JRSM > Volume 99, Number 5 > Pp. 250-257

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Trends in national and state-level obesity in the USA after correction for self-report bias: analysis of health surveys

Majid Ezzati^1,2 Hilarie Martin² Suzanne Skjold² Stephen Vander Hoorn³   Christopher J L Murray^1,2

¹ Harvard School of Public Health, Boston
² Initiative for Global Health, Harvard University, Cambridge, USA
³ Clinical Trials Research Unit, University of Auckland, New Zealand

View larger version (19K): [in a new window]   Figure 1. Measured (National Health and Nutrition Examination Survey [NAHNES]) and self-reported (NHANES in-person and Behavioral Risk Factor Surveillance System [BRFSS] telephone) BMI by age and sex. Each data point shows the 95% confidence interval (CI) for estimated body mass index as two horizontal lines. When the 95% CI is small, the two horizontal lines appear to overlap. This is particularly the case for BRFSS (shown in red), which has very large sample size. For each survey, a local (non-parametric) regression was used to estimate the age pattern, shown as solid lines.

 

View larger version (25K): [in a new window]   Figure 2. Measured (National Health and Nutrition Examination Survey [NAHNES]) and self-reported (NHANES in-person and Behavioral Risk Factor Surveillance System [BRFSS] telephone) height and weight by age and sex. Each data point shows the 95% confidence (CI) for estimated body mass index as two horizontal lines. When the 95% CI is small, the two horizontal lines appear to overlap. This is particularly the case for BRFSS (shown in red), which has very large sample size. For each survey, a local (non-parametric) regression was used to estimate the age pattern, shown as solid lines.

 

View larger version (15K): [in a new window]   Figure 3. Self-reported height and weight in Behavioral Risk Factor Surveillance System (BRFSS) telephone surveys in relation to measured height and weight from National Health and Nutrition Examination Survey (NAHNES). Each point represents one 5-year age group (i.e. see the points in Figure 2), shown in blue for 1988-1994 and in red for 1999-2002

 

View larger version (15K): [in a new window]   Figure 4. Trends in mean body mass index and obesity in men and women in the USA, based on self-reported Behavioral Risk Factor Surveillance System (BRFSS) height and weight as well as corrected height and weight. All values are age-standardized to the 2000 USA population

 

View larger version (50K): [in a new window]   Figure 5. Prevalence of obesity in USA states in (a) 1990 and (b) 2000, based on self-reported Behavioral Risk Factor Surveillance System (BRFSS) height and weight as well as corrected height and weight. All values are age-standardized to the 2000 USA population.

 

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