MEDICAL: RESEARCH : MEDICAL: DISEASES: DIABETES: Diabetes: New Cases and Spending to Surge Over 25 Years, Study Says

[David P. Dillard]

.


MEDICAL: RESEARCH :
MEDICAL: DISEASES: DIABETES:
Diabetes: New Cases and Spending to Surge Over 25 Years, Study Says



Diabetes: New Cases and Spending to Surge Over 25 Years, Study Says
By Deborah L. Shelton
Tribune reporter
November 27, 2009
<http://www.chicagotribune.com/news/
chi-diabetes-27-nov27,0,7282434.story>


A shorter URL for the above link:


<http://tinyurl.com/ygnxmeg>


Even if the percentage of Americans who are obese stays the same, diabetes
cases will nearly double in the U.S. in the next 25 years and the cost of
treating the disease will almost triple, according to a new study by
researchers based at the University of Chicago.

The study, published Friday in the journal Diabetes Care, found the number
of people with diagnosed and undiagnosed diabetes will climb from almost
24 million this year to about 44 million in 2034. Over the same period,
annual diabetes-related treatment costs are expected to increase from $113
billion to $336 billion in 2007 dollars.

Alarmingly, Medicare spending on diabetes is expected to jump from $45
billion to $171 billion and could exceed current projections for all
Medicare costs, the researchers said. Much of the increase in cases and
costs will be driven by aging baby boomers, the 77 million Americans born
between 1946 and 1957.

"It's a combination of the increasing numbers of people who have diabetes
along with the cost of treating diabetes that gives us these frightening
numbers," said study co-author Dr. Elbert Huang, professor of medicine at
the U. of C. "The study reinforces the importance of public health efforts
to prevent diabetes -- by transforming the way we eat and increasing the
amount of exercise we do -- and emphasizes the importance of finding new
ways of treating diabetes efficiently."

Huang also said the study's findings could be considered conservative
because the researchers' estimates are based on stable obesity rates.

The number of people becoming obese has risen steadily for many years,
though the authors predict that obesity levels among people who don't have
diabetes will top out in the next decade, then decline slightly, from 30
percent today to about 27 percent by 2033.

Costs related to diabetes are rising in part because the disease is
striking people at younger ages, which can mean more time to develop
expensive complications. Diabetes is the leading cause of blindness,
amputations and end-stage kidney disease.





National Health and Nutrition Examination Survey
Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333, USA
800-CDC-INFO
(800-232-4636)
TTY:
(888) 232-6348,
24 Hours/Every Day -
cdc...@cdc.gov
<http://www.cdc.gov/nchs/nhanes.htm>


The National Health and Nutrition Examination Survey (NHANES) is a program
of studies designed to assess the health and nutritional status of adults
and children in the United States. The survey is unique in that it
combines interviews and physical examinations.


National Health and Nutrition Examination Survey
Health Professionals
<http://www.cdc.gov/nchs/nhanes/hlthprofess.htm>



Participant Involvement and Benefits

The National Health and Nutrition Examination Survey is a population-based
survey designed to collect information on the health and nutrition of the
U.S. household population. You may have come across data gathered through
NHANES during your professional education. NHANES data have been used to
influence policy and improve the health of the U.S. population in many
ways including: getting lead removed from gasoline; creating and updating
the pediatric growth charts; and establishing national baseline estimates
for cholesterol, blood pressure, and Hepatitis C in the U.S.

There are two parts to this survey: the home interview and the health
examination. We obtain written informed consent from each participant for
both the in-home interview and the health exam. During the in-home
interview participants are asked questions about health status, disease
history, and diet. The health examination is performed in a mobile exam
center (MEC). The MEC is made up of four trailers, linked sideways,
containing high-tech medical equipment. During the health examination many
tests are performed; however, no internal exams or invasive procedures are
done. Some of these tests (e.g. digital images of the retina) are not
normally performed at a physicians office and could give the participant
and his/her doctor additional information on his/her health. The
examinations a participant will have depend on that participants age and
gender.

For a list of examinations, click here. Participants are informed that
the NHANES health exam is not a substitute for their regular health care
visits.

All participants receive a written Report Of Findings approximately 12
weeks after the exam. If the survey program detects an abnormal value, the
participant is notified immediately by letter.

For additional information on participant involvement and benefits please
refer to the Participant Page.

Notification and Referral for Selected Infectious Diseases

The NHANES is conducted by the National Center for Health Statistics,
which is part of the Centers for Disease Control and Prevention (CDC). The
objective of the survey is to assess the health and nutritional status of
adults and children in the United States. We gather and protect all
information in keeping with the requirements of Federal Law. The Public
Health Service Act (42 USC 242k) authorizes data collection. Section
308(d) of that law (42 USC 242 m) and the Privacy Act of 1974 (5 USC 552A)
prohibit us from giving out information that identifies individuals in the
survey without their consent.

Because the survey is for health research purposes only, our methods
encompass procedures for measuring health status in the general
population. These methods are not always similar to those used in clinical
settings. Additionally, our survey physicians do not complete a history or
physical exam on individual participants and therefore do not diagnose
medical conditions. If a health problem is suspected based on findings
from the survey protocol, participants are informed and referred to their
local health care provider or health department clinic for evaluation and
management. The legal obligation to report notifiable diseases to
authorities will be fulfilled by the local provider or health department
clinic if the participants clinical or laboratory assessment by the
provider meets the case definition for infectious conditions under public
health surveillance in their state.

