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Objective. To present a clinical version of the 2000 Centers for Disease Control and Prevention (CDC) growth charts and to compare them with the previous version, the 1977 National Center for Health Statistics (NCHS) growth charts. Methods. The 2000 CDC percentile curves were developed in 2 stages. In the first stage, the empirical percentiles were smoothed by a variety of parametric and nonparametric procedures. To obtain corresponding percentiles and z scores, we approximated the smoothed percentiles using a modified LMS estimation procedure in the second stage. The charts include of a set of curves for infants, birth to 36 months of age, and a set for children and adolescents, 2 to 20 years of age. Results. The charts represent a cross-section of children who live in the United States; breastfed infants are represented on the basis of their distribution in the US population. The 2000 CDC growth charts more closely match the national distribution of birth weights than did the 1977 NCHS growth charts, and the disjunction between weight-for-length and weight-for-stature or length-for-age and stature-for-age found in the 1977 charts has been corrected. Moreover, the 2000 CDC growth charts can be used to obtain both percentiles and z scores. Finally, body mass index-for-age charts are available for children and adolescents 2 to 20 years of age. Conclusion. The 2000 CDC growth charts are recommended for use in the United States. Pediatric clinics should make the transition from the 1977 NCHS to the 2000 CDC charts for routine monitoring of growth in infants, children, and adolescents. Pediatrics 2002;109:45-60; growth charts, stature, length, weight, body mass index, head circumference, NHANES, preschool-age children, disjunction., ABBREVIATIONS. NCHS, National Center for Health Statistics; CDC, Centers for Disease Control and Prevention; WHO, World Health Organization; BMI, body mass index; NHANES, National Health and Nutrition Examination Survey. The [...]

Research indicates that reasonable precision of percentile estimates for the National Center for Health Statistics 1977 Growth Charts is dependent on the pooling of both NCHS survey data and The Third National Health and Nutritional Examination Survey, which was conducted between 1988 and 1991.

Mexican American children ages 1-18 years were examined in order to compare health statistics with those recorded during the Hispanic Health and Nutrition Examination Survey, or NHANES. Research shows that Mexican American children tend to be shorter and heavier after preschool years than those children examined in the NHANES; implication for future health risks due to such factors as weight and stature are also discussed.

Objective To develop new, nationally representative equations to predict stature for racial/ethnic groups of the elderly population in the United States. Design Anthropometric data for stature, knee height, and sitting height for adults aged 60 years or older were collected from a sample of persons in the third National Health and Nutrition Examination Survey (1988-1994), a national probability sample of the US population. Subjects A gender- and racial/ethnic-stratified sample of 4,750 persons from the US population (1,369 non-Hispanic white men, 1,472 non-Hispanic white women, 474 non-Hispanic black men, 481 non-Hispanic black women, 497 Mexican-American men, 457 Mexican-American women) aged 60 years or older participated in this study. Statistical analyses Sampling weights were used to adjust the individual data to account for unequal probabilities of selection, nonresponse, and coverage errors so that all individual data used in these analyses represented national probability estimates. Regression analysis was performed to predict stature in each gender and ethnic group, and the results were cross-validated. Results Stature prediction models using knee height and age and sitting height and age were evaluated for each gender and racial/ethnic group. The equations with knee height and age were selected on the basis of root mean square error and pure errors in cross-validation and on the accuracy and validity of measures of knee height over sitting height. Results of these regressions, including regression coefficients, standard errors of the coefficients, multiple correlation coefficients, root mean square error, and the standard error for the individual for the final equations, are presented. Conclusions New stature prediction equations using knee height and age are presented for non-Hispanic white, non-Hispanic black and Mexican-American elderly persons from current nationally representative data. These equations should be applied when a measure of stature cannot be obtained, for example, for persons with amputations of the leg, or with spinal curvature or who are confined to bed. Predicted stature values are acceptable surrogates in nutritional indexes., The stature of an elderly person is important because of the role it plays in indexes of nutritional and clinical status and in calculation of nutrient needs. If stature cannot [...]

Quitting smoking may be associated with weight gain among individuals and an overall increase in the number of people who are overweight. Researchers analyzed records of 5247 adults who participated in a US health survey consisting of interviews and physical exams conducted between 1988 and 1991. Adjusting for age and other factors, the average weight gain due to quitting smoking was 4.4 kilograms (kg) among men and 5.0 kg among women. Men who quit smoking in the previous 10 years were 2.4 times more likely to become overweight during that time than men who never smoked. Women who quit smoking in the previous 10 years were 2.0 time more likely to become overweight than women who had never smoked. However, the prevalence of overweight among people who quit more than 10 years before the survey was the same as the prevalence among people who never smoked.

