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Nutrition and Weight Status Data Details

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Changed Since the Healthy People 2020 Launch
No
Measure
number 
Baseline (Year)
24 (2006)
Target
34
Target-Setting Method
Maintain consistency with national programs, regulations, policies, and laws.
Numerator
Number of states (including D.C.) in which all licensed day care centers are required to follow standard regulations regarding meal and snack standards for pre-school children.  Number of states (including D.C.) in which all licensed day care centers are required to follow standard regulations regarding meal and snack standards for pre-school children.  
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

A state is considered to have food and beverage nutrition standards for children in child care if all licensed day care centers in the state adhere to one of the following regulations for preschool children: (1) meals and snacks follow federal Child and Adult Care Food Program or similar meal requirements, or (2) meals and snacks are consistent with the Dietary Guidelines for Americans.

For most states, licensed daycare includes child care centers, small family child care homes, and large family or group child care homes. Some states do not regulate small family child care homes. Other states do not include large family or group child care homes as a type of day care setting; instead they have one classification of family child care homes.

References

Additional resources about the objective.

  1. Kaphingst KM, Story M. Child care as an untapped setting for obesity prevention: state child car licensing regulations related to nutrition, physical activity, and media use of preschool-aged children in the United States. Prev Chronic Dis 2009; 6(1).
NWS-2 Increase the proportion of schools that offer nutritious foods and beverages outside of school meals

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
School Health Policies and Practices Study (SHPPS); Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (CDC/NCHHSTP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
9.3 (2006)
Target
21.3
Target-Setting Method
Projection/trend analysis
Numerator
Number of public and private elementary, middle, and high schools who do not offer any of the following: (1) soda pop or fruit drinks that are not 100% juice; (2) sports drinks; (3) sweetened iced tea AND who do not sell any of the following from vending machines or schools stores: (1) soda pop or fruit drinks that are not 100% juice; (2) sports drinks.
Denominator
Number of public and private elementary, middle, and high schools.
Questions Used to Obtain the National Baseline Data

From the 2006 School Health Policies and Programs Study:

From the Food Service School Questionnaire

During a typical week, are students at this school offered? (23 items are listed. Items relevant to this indicator are listed below)

Soda pop or fruit drinks that are not 100% juice

  1. Yes
  2. No

Sports drinks such as Gatorade®

  1. Yes
  2. No

Sweetened iced tea

  1. Yes
  2. No

From the School Policy and Environment School Questionnaire

Can students purchase the following from vending machines or school stores?

Soda pop or fruit drinks that are not 100% juice

  1. Yes
  2. No

Sports drinks such as Gatorade®

  1. Yes
  2. No
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Starting with the 2012 survey, the name of the SHPPS survey was changed from the School Health Policies and Programs Study to the School Health Policies and Practices Study.

A school is considered to meet the criteria for this objective if the response to ALL of the questions listed is “yes.”

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
School Health Policies and Practices Study (SHPPS); Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (CDC/NCHHSTP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
6.6 (2006)
Target
18.6
Target-Setting Method
Maintain consistency with national programs, regulations, policies, and laws.
Numerator
Number of school districts who require that schools make fruits or vegetables available to students whenever other food is offered or sold.
Denominator
Number of school districts
Questions Used to Obtain the National Baseline Data

From the 2006 School Health Policies and Programs Study, Food Service District Questionnaire:

Does your district require or recommend that schools make fruits or vegetables available to students whenever other foods is offered or sold, for example at school parties or in school stores?

  1. Require
  2. Recommend
  3. Neither
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Starting with the 2012 survey, the name of the SHPPS survey was changed from the School Health Policies and Programs Study to the School Health Policies and Practices Study.

A school districted is considered to meet the criteria for this objective if the response to the cited question is “required.”