The following is the survey protocol for notification and referral:

Participants are given STD/HIV test results by a health educator certified
in HIV counseling by phone one month after their examination. Adults who
do not call in receive up to 3 reminder letters. Teenagers are reminded
by telephone. Participant identity is confirmed by a password. A
participant with a positive test result based on the lab assays described
below, is counseled and referred to his/her local doctor or health
department STD clinic for repeat testing and evaluation. Upon request, a
results letter is mailed to the participant: In addition to test results,
laboratory assays used are reported in the letter as follows:

Explanation of the laboratory assays:

Chlamydia and gonorrhea

Urine is tested using a ligase chain reaction (LCR) test (Abbott) designed
to detect the presence of DNA of chlamydia and/or gonorrhea.

Herpes Type 2

Blood is tested by type-specific immunodot assay developed and performed
by scientists at the Emory University School of Medicine to detect
andt-HSV-2 antibodies.

HIV

Blood is tested using an enzyme-linked immunoassay (ELISA) to detect
antibody to HIV with a western blot confirmation of positive ELISA tests.

Human Papillomavirus

High-risk types
A vaginal swab is tested using the Digene HybridCapture II test to detect
the presence of HPV types: 16/18/31/35/39/45/51/52/56/58/59/68.

Low-risk types

A vaginal swab is tested using the Digene HybridCapture II test to detect
the presence of HPV types: 6/11/42/43/44.



Survey Results and Products from the National Health and Nutrition
Examination Survey
<http://www.cdc.gov/nchs/nhanes/nhanes_products.htm>


Overview of Data Accomplishments from NHANES
<http://www.cdc.gov/nchs/nhanes/DataAccomp.htm>

2000 CDC Growth Charts: United States
<http://www.cdc.gov/growthcharts>

MMWR, Short Reports or Health E-Stats
<http://www.cdc.gov/nchs/nhanes/nhanesmmwrsintro.htm>

Data Briefs
<http://www.cdc.gov/nchs/nhanes/Databriefs.htm>

Data Tables
<http://www.cdc.gov/nchs/nhanes/datatblelink.htm>

National Health Statistics Reports (replaces Advance Data)
<http://www.cdc.gov/nchs/products/nhsr.htm>

Series Reports
<http://www.cdc.gov/nchs/nhanes/seriesnhanes.htm>

National Library of Medicine Pub Med
Customized search for articles, journals, etc. based or referencing NHANES
<http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?db=pubmed&orig_db=PubMed&term=NHANES&cmd=search>


A shorter URL for the above link:


<http://tinyurl.com/ycn72lq>



Other Related Links


Healthy Eating Index, USDA Center for Nutrition Policy and Promotion
<http://www.cdc.gov/nchs/nhanes/hei.htm>

What We Eat in America, DHHS-USDA Dietary Survey Integration
<http://www.cdc.gov/nchs/nhanes/wweia.htm>

National Report on Human Exposure to Environmental Chemicals,
National Center for Environmental Health
<http://www.cdc.gov/exposurereport>




Data Accomplishments
<http://www.cdc.gov/nchs/nhanes/DataAccomp.htm>


How has the National Health and Nutrition Examination Survey (NHANES)
improved the health of all Americans?

For the past 40 years, the U.S. Public Health Service has been
interviewing and examining tens of thousands of Americans. Now teams of
doctors, dentists, nutritionists, and health technicians are heading out
to communities across the United States for the National Health and
Nutrition Examination Survey (NHANES), which will be updated annually.

An interviewer may never have knocked on your door before, but you and
everyone living in the United States has benefited from these surveys.
Here are some examples of how we have all benefited from NHANES.


How is my baby growing? How does my child compare with other children the
same age?

Those are important questions that your doctor can answer, using the
growth charts developed by the National Health and Nutrition Examination
Survey. The NHANES growth charts are found on the walls of pediatricians'
offices and clinics not only across the United States, but also around the
world. With new information on younger babies, the current charts have
been expanded and improved.


Who decides what vitamins and minerals belong in our food and diet?

Scientists and nutritionists at the U.S. Department of Agriculture and at
universities make a career of studying the amount of vitamins and minerals
essential for a healthy diet. They rely heavily on the information that
the National Health and Nutrition Examination Survey gathers to help
determine just what Americans are eating. The earlier NHANES showed that
low iron levels were a serious problem for many people, including women of
childbearing age, preschool children, and the elderly. As a result, the
government decided to fortify grain and cereal with iron to correct this
deficiency.

Thats not all. These surveys showed the need for folate to eliminate
another deficiency and prevent birth defects. Today, we have a wealth of
information at our fingertips and, indeed, on our food labels to make
better choices about what to eat. And much of that information comes
directly from the National Health and Nutrition Examination Survey.


What about cholesterol? How do I know if that is too high?

Here again NHANES helps us come up with the answers. This is probably the
surveys biggest success story. The first survey back in the 1960s led
public health officials to sound the alarm about the link between high
cholesterol levels and the risk of heart disease. Today, people routinely
keep an eye on their cholesterol. When NHANES started testing, one-third
of adults had high cholesterol. Today fewer than 1 in 5 adults has high
cholesterol. Changes in diet and lifestyle all built on information from
the national survey have sharply reduced our risk of dying from a heart
attack. These strategies have also helped doctors find ways to better
treat heart attack patients and speed their recovery.


What did this survey have to do with lead-free gasoline?

It was NHANES that gave us the first clear-cut evidence that Americans had
too much lead in their blood. This led congress, the Environmental
Protection Agency, and others to phase out the use of lead as an additive
in gasoline, and the results have been remarkable. By the 1990s, NHANES
found that only 4% of Americans had too much lead in their blood. But it
remains a problem for certain groups, especially poor children living in
old houses in cities where lead paint was once common. The survey helps
our public health agencies pinpoint where lead remains a problem.


What else do we get from these surveys?