A comparison of the National Health and Nutrition Examination Survey (NHANES) from 1988-1991 with the NHANES from 1976-1980 indicates an 8% increase in the number of Americans who are overweight. The NHANES program calculates the body mass index for a cross-section of Americans by dividing an individual's weight in kilograms by their height in meters, squared. The NHANES from 1988-1991 suggests that 33.4% of Americans aged 20 years and older are overweight. A body mass index increase from the NHANES of 1976-1980 was noted in all demographic groups. The average body mass index for all groups aged 20 to 74 increased from 25.3 to 26.3, while the average increase in body weight was 3.6 kilograms. Americans must significantly alter their nutritional intake and exercise levels to achieve more healthy lifestyles., Objective.--To examine trends in overweight prevalence and body mass index of the US adult population. Design.--Nationally representative cross-sectional surveys with an in-person interview and a medical examination, including measurement of height and weight. Setting/participants.-between 6000 and 13 000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 to 1962 (the first National Health Examination Survey [NHES I]), 1971 to 1974 (the first National Health and Nutrition Examination Survey [NHANES I]), 1976 to 1980 (NHANES II), and 1988 to 1991 (NHANES III phase 1). Results.--In the period 1988to 1991,33.4%of US adults 20 years of age or older were estimated to be overweight. Comparisons of the 1988 to 1991 overweight prevalence estimates with data from earlier surveys indicate dramatic increases in all race/sex groups. Overweight prevalence increased 8% between the 1976 to 1980 and 1988 to 1991 surveys. During this period, for adult men and women aged 20 through 74 years, mean body mass index increased from 25.3 to 26.3; mean body weight increased 3.6 kg. Conclusions.--These nationally representative data document a substantial increase in overweight among US adults and support the findings of other investigations that show notable increases in overweight during the past decade. These observations suggest that the Healthy People 2000 objective of reducing the prevalence of overweight US adults to no more than 20% may not be met by the year 2000. Understanding the reasons underlying the increase in the prevalence of overweight in the United States and elucidating the potential consequences in terms of morbidity and mortality present a challenge to our understanding of the etiology, treatment, and prevention of overweight.

Most studies using bioelectric impedance have estimated the volume of total body water, fat-free mass and on occasion extracellular fluid volume using whole-body resistance and reactance. However, the validity of bioelectric impedance has not been established for the elderly except in small samples of limited age ranges. The estimation of whole-body composition from impedance of body segments may be an alternative method that can be applied to many chair- and bedfast elderly patients. Also, measures of bioelectric impedance at lower and higher frequencies than 50 kHz are reported to differentiate the proportions of intra- and extracellular fluid volumes, and this could also provide important information about fluid quantities and balances in the elderly. Distribution statistics for body measurements for persons 65-85 y of age are available from the national health surveys and large clinical studies but reference data for persons greater than or equal to 80 y are sparse. Some reference data may be from groups that are not representative of the elderly because the samples were from cohorts older than elderly persons living today and significant group and racial differences existed among these as children and adults. These differences may have increased interindividual variances among the elderly. Suitable reference data for the present generations of elderly in the United States will be available with the culmination of NHANES III after 1994, but limited reference data for elderly persons up to 90 y of age have been published. The most pressing need is for the development of current reference data for body composition and anthropometry in large representative samples of elderly persons in almost every country of the world.

ABSTRACT Objective To compare self-reported to measured heights and weights of adults examined in the Third National Health and Nutrition Examination Survey (NHANES III), and to determine to what extent [...]

ABSTRACT Objective To present selected anthropometric data derived from adults aged 60 years and older examined in the third National Health and Nutrition Examination Survey (NHANES III). Design NHANES III [...]

Previous research in this laboratory, using relatively lean males, indicated that the skinfold caliper and ultrasound techniques gave similar predictions of body density. The present study compared caliper with ultrasound measurements in predicting body density of 44 white, obese, free-living adult volunteers of both sexes. Subcutaneous-fat thickness was measured at six body sites with a Lange caliper and an ADR 2130 ultrasound scanner. By hydrostatic weighing, mean (±SD) body density was 1.01 g/mL (±0.02) and percentage body fat, 41.7% (±7.8). The best predictors of body density were the thigh and biceps sites with ultrasound (r = 0.820) and the triceps site with the calipers (r = 0.633). Further, ultrasound proved to be superior to the caliper technique in measuring subcutaneous fat of obese persons. [ABSTRACT FROM AUTHOR]

Objectives: This report provides detailed information on how the 2000 Centers for Disease Control and Prevention (CDC) growth charts for the United States were developed, expanding upon the report that accompanied the initial release of the charts in 2000., Methods: The growth charts were developed with data from five national health examination surveys and limited supplemental data. Smoothed percentile curves were developed in two stages. In the first stage, selected empirical percentiles were smoothed with a variety of parametric and nonparametric procedures. In the second stage, parameters were created to obtain the final curves, additional percentiles and z-scores. The revised charts were evaluated using statistical and graphical measures., Results: The 1977 National Center for Health Statistics (NCHS) growth charts were revised for infants (birth to 36 months) and older children (2 to 20 years). New body mass index-for-age (BMI-for-age) charts were created. Use of national data improved the transition from the infant charts to those for older children. The evaluation of the charts found no large or systematic differences between the smoothed percentiles and the empirical data., Conclusion: The 2000 CDC growth charts were developed with improved data and statistical procedures. Health care providers now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States. It is recommended that these charts replace the 1977 NCHS charts when assessing the size and growth patterns of infants, children, and adolescents.