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
State Indicator Report on Fruits and Vegetables; Centers for Disease Control and Prevention (CDC)
Changed Since the Healthy People 2020 Launch
No
Measure
number 
Baseline (Year)
8 (2009)
Target
18
Target-Setting Method
Projection/trend analysis
Numerator
Number of states who enacted state level food retail policies (legislation or executive action).  
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

States are considered to have food retail policies that meet the criteria of this objective if their policies support at least one of the following objectives: (1) the building and/or placement of new food retail outlets (e.g., new supermarkets in underserved areas, loan financing programs for small business development); (2) renovation and equipment upgrades of existing food retail outlets (e.g., purchasing refrigerators for small corner stores to allow for the sale of fresh product); (3) increases in, and promotion of, foods encouraged by the 2005 Dietary Guidelines for Americans stocked or available at food retail outlets (e.g., increase display or shelf space of encouraged foods such as fruits and vegetables, assistance in marketing of these healthier food such as through point of decision information).

References

Additional resources about the objective.

  1. CDC Nutrition, Physical Activity, and Obesity Legislative Database.
    http://apps.nccd.cdc.gov/DNPALeg
  2. CDC State Indicator Report on Fruits and Vegetables, 2009. Available at; http://www.fruitsandveggiesmatter.gov/downloads/StateIndicatorReport2009.pdf
  3. National Conference of State Legislatures Healthy Community Design and Access to Healthy Food Legislation Database. National Resource Center for Health and Safety in Child Care and Early Education
  4. The Food Trust.
    http://www.thefoodtrust.org

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
TBD
Comparable Healthy People 2010 Objective
Not applicable
NWS-5 Increase the proportion of primary care physicians who regularly measure the body mass index of their patients

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Energy Balance Related Care among Primary Care Physicians; Food and Drug Administration and National Institutes of Health, National Cancer Institute, Applied Research Program (FDA and NIH/NCI/APR)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
48.7 (2008)
Target
53.6
Target-Setting Method
10 percent improvement
Numerator
Number of primary care physicians who  measure their adult patient’s body mass index at every well-patient visit, every visit, or annually
Denominator
Number of primary care physicians who treat patients aged 18 and over
Questions Used to Obtain the National Baseline Data

From the 2008 National Survey of Energy Balance Related Care among Primary Care Physicians, Adult Questionnaire:

[NUMERATOR:]

How often do you assess the following:

Body mass index

  1. Every well patient visit
  2. Every visit
  3. Annually
  4. As clinically indicated
  5. Never
  6. Other interval (specified by respondent)
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Primary care physicians include family medicine physicians, general internists, and obstetricians/gynecologists.

Sample weights are used to reflect differential selection probabilities of the three physician specialties, non-response, and undercoverage of the target population.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Energy Balance Related Care among Primary Care Physicians; Food and Drug Administration and National Institutes of Health, National Cancer Institute, Applied Research Program (FDA and NIH/NCI/APR)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
49.7 (2008)
Target
54.7
Target-Setting Method
10 percent improvement
Numerator
Number of primary care physicians who assess the body mass index for age in their patient’s aged 2-17 at every well-patient visit, every visit, or annually
Denominator
Number of primary care physicians who see patients 17 years and younger
Questions Used to Obtain the National Baseline Data

From the 2008 National Survey on Energy Balance Related Care Among Primary Care Physicians, Child Questionnaire:

[NUMERATOR:]

How often do you assess the following in children or adolescents (ages 2-17)?

Body mass index (BMI)-for age growth chart

  1. Every well patient visit
  2. Every visit
  3. Annually
  4. As clinically indicated
  5. Never
  6. Other interval (specified by respondent)
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Primary care physicians include family practice physicians and pediatricians.

Sample weights are used to reflect differential selection probabilities of the two physician specialties, non-response, and undercoverage of the target population.

NWS-6 Increase the proportion of physician office visits that include counseling or education related to nutrition or weight

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Ambulatory Medical Care Survey (NAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
20.8 (2007)
Target
22.9
Target-Setting Method
10 percent improvement
Numerator
Number of visits by ambulatory patients aged 20 years and over to non-Federal physicians in office-based practice with diagnosis of cardiovascular disease (ICD-9-CM codes 391-392.0, 393-398, 401, 402, 404, 410-416, 420-429), diabetes mellitus (ICD-9-CM code 250), or hyperlipidemia (ICD-9-CM codes 272.0-272.4) OR whose physician reports that the patient currently has congestive heart failure, diabetes, hyperlipidemia, hypertension or ischemic heart disease in which diet and nutrition education was ordered or provided
Denominator
Number of visits by ambulatory patients aged 20 years and over to non-Federal physicians in office-based practice with diagnosis of cardiovascular disease, diabetes mellitus, or hyperlipidemia or the physician reports that the patient currently has congestive heart failure, diabetes, hyperlipidemia, hypertension or ischemic heart disease
Questions Used to Obtain the National Baseline Data

From the 2007 National Ambulatory Medical Care Survey patient record:

[NUMERATOR:]

Was any health education ordered or provided at this visit? (A check box is provided for "diet/nutrition.")