The National Health and Nutrition Examination Survey has helped write some
of the most exciting chapters in the history of improving public health,
but this story is far from finished. New chapters are still being written,
thanks to the thousands of Americans who open their doors when the
National Center for Health Statistics interviewers come calling. Here are
some ways that this information will be put to use:

Osteoporosis. This condition, in which bones get weaker as people grow
old, is blamed for many of the fractures among the elderly. The National
Health and Nutrition Examination Survey measures the density of
participants bones.

Environmental smoke. The last NHANES found that nearly 9 out of 10
nonsmoking Americans were exposed to smoke either at home or on the job.

Obesity. Despite the public health gains in recent years, more Americans
are overweight than ever before. Today, more than half of the adults in
the U.S. are overweight, and the number of overweight children and teens
has doubled in the past decade. This has led public health experts to look
for ways to improve both diet and fitness.

Changes in Food/Diet. Today consumers can find a wide range of low fat and
light foods in their grocery stores, from dinner entrees to snacks. As the
food we eat changes, NHANES helps monitor whether these new foods and
dietary changes actually are in the best interest of our health.

Immunizations. The National Health and Nutrition Examination Survey has
turned up important information about the extent of hepatitis B
infections, and led to the recommendation that all infants and children be
vaccinated against it. While we think of babies and children as the
primary target for immunizations, the survey also has alerted doctors to
the importance of tetanus shots for older people.




Healthy Eating Index
<http://www.cdc.gov/nchs/nhanes/hei.htm>


The Healthy Eating Index (HEI) is a measure of diet quality that assesses
conformance to federal dietary guidance. USDA calculated Healthy Eating
Index component and overall scores from dietary recall interviews
collected during the National Health and Nutrition Examination Survey
(NHANES).

The overall HEI score is the sum of 10 dietary components, weighted
equally. Each component of the index has a maximum score of 10 and a
minimum score of zero. The maximum overall HEI score is 100. High
component scores indicate intakes close to the recommended ranges or
amounts; low component scores indicate less compliance with the
recommended ranges or amounts.

Healthy Eating Index

By clicking the link above, you are exiting the National Health and
Nutrition Examination Survey (NHANES) website. The Center for Nutrition
Policy and Promotion (CNPP) at USDA, is responsible for the data and
documentation on its website. The content on the website is subject to
change at any time without notice. Reasonable measures have been taken to
ensure the accuracy of the information on the website. However, the
accuracy of the information on the site is not guaranteed and data users
should always check the programs and resulting data output carefully.
Questions or problems pertaining to the CNPP data and documentation or
website should be directed to CNPP, not NCHS.



Notes

2007-2008 Data Documentation
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/datadoc_changes_0708.htm>

2007-2008 Sampling Methodology
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/sampling_0708.htm>




What's New


New


Depression Screener (DPQ_E 2007-2008)
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/quex07_08.htm>

Osteoporosis (OSQ_E 2007-2008)
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/quex07_08.htm>

Sleep Disorders (SLQ_E 2007-2008)
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/quex07_08.htm>

Surplus Sera- Unmetabolized Folic Acid (SSFOL_B 2001-2002)
<http://www.cdc.gov/nchs/nhanes/nhanes2001-2002/lab01_02.htm>

Surplus Sera- Unmetabolized Folic Acid (SSFOL_A 1999-2000)
<http://www.cdc.gov/nchs/nhanes/lab99_00.htm>

Documentation for Datasets Available through the Research Data Center
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/non_public_07-08.htm>

Depression Screener - Youth (DPQYTH_E 2007-2008)
<http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/non_public_07-08.htm>



About the National Health and Nutrition Examination Survey
<http://www.cdc.gov/nchs/nhanes/about_nhanes.htm>


Introduction to NHANES - PDF Version (1.9 MB)
<http://www.cdc.gov/nchs/nhanes/about_nhanes.htm>


The National Health and Nutrition Examination Survey (NHANES) is a program
of studies designed to assess the health and nutritional status of adults
and children in the United States. The survey is unique in that it
combines interviews and physical examinations. NHANES is a major program
of the National Center for Health Statistics (NCHS). NCHS is part of the
Centers for Disease Control and Prevention (CDC) and has the
responsibility for producing vital and health statistics for the Nation.

The NHANES program began in the early 1960s and has been conducted as a
series of surveys focusing on different population groups or health
topics. In 1999, the survey became a continuous program that has a
changing focus on a variety of health and nutrition measurements to meet
emerging needs. The survey examines a nationally representative sample of
about 5,000 persons each year. These persons are located in counties
across the country, 15 of which are visited each year.

The NHANES interview includes demographic, socioeconomic, dietary, and
health-related questions. The examination component consists of medical,
dental, and physiological measurements, as well as laboratory tests
administered by highly trained medical personnel.

Findings from this survey will be used to determine the prevalence of
major diseases and risk factors for diseases. Information will be used to
assess nutritional status and its association with health promotion and
disease prevention. NHANES findings are also the basis for national
standards for such measurements as height, weight, and blood pressure.
Data from this survey will be used in epidemiological studies and health
sciences research, which help develop sound public health policy, direct
and design health programs and services, and expand the health knowledge
for the Nation.



Survey Content


Survey Contents 1999-2010 - PDF Version (1.4 MB)
<http://www.cdc.gov/nchs/data/nhanes/survey_content_99_10.pdf>


As in past health examination surveys, data will be collected on the
prevalence of chronic conditions in the population. Estimates for
previously undiagnosed conditions, as well as those known to and reported
by respondents, are produced through the survey. Such information is a
particular strength of the NHANES program.

