found that diet patterns in Asian countries include fish and shellfish intake levels greater than the average seafood consumption worldwide and that the food choices of people of Asian descent living in the U.S. , are influences by Asian dietary patterns (Liu et al, Environmental Research, October 2017).

Q: Does the fact that seafood consumption has declined mean the population is at less of a risk for mercury exposure?

AT: We did not assess mercury exposure in this report.

Q: What are the health benefits to eating seafood?

AT: The Dietary Guidelines for Americans recommend for the general population consumption of about 8 oz per week of a variety of seafood. Fish and shellfish are excellent sources of high quality protein, are low in saturated fat, are rich in minerals and vitamins, and provide certain omega-3 fatty acids (EPA and DHA) that the body cannot make and are important for normal growth and development.  Seafood and omega-3 fatty acids have been shown to protect against health problems.

Q: What kinds of seafood are most healthy to eat?

AT: Cold water oily fish have the highest levels of omega-3 fatty acids but lower in methyl mercury (according to the 2015-2020 Dietary Guidelines for Americans). Cold water oily fish include:  Salmon, Anchovies, Herring, Shad, Atlantic and Pacific mackerel

Fact or Fiction: Is Undiagnosed diabetes more prevalent among American adults than diabetes that has already been diagnosed by a physician?

September 19, 2018

Source: National Health and Nutrition Examination Survey, 2013-2016

Prevalence of Total, Diagnosed, and Undiagnosed Diabetes Among Adults: United States, 2013-2016

September 19, 2018

Questions for Mark Eberhardt, Health Statistician and Lead Author of “Prevalence of Total, Diagnosed, and Undiagnosed Diabetes Among Adults: United States, 2013-2016

Q: Why did you decide to focus on diabetes in the United States for this report?

ME: The National Health and Nutrition Examination Survey (NHANES) is the only nationally representative survey that can estimate undiagnosed diabetes, since more recent data are available to consider this subject, it was appropriate to present it.

Q: Can you explain the differences between diagnosed and undiagnosed diabetes?

ME: People with diagnosed diabetes are those who report a medical history of diabetes (that is, a health care provider previously told them that they have diabetes). People with undiagnosed diabetes are those who do not report a previous medical history of diabetes, but who have laboratory results from blood specimens obtaining in NHANES which are in the diabetic range, as defined by the American Diabetes Association.

Q: How did the findings vary by sex, age, race and weight?

ME: The percent of adults with diabetes increases with age; a higher percent of men, compared to women, have total diabetes (which includes diagnosed and undiagnosed diabetes); a higher percent of non-Hispanic black and Hispanic adults have diabetes and total diabetes compared to non-Hispanic white adults. The percent of adults with diabetes (diagnosed, undiagnosed, or total diabetes) is higher among those who are overweight or obese.

Q: How did you obtain this data?

ME: The data were obtained in 2013-2016 by NHANES. This is a population-based community health survey conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC). NHANES has staff and mobile examination centers that travel around the US and obtain health-related interview, examination and laboratory information from a nationally representative sample of people in the US.

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

ME: Diabetes remains a serious common health condition among adults in the US, and a substantial percent of adults with diabetes still report not having it.