[NUMERATOR AND DENOMINATOR:]

(Question 5a) As specifically as possible, list diagnose related to this visit including chronic conditions (For example, depression, obesity, or asthma. Up to three diagnoses may be reported.)

  1. Primary Diagnosis:_______________
  2. Other: _______________
  3. Other: _______________

(Question 5b) Regardless of the diagnosis written in 5a, does the patient now have: (A list of 15 conditions is provided for the physicians to check. Conditions relevant to this question are: has congestive heart failure, diabetes, hyperlipidemia, hypertension or ischemic heart disease.)

Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 20-44, 45-64, 65+
  • Sex: 20-44, 45-64, 65+
  • Race/Ethnicity: 20-44, 45-64, 65+
  • Geographic Location: 20-44, 45-64, 65+
  • Health Insurance Status: 20-44, 45-64
Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 19-17 in that the definition was modified to include patients with a diagnosis of cardiovascular disease, diabetes, or hyperlipidemia not only based on the ICD-9-CM codes, but also those whose physician reported that they have congestive heart failure, diabetes, hyperlipidemia, hypertension or ischemic heart disease using the checkboxes in the patient record.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Ambulatory Medical Care Survey (NAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
28.9 (2007)
Target
31.8
Target-Setting Method
10 percent improvement
Numerator
Number of visits by ambulatory patients aged 20 years and over to non-Federal physicians in office-based practice who are obese with a body mass index (BMI) of 30 or higher, in which health education related to weight reduction, nutrition, or physical activity was ordered or provided
Denominator
Number of visits by ambulatory patients aged 20 years and over to non-Federal physicians in office-based practice who are obese with a BMI of 30 or higher
Questions Used to Obtain the National Baseline Data

From the 2007 National Ambulatory Medical Care Survey patient record:

[NUMERATOR:]

Was any health education ordered or provided at this visit? (A check box is provided for "weight reduction", "diet/nutrition," and "exercise.")

[NUMERATOR AND DENOMINATOR:]

  1. Height:_______________
  2. Weight:_______________
.
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

BMI is calculated by dividing weight in kilograms by the square of height in meters. Obesity is defined as a BMI of 30.0 or greater.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 20-44, 45-64, 65+
  • Sex: 20-44, 45-64, 65+
  • Race/Ethnicity: 20-44, 45-64, 65+
  • Geographic Location: 20-44, 45-64, 65+
  • Health Insurance Status: 20-44, 45-64

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Ambulatory Medical Care Survey (NAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
12.2 (2007)
Target
15.2
Target-Setting Method
Maintain consistency with national programs, regulations, policies, and laws.
Numerator
Number of visits by ambulatory patients of all ages to non-Federal physicians in office-based practice in which diet and nutrition counseling or education was ordered or provided
Denominator
Number of visits by ambulatory patients of all ages to non-Federal physicians in office-based practice
Questions Used to Obtain the National Baseline Data

From the 2007 National Ambulatory Medical Care Survey patient record:

[NUMERATOR:]

Was any health education ordered or provided at this visit? (A check box is provided for "diet/nutrition.")

Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 0-17, 18-44, 45-64, 65-74, 75+
  • Sex: 0-17, 18-44, 45-64, 65-74, 75+
  • Race/Ethnicity: 0-17, 18-44, 45-64, 65-74, 75+
  • Geographic Location: 0-17, 18-44, 45-64, 65-74, 75+
  • Health Insurance Status: 0-17, 18-44, 45-64

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Number of worksites with 50 or more employees in nongovernmental organizations that offer nutrition or weight management classes or counseling at the worksite or through their health plans
Denominator
Number of worksites with 50 or more employees in nongovernmental organizations
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
30.8 (2005-2008)
Target
33.9
Target-Setting Method
10 percent improvement
Numerator
Number of persons aged 20 years and over with a body mass index (BMI) equal to or greater than 18.5 and less than 25.0
Denominator
Number of persons aged 20 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters.