Risk factors, those aspects of a persons lifestyle, constitution,
heredity, or environment that may increase the chances of developing a
certain disease or condition, will be examined. Smoking, alcohol
consumption, sexual practices, drug use, physical fitness and activity,
weight, and dietary intake will be studied. Data on certain aspects of
reproductive health, such as use of oral contraceptives and breastfeeding
practices, will also be collected.

The diseases, medical conditions, and health indicators to be studied
include:

Anemia
Cardiovascular disease
Diabetes
Environmental exposures
Eye diseases
Hearing loss
Infectious diseases
Kidney disease
Nutrition
Obesity
Oral health
Osteoporosis
Physical fitness and physical functioning
Reproductive history and sexual behavior
Respiratory disease (asthma, chronic bronchitis, emphysema)
Sexually transmitted diseases
Vision



The sample for the survey is selected to represent the U.S. population of
all ages. To produce reliable statistics, NHANES over-samples persons 60
and older, African Americans, and Hispanics.


Since the United States has experienced dramatic growth in the number of
older people during this century, the aging population has major
implications for health care needs, public policy, and research
priorities. NCHS is working with public health agencies to increase the
knowledge of the health status of older Americans. NHANES has a primary
role in this endeavor.


All participants visit the physician. Dietary interviews and body
measurements are included for everyone. All but the very young have a
blood sample taken and will have a dental screening. Depending upon the
age of the participant, the rest of the examination includes tests and
procedures to assess the various aspects of health listed above. In
general, the older the individual, the more extensive the examination.



Survey Operations


Survey Operations Schedule - PDF Version (45 KB)
MEC Tour (1999-2006) [WMV, 5.7 MB]
<http://www.cdc.gov/nchs/pressroom/images/NHANES_TOUR.wmv>
<http://www.cdc.gov/nchs/data/nhanes/nhanes_release_schedule.pdf>



Health interviews are conducted in respondents homes. Health measurements
are performed in specially-designed and equipped mobile centers, which
travel to locations throughout the country. The study team consists of a
physician, medical and health technicians, as well as dietary and health
interviewers. Many of the study staff are bilingual (English/Spanish).


An advanced computer system using high-end servers, desktop PCs, and
wide-area networking collect and process all of the NHANES data, nearly
eliminating the need for paper forms and manual coding operations. This
system allows interviewers to use notebook computers with electronic pens.
The staff at the mobile center can automatically transmit data into data
bases through such devices as digital scales and stadiometers.
Touch-sensitive computer screens let respondents enter their own responses
to certain sensitive questions in complete privacy. Survey information is
available to NCHS staff within 24 hours of collection, which enhances the
capability of collecting quality data and increases the speed with which
results are released to the public.


In each location, local health and government officials are notified of
the upcoming survey. Households in the study area receive a letter from
the NCHS Director to introduce the survey. Local media may feature stories
about the survey.


NHANES is designed to facilitate and encourage participation.
Transportation is provided to and from the mobile center if necessary.
Participants receive compensation and a report of medical findings is
given to each participant. All information collected in the survey is kept
strictly confidential. Privacy is protected by public laws.



Uses of the Data


NHANES Data Release and Access Policy - PDF Version (48 KB)
<http://www.cdc.gov/nchs/data/nhanes/nhanes_release_policy.pdf>


Information from NHANES is made available through an extensive series of
publications and articles in scientific and technical journals. For data
users and researchers throughout the world, survey data are available on
the internet and on easy-to-use CD-ROMs.


Research organizations, universities, health care providers, and educators
benefit from survey information. Primary data users are federal agencies
that collaborated in the design and development of the survey. The
National Institutes of Health, the Food and Drug Administration, and CDC
are among the agencies that rely upon NHANES to provide data essential for
the implementation and evaluation of program activities. The U.S.
Department of Agriculture and NCHS cooperate in planning and reporting
dietary and nutrition information from the survey.


NHANES partnership with the U.S. Environmental Protection Agency allows
continued study of the many important environmental influences on our
health.


NHANES record of important accomplishments is made possible by the
thousands of Americans who have participated.

Past surveys have provided data to create the growth charts used
nationally by pediatricians to evaluate childrens growth. The charts have
been adapted and adopted worldwide as a reference standard and have
recently been updated using the latest NHANES figures.


Blood lead data were instrumental in developing policy to eliminate lead
from gasoline and in food and soft drink cans. Recent survey data indicate
the policy has been even more effective than originally envisioned, with a
decline in elevated blood lead levels of more than 70% since the 1970s.
Overweight prevalence figures have led to the proliferation of programs
emphasizing diet and exercise, stimulated additional research, and
provided a means to track trends in obesity.


Data have continued to indicate that undiagnosed diabetes is a significant
problem in the United States. Efforts by government and private agencies
to increase public awareness, especially among minority populations, have
been intensified. These are just a few examples of what survey findings
have meant. The current program promises continuing contributions and some
new initiatives.


Information collected in this survey will help the Food and Drug
Administration decide if there is a need to change vitamin and mineral
fortification regulations for the Nations food supply.


National programs to reduce hypertension and cholesterol levels continue
to depend on NHANES data to steer education and prevention programs toward
those at risk and to measure success in curtailing risk factors associated
with heart disease, the Nations number one cause of death.
New measures of lung function will further our understanding of
respiratory disease and better describe the burden of asthma in the United
States.


Because NHANES is now an ongoing program, the information collected
contributes to annual estimates in topic areas included in the survey. For
small population groups and less prevalent conditions and diseases, data
must be accumulated over several years to provide adequate estimates. The
new continuous design also allows increased flexibility in survey content.


Results of NHANES benefit people in the United States in important ways.
Facts about the distribution of health problems and risk factors in the
population give researchers important clues to the causes of disease.
Information collected from the current survey is compared with information
collected in previous surveys. This allows health planners to detect the
extent various health problems and risk factors have changed in the U.S.
population over time. By identifying the health care needs of the
population, government agencies and private sector organizations can
establish policies and plan research, education, and health promotion
programs that help improve present health status and will prevent future
health problems.



Related Links


Introduction to NHANES [PDF - 1.9 MB]
<http://www.cdc.gov/nchs/data/nhanes/
nhanes_07_08/overviewbrochure_0708.pdf>


A shorter URL for the above link:


<http://tinyurl.com/yjwnwwh>


MEC Tour (1999-2006) [WMV - 5.7 MB]
<http://www.cdc.gov/nchs/pressroom/images/NHANES_TOUR.wmv>

Institutional Review Board Approval
<http://www.cdc.gov/nchs/nhanes/irba98.htm>

Survey Contents 1999-2008 [PDF - 11 MB]
<http://www.cdc.gov/nchs/data/nhanes/survey_content_99_10.pdf>

Survey Operations Schedule [PDF - 45 KB]
<http://www.cdc.gov/nchs/data/nhanes/nhanes_release_schedule.pdf>

NHANES Forum
<http://www.cdc.gov/nchs/nhanes/dhanes_forum.htm>

NHANES Data Release and Access Policy [PDF - 48 KB]
<http://www.cdc.gov/nchs/data/nhanes/nhanes_release_policy.pdf>



Questionnaires, Datasets, and Related Documentation
<http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm>


NHANES Analytic Guidelines

NHANES Web Tutorial

Suggested NHANES Citation for use in Publications

Cross-Year Variable Tables (beta)

NHANES 2009-2010 (New)

NHANES 2007-2008

NHANES 2005-2006

NHANES 2003-2004

NHANES 2001-2002

NHANES 1999-2000

NHANES III, NHANES II, NHANES I

Hispanic HANES

NHES III, NHES II, NHES I

NHANES I Epidemiologic Followup Study

NHANES Linked Mortality files

NHANES Genetic Data

NHANES Medicare Utilization and Expenditure Linked Files

NHANES Linked Social Security Administration Files

NHANES Data Release and Access Policy [PDF - 48 KB]

Stored Biologic Specimens



National Health and Nutrition Examination Survey

Basic Tutorial

<http://www.cdc.gov/nchs/tutorials/>

Continuous NHANES tutorial

Everything you want and need to know about analyzing continuous NHANES
data is now available in a web-based product. The Continuous NHANES
Tutorial is designed to help users navigate through the dataset. Users
can browse through different modules to gain insight into NHANES data.



Supplemental Tutorials



NHANES III Tutorial

This tutorial will orient you to NHANES III data, guide you through
preparing an analytic dataset, and explain the nuances of the survey
design. Users already familiar with Continuous NHANES data and interested
in using NHANES III data should use this tutorial. New users of NHANES
data should complete the Continuous NHANES tutorial before beginning this
tutorial.


NHANES II Tutorial

This tutorial will orient you to NHANES II data, guide you through
preparing an analytic dataset, and explain the nuances of the survey
design. Users already familiar with Continuous NHANES data and interested
in using NHANES II data should use this tutorial. New users of NHANES data
should complete the Continuous NHANES tutorial before beginning this
tutorial.


NHANES I Tutorial

This tutorial will orient you to NHANES I data, guide you through
preparing an analytic dataset, and explain the nuances of the survey
design. Users already familiar with Continuous NHANES data and interested
in using NHANES I data should use this tutorial. New users of NHANES data
should complete the Continuous NHANES tutorial before beginning this
tutorial.



Special Topics


NHANES Dietary Tutorial

This tutorial walks you through the steps of conducting an analytical
project from beginning to end, with examples of many common analytic
procedures. Relevant dietary data information and nuances, tips, and
explanations for SAS or SUDAAN programs; downloadable sample program code;
and analytical guidance are organized and integrated into different
modules and tasks to facilitate this learning process.





Proposal Guidelines
<http://www.cdc.gov/nchs/nhanes/proposal_guidelines.htm>

Deadlines for Proposals for 2011-12 Content

PDF Version (20 KB)

Guidelines for NHANES Stored Biological Specimens Proposal

National Health and Nutrition Examination Survey (NHANES) DNA Specimens:

Guidelines for Proposals To Use Samples and Cost Schedule
(Updated October, 2007)

PDF Version (250 KB)



The NHANES Listserv

The National Health and Nutrition Examination Survey (NHANES) list
provides a mechanism for dissemination of information regarding NHANES
activities, products, and release dates.

How to Subscribe to the NHANES List
Subscribe using one of the following two options:


<http://www.cdc.gov/nchs/nhanes/nhanes_listserv.htm>




What We Eat in America, NHANES (Home)
United States Department of Agriculture
<http://www.ars.usda.gov/Services/docs.htm?docid=9098>


What We Eat In America, NHANES ...