The selection of a BMI cut point to establish the healthy weight range is based on the relationship of overweight or obesity to disease or death. A BMI of less than 25 has been accepted by numerous groups as the upper limit of the healthy weight range, because more disease occurs in most populations at or above this cut point. The lower cut point for the healthy weight range (BMI of 18.5) was selected to be consistent with national and international recommendations.

Pregnant women are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
  • Arthritis Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Diabetes Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Hypertension Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the method for computing the confidence intervals was revised from the standard Wald method to the Wald method on the log scale.

References

Additional resources about the objective.

  1. National Institutes of Health. Clinical guideline on the identification, evaluation and treatment of overweight and obesity in adults - The Evidence Report. NIH. Obesity Research 6 (Suppl. 2):51S-209S, 1998.
  2. U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS). Dietary Guidelines for Americans. 5th ed. USDA Home and Garden Bulletin No. 232, 2000.
  3. World Health Organization (WHO) Expert Committee. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series: 854, 1992. Geneva, Switzerland: World Health Organization, 1995.
NWS-9 Reduce the proportion of adults who are obese Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
33.9 (2005-2008)
Target
30.5
Target-Setting Method
10 percent improvement
Numerator
Number of persons aged 20 years and over with a body mass index (BMI) equal to or greater than 30.0
Denominator
Number of persons aged 20 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Leading Health Indicator
Nutrition, Physical Activity, and Obesity
Methodology Notes

The NHANES obtains measured weights in examination gowns and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters.

In 1997, a Consultation on Obesity convened by the World Health Organization recommended standardizing the classification of overweight and obesity. Obesity was defined as a BMI of 30.0 or greater. Further classification of obesity was made as follows: 30.0-34.9 was defined as Class I obesity, 35.0-39.9 as Class II, and 40.0 or greater as Class III. The Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, convened by NIH in 1998 adopted general concepts of the World Health Organization classification system and it has now been endorsed by more than 50 professional medical societies, consumer groups, and government agencies. For this objective, therefore, a BMI cut point of 30.0 was chosen for adults aged 20 years and older.

Pregnant women are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups for four-year data:

  • Total: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
  • Arthritis Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Diabetes Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Hypertension Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

This Indicator uses Age-Adjustment Groups for two-year data:

  • Total: 20-39, 40-59, 60+
  • Sex: 20-39, 40-59, 60+
  • Race/Ethnicity: 20-39, 40-59, 60+
  • Educational Attainment: 25-39, 40-59, 60+
  • Family Income: 20-39, 40-59, 60+
  • Country of Birth: 20-39, 40-59, 60+
  • Disability Status: 20-39, 40-59, 60+
  • Health Insurance Status: 20-39, 40-59, 60-64
  • Arthritis Status: 20-39, 40-59, 60+
  • Diabetes Status: 20-39, 40-59, 60+
  • Hypertension Status: 20-39, 40-59, 60+
  • Marital Status: 20-39, 40-59, 60+
  • Veteran Status: 20-39, 40-59, 60+
Caveats and Limitations
BMI will be used as a proxy for obesity in adults until a better marker to identify increased health risk associated with increased relative weight is developed.
Trend Issues
Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Different age adjustment groups are used for the two year and four year data. Two-year estimates are generally less stable and reliable than four-year estimates.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the original baseline was revised from 34.0 to 33.9 percent due to a change in the methodology. Obesity was originally coded based on the calculated BMI variable which is rounded in NHANES and had an error in the 2007-08 dataset. To be consistent with NHANES reports, instead of using the calculated BMI variable, BMI is now computed directly from the weight and height variables. The target was proportionately adjusted from 30.6 to 30.5 percent based on the original target setting method.

References

Additional resources about the objective.