Overview

Integrated Federal Food Survey

Data Collection

Information Collected During Interview

Data Processing

Data Release

Dietary Intake

Data Files

Fast Facts, Reports/Articles, and Tables
2003-2004
2001-2002

Dietary Data and Documentation
WWEIA, NHANES: 2003-2004
WWEIA, NHANES: 2001-2002

WWEIA Frequently Asked Questions
Related Links
Suggested Citation




America's Children: Key National Indicators of Well-Being, 2009
Child Stats.gov
<http://www.childstats.gov/AMERICASCHILDREN/surveys.asp>



NHANES : National Health and Nutrition Examination Survey
Intute
<http://www.intute.ac.uk/cgi-bin/fullrecord.pl?handle=20090502-12232972>

Keywords - controlled: Health Surveys; Research Interviews; Interviews;
Nutritional Status; Nutrition Surveys; Nutrition Assessment; Nutrition



NHANES Data -- National Health and Nutrition Examination Survey Data
"The National Health and Nutrition Examination Survey (NHANES) is a
program of studies designed to assess the health and nutritional status of
adults and children in the United States. The survey is unique in that it
combines interviews and physical examinations. NHANES is a major program
of the National Center for Health Statistics (NCHS)."
National Bureau of Economic Research
<http://www.nber.org/data/
national-health-and-nutrition-examination-survey.html>


A shorter URL for the above link:


<http://tinyurl.com/y9jdlsy>


SODA POP

National Health and Nutrition Examination Survey (NHANES)
Views Description Search Functions

<http://sodapop.pop.psu.edu/data-collections/nhanes>

STIPULATIONS FOR USE:

Open Access to SodaPop. No data collected by NCHS is to be used for any
purpose other than statistical analysis and reporting. NCHS further
requires that analysts not use the data to learn the identity of any
persons or establishments and the director of NCHS is to be notified if
any identities are inadvertently discovered.

This page is the gateway to all waves of NHANES data. The Search
Functions tab on this page enables variable searching across all waves of
the NHANES.

Use the NHANES Gateway portlet on the upper right-hand side of the page to
navigate between waves. The Download tab within each wave will direct you
to the various topical sections within the wave, such as Examinations,
Laboratory results and Questionnaires. The Search Functions tab within a
wave limits your searches to that wave.



High Body Mass Index for Age Among US Children and Adolescents, 2003-2006
Cynthia L. Ogden, PhD; Margaret D. Carroll, MSPH; Katherine M. Flegal, PhD
JAMA. 2008;299(20):2401-2405.
<http://jama.ama-assn.org/cgi/content/short/299/20/2401>


The National Health and Nutrition Examination Surveys (NHANES), conducted
by the National Center for Health Statistics, Centers for Disease Control
(NCHS/CDC), are designed to assess the health and nutritional status of
adults and children in the United States through interviews and direct
physical examinations. Here are materials related to the second and third
National Health and Nutrition Examination Surveys (NHANES II and III),
carried out during the years 1976-1980 and 1988-1994, respectively.
National Library of Medicine

<http://archive.nlm.nih.gov/proj/dxpnet/nhanes/nhanes.php>


Digitization of the NHANES Radiographs

The NHANES radiographs have been scanned by Dr. Bernie Huang at the
University of California at Los Angeles and the University of California
at San Francisco. Dr. Huang's group used a Lumysis 100 with a 175 micron
spot to scan the first 6000 radiographs. The remaining radiographs will be
scanned on the Lumysis 150 again with a 175 micron spot size.

The radiographs are transferred from the Lumysis scanner internal disk to
a SUN Sparc Classic LX via FTP. Once on the SUN, the quality control
technician checks each image to insure that it passes stage-1 of the
National Center for Health Statistics three-tiered quality control
process. After the images have passed quality control, they are
transferred to an erasable optical platter storage and transport to NCHS.
NCHS then conducts stage-2 and stage-3 quality control on the images. Any
image failing stage 1 is redigitized; any image failing stage 2 or 3 is
tagged as failing quality control.


Documents and Repositories

NHANES II and III documents
Digitized NHANES II x-ray films


Related Projects

WebMIRS: Providing Internet access to NHANES II and III data and images
Digital Spine Atlas



Selected Sample of Publications Regarding NHANES


Metabolic Syndrome Rates in United States Adolescents, from the
National Health and Nutrition Examination Survey, 19992002
COOK, S
Journal: The Journal of pediatrics
ISSN: 0022-3476 Date: 2008
Volume: 152 Issue: 2 Page: 165



Serum 25-Hydroxyvitamin D Levels and the Prevalence of Peripheral
Arterial Disease: Results from NHANES 2001 to 2004
Melamed, M. L.
Journal: Arteriosclerosis, thrombosis, and vascular biology
ISSN: 1079-5642 Date: 2008
Volume: 28 Issue: 6 Page: 1179



Laboratory-based versus non-laboratory-based method for assessment
of cardiovascular disease risk: the NHANES I Follow-up Study cohort
Gaziano, Thomas A
Journal: The Lancet (British edition)
ISSN: 0140-6736 Date: 2008
Volume: 371 Issue: 9616 Page: 923



The Obese Without Cardiometabolic Risk Factor Clustering and the
Normal Weight With Cardiometabolic Risk Factor Clustering: Prevalence and
Correlates of 2 Phenotypes Among the US Population (NHANES 1999-2004)
Wildman, R. P.
Journal: Archives of internal medicine (1960)
ISSN: 0003-9926 Date: 2008
Volume: 168 Issue: 15 Page: 1617



Education, income and ethnic differences in cumulative biological
risk profiles in a national sample of US adults: NHANES III (19881994)
Seeman, Teresa
Journal: Social science & medicine (1982)
ISSN: 0277-9536 Date: 2008
Volume: 66 Issue: 1 Page: 72



Prevalence, Treatment, and Control of Diagnosed Diabetes in the
U.S. National Health and Nutrition Examination Survey 19992004
ONG, K
Journal: Annals of epidemiology
ISSN: 1047-2797 Date: 2008
Volume: 18 Issue: 3 Page: 222



Serum Cystatin C in the United States: The Third National Health
and Nutrition Examination Survey (NHANES III)
KOTTGEN, A
Journal: American journal of kidney diseases
ISSN: 0272-6386 Date: 2008
Volume: 51 Issue: 3 Page: 385



Association Between Serum 25-Hydroxyvitamin D Level and Upper
Respiratory Tract Infection in the Third National Health and Nutrition
Examination Survey
Ginde, A. A.
Journal: Archives of internal medicine (1960)
ISSN: 0003-9926 Date: 2009
Volume: 169 Issue: 4 Page: 384



Deteriorating Dietary Habits Among Adults With Hypertension: DASH
Dietary Accordance, NHANES 1988-1994 and 1999-2004
Mellen, P. B.
Journal: Archives of internal medicine (1960)
ISSN: 0003-9926 Date: 2008
Volume: 168 Issue: 3 Page: 308



NHANES IV, 19992004
Author: NHANES IV, 19992004
Flores, YN
Journal: The American journal of gastroenterology
ISSN: 0002-9270 Date: 2008
Volume: 103 Page: 2231



Hypertension and CKD: Kidney Early Evaluation Program (KEEP) and
National Health and Nutrition Examination Survey (NHANES), 1999-2004 Rao,
Madhav V.
Journal: American journal of kidney diseases
ISSN: 0272-6386 Date: 2008
Volume: 51 Issue: 4 Page: S30



Prevalence of Tuberculosis Infection in the United States
Population: The National Health and Nutrition Examination Survey,
1999-2000
Bennett, D. E.
Journal: American journal of respiratory and critical care medicine
ISSN: 1073-449X Date: 2007
Volume: 177 Issue: 3 Page: 348



Optimal vitamin D status attenuates the age-associated increase in
systolic blood pressure in white Americans: results from the third
National Health and Nutrition Examination Survey
Judd, SE
Journal: The American journal of clinical nutrition
ISSN: 0002-9165 Date: 2008
Volume: 87 Issue: 1 Page: 136



CKD in the United States: kidney early evaluation program (KEEP)
and National Health and Nutrition Examination Survey (NHANES) 1999-2004
Whaley-Connell, AT
Journal: American journal of kidney diseases
ISSN: 0272-6386 Date: 2008
Volume: 51 Issue: 2 Page: 13



Serum Total Bilirubin Level and Prevalent Lower-Extremity
Peripheral Arterial Disease: National Health and Nutrition Examination
Survey (NHANES) 1999 to 2004
Perlstein, T. S.
Journal: Arteriosclerosis, thrombosis, and vascular biology
ISSN: 1079-5642 Date: 2007
Volume: 28 Issue: 1 Page: 166



Dietary fructose consumption among US children and adults: the
Third National Health and Nutrition Examination Survey
Vos, MB
Journal: Medscape journal of medicine
ISSN: 1934-1997 Date: 2008
Volume: 10 Issue: 7 Page: 160



Implications of a New Definition of Vitamin D Deficiency in a
Multiracial US Adolescent Population: The National Health and Nutrition
Examination Survey III
Saintonge, S.
Journal: Pediatrics (Evanston)
ISSN: 0031-4005 Date: 2009
Volume: 123 Issue: 3 Page: 797



Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid
level: The third national health and nutrition examination survey
Choi, Jee Woong J.
Journal: Arthritis and rheumatism
ISSN: 0004-3591 Date: 2007
Volume: 59 Issue: 1 Page: 109



Frequency of Leisure-Time Physical Activity and Serum
25-Hydroxyvitamin D Levels in the US Population: Results from the Third
National Health and Nutrition Examination Survey
Scragg, R.
Journal: American journal of epidemiology
ISSN: 0002-9262 Date: 2008
Volume: 168 Issue: 6 Page: 577



High Blood Pressure, Hypertension, and High Pulse Pressure Are
Associated with Poorer Cognitive Function in Persons Aged 60 and Older:
The Third National Health and Nutrition Examination Survey.
Obisesan, TO
Journal: Journal of the American Geriatrics Society
ISSN: 0002-8614 Date: 2008
Volume: 56 Issue: 3 Page: 501



High Blood Pressure and Cardiovascular Disease Mortality Risk
Among U.S. Adults: The Third National Health and Nutrition Examination
Survey Mortality Follow-up Study
GU, Q
Journal: Annals of epidemiology
ISSN: 1047-2797 Date: 2008
Volume: 18 Issue: 4 Page: 302



Prevalence of Hypovitaminosis D in Cardiovascular Diseases
(from the National Health and Nutrition Examination Survey 2001 to 2004)
KIM, D
Journal: The American journal of cardiology
ISSN: 0002-9149 Date: 2008
Volume: 102 Issue: 11 Page: 1540



The Obese Without Cardiometabolic Risk Factor Clustering and the
Normal Weight With Cardiometabolic Risk Factor Clustering: Prevalence and
Correlates of 2 Phenotypes Among the US Population NHANES
Wildman, RP
Journal: Archives of internal medicine (1960)
ISSN: 0003-9926 Date: 2008
Volume: 168 Issue: 15 Page: 1617



Association of Hypertension, Diabetes, Dyslipidemia, and Metabolic
Syndrome with Obesity: Findings from the National Health and Nutrition
Examination Survey, 1999 to 2004
NGUYEN, N
Journal: Journal of the American College of Surgeons
ISSN: 1072-7515 Date: 2008
Volume: 207 Issue: 6 Page: 928



The prevalence of previously diagnosed and undiagnosed psoriasis
in US adults: Results from NHANES 2003-2004
KURD, S
Journal: Journal of the American Academy of Dermatology
ISSN: 0190-9622 Date: 2009
Volume: 60 Issue: 2 Page: 218



Current protein intake in America: analysis of the National Health
and Nutrition Examination Survey, 2003-2004 Fulgoni III, VL
Journal: The American journal of clinical nutrition
ISSN: 0002-9165 Date: 2008
Volume: 87 Issue: 5 Page: 1554S