  1. National Institutes of Health. Clinical guideline on the identification, evaluation and treatment of overweight and obesity in adults - The Evidence Report. NIH. Obesity Research 6 (Suppl. 2):51S-209S, 1998.
  2. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, Geneva, June 1997. Geneva, Switzerland: WHO, 1998.
NWS-10 Reduce the proportion of children and adolescents who are considered obese

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
10.4 (2005-2008)
Target
9.4
Target-Setting Method
10 percent improvement
Numerator
Number of children aged 2 to 5 years with a body mass index (BMI) at or above the sex-and age-specific 95th percentile from the CDC Growth Charts; United States
Denominator
Number of children aged 2 to 5 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters. Children and adolescents with a BMI at or above the sex-and age-specific 95th percentile based on the 2000 CDC growth charts are considered obese.

Caveats and Limitations
Obesity is generally defined as excess body fat. However, since excess body fat is difficult to measure directly, obesity is often defined as excess body weight adjusted for height as measured by BMI or age and sex specific BMI percentiles for children and adolescents. BMI will be used as a proxy for obesity in children and adolescents until a better measure is developed. Clinical assessment and other markers should be considered when determining a child’s overall health and development. Among children, the marked BMI changes that occur with growth and development make it necessary to specify a high BMI relative to children of the same sex and age.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the original baseline was revised from 10.7 to 10.4 percent due to a change in the methodology. Obesity was originally coded based on the calculated BMI variable which is rounded in NHANES and had an error in the 2007-08 dataset. To be consistent with NHANES reports, instead of using the calculated BMI variable, BMI is now computed directly from the weight and height variables. The method for computing the CI's was revised from the standard Wald method to the Wald method on the log scale. The target was proportionately adjusted from 9.6 to 9.4 percent based on the original target-setting method.

References

Additional resources about the objective.

  1. CDC Growth Charts
    http://www.cdc.gov/growthcharts
  2. Troiano RP and Flegal KM. Overweight children and adolescents: Description, epidemiology, and demographics. Pediatrics 101:497-504, 1998.
  3. U.S. Department of Health and Human Services. The Surgeon General’s Vision for Health and Fit Nation, Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.4

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
17.4 (2005-2008)
Target
15.7
Target-Setting Method
10 percent improvement
Numerator
Number of children aged 6 to 11 years with a body mass index (BMI) at or above the sex-and age-specific 95th percentile from the CDC Growth Charts; United States
Denominator
Number of children aged 6 to 11 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters. Children and adolescents with a BMI at or above the sex-and age-specific 95th percentile based on the 2000 CDC growth charts are considered obese.

Caveats and Limitations
Obesity is generally defined as excess body fat. However, since excess body fat is difficult to measure directly, obesity is often defined as excess body weight adjusted for height as measured by BMI or age and sex specific BMI percentiles for children and adolescents. BMI will be used as a proxy for obesity in children and adolescents until a better measure is developed. Clinical assessment and other markers should be considered when determining a child’s overall health and development. Among children, the marked BMI changes that occur with growth and development make it necessary to specify a high BMI relative to children of the same sex and age.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the method for computing the confidence intervals was revised from the standard Wald method to the Wald method on the log scale.

References

Additional resources about the objective.

  1. CDC Growth Charts
    http://www.cdc.gov/growthcharts
  2. Troiano RP and Flegal KM. Overweight children and adolescents: Description, epidemiology, and demographics. Pediatrics 101:497-504, 1998.
  3. U.S. Department of Health and Human Services. The Surgeon General’s Vision for Health and Fit Nation, Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
17.9 (2005-2008)
Target
16.1
Target-Setting Method
10 percent improvement
Numerator
Number of persons aged 12 to 19 years with a body mass index (BMI) at or above the sex-and age-specific 95th percentile from the CDC Growth Charts; United States
Denominator
Number of persons aged 12 to 19 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters. Children and adolescents with a BMI at or above the sex-and age-specific 95th percentile based on the 2000 CDC growth charts are considered obese.

Caveats and Limitations
Obesity is generally defined as excess body fat. However, since excess body fat is difficult to measure directly, obesity is often defined as excess body weight adjusted for height as measured by BMI or age and sex specific BMI percentiles for children and adolescents. BMI will be used as a proxy for obesity in children and adolescents until a better measure is developed. Clinical assessment and other markers should be considered when determining a child’s overall health and development. Among children, the marked BMI changes that occur with growth and development make it necessary to specify a high BMI relative to children of the same sex and age.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the method for computing the confidence intervals