Periodontal Disease and Incident Type 2 Diabetes: Results from the
First National Health and Nutrition Examination Survey and its
Epidemiologic Follow-Up Study
Demmer, R. T.
Journal: Diabetes care
ISSN: 0149-5992 Date: 2008
Volume: 31 Issue: 7 Page: 1373



Prevalence and extent of dyslipidemia and recommended lipid levels
in US adults with and without cardiovascular comorbidities: The National
Health and Nutrition Examination Survey 2003-2004
GHANDEHARI, H
Journal: The American heart journal
ISSN: 0002-8703 Date: 2008
Volume: 156 Issue: 1 Page: 112



High Body Mass Index for Age Among US Children and Adolescents,
2003-2006
Ogden, C. L.
Journal: JAMA : the journal of the American Medical Association
ISSN: 0098-7484 Date: 2008
Volume: 299 Issue: 20 Page: 2401



Association of Insulin Resistance and Inflammation With Peripheral
Arterial Disease: The National Health and Nutrition Examination Survey,
1999 to 2004
Pande, R. L.
Journal: Circulation (New York, N.Y.)
ISSN: 0009-7322 Date: 2008
Volume: 118 Issue: 1 Page: 33



Iodine Status of the U.S. Population, National Health and
Nutrition Examination Survey 20032004
Caldwell, Kathleen L.
Journal: Thyroid (New York, N.Y.)
ISSN: 1050-7256 Date: 2008
Volume: 18 Issue: 11 Page: 1207



Serum Calcium and Incident and Fatal Prostate Cancer in the
National Health and Nutrition Examination Survey
Skinner, H. G.
Journal: Cancer epidemiology, biomarkers & prevention
ISSN: 1055-9965 Date: 2008
Volume: 17 Issue: 9 Page: 2302



The change in weight perception of weight status among the
overweight: comparison of NHANES III (1988-1994) and 1999-2004 NHANES
Johnson-Taylor, Wendy L
Journal:
The international journal of behavioral nutrition and physical activity
ISSN: 1479-5868 Date: 2008
Volume: 5 Page: 9



Sodium Intake and Mortality Follow-Up in the Third National Health
and Nutrition Examination Survey (NHANES III)
Cohen, Hillel W.
Journal: Journal of general internal medicine : JGIM
ISSN: 0884-8734 Date: 2008
Volume: 23 Issue: 9 Page: 1297



Serum Total Bilirubin Level, Prevalent Stroke, and Stroke
Outcomes: NHANES 19992004
PERLSTEIN, T
Journal: The American journal of medicine
ISSN: 0002-9343 Date: 2008
Volume: 121 Issue: 9 Page: 781



Gender Differences in Hypertension Treatment, Drug Utilization
Patterns, and Blood Pressure Control Among US Adults With Hypertension:
Data From the National Health and Nutrition Examination Survey 19992004
Gu, Qiuping
Journal: American journal of hypertension
ISSN: 0895-7061 Date: 2008
Volume: 21 Issue: 7 Page: 789



The relative risk of cardiovascular death among racial and ethnic
minorities with metabolic syndrome: data from the NHANES-II mortality
follow-up
Martins, D
Journal: Journal of the National Medical Association
ISSN: 0027-9684 Date: 2008
Volume: 100 Issue: 5 Page: 565



Trends in A1C Concentrations Among U.S. Adults With Diagnosed
Diabetes From 1999 to 2004
Ford, E. S.
Journal: Diabetes care
ISSN: 0149-5992 Date: 2007
Volume: 31 Issue: 1 Page: 102



Socioeconomic disparities in the seroprevalence of cytomegalovirus
infection in the US population: NHANES III
DOWD, J. B.
Journal: Epidemiology and infection
ISSN: 0950-2688 Date: 2009
Volume: 137 Issue: 01 Page: 58



Is Glycemic Control Improving in U.S. Adults?
Hoerger, T. J.
Journal: Diabetes care
ISSN: 0149-5992 Date: 2007
Volume: 31 Issue: 1 Page: 81



CKD and Cardiovascular Disease in Screened High-Risk Volunteer and
General Populations: The Kidney Early Evaluation Program (KEEP) and
National Health and Nutrition Examination Survey (NHANES) 1999-2004
McCullough, Peter A.
Journal: American journal of kidney diseases
ISSN: 0272-6386 Date: 2008
Volume: 51 Issue: 4 Page: S38



Whole grain consumption and body mass index in adult women: an
analysis of NHANES 1999-2000 and the USDA Pyramid Servings Database
Good, CK
Journal: Journal of the American College of Nutrition
ISSN: 0731-5724 Date: 2008
Volume: 27 Issue: 1 Page: 80



Seroepidemiology of human papillomavirus type 11 in the United
States: results from the Third National Health and Nutrition Examination
Survey, 19911994
Hariri, S
Journal: Sexually transmitted diseases
ISSN: 0148-5717 Date: 2008
Volume: 35 Page: 298



From Here to JUPITER: Identifying New Patients for Statin Therapy
Using Data From the 1999-2004 National Health and Nutrition Examination
Survey
Spatz, E. S.
Journal: Circulation Cardiovascular quality and outcomes
ISSN: 1941-7713 Date: 2009
Volume: 2 Issue: 1 Page: 41



Association of Environmental Toxicants and Conduct Disorder in
U.S. Children: NHANES 2001-2004
Braun, Joseph M.
Journal: Environmental health perspectives
ISSN: 0091-6765 Date: 2008
Volume: 116 Issue: 7 Page: 956





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Temple University
(215) 204 - 4584
jw...@temple.edu
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<http://tinyurl.com/p63whl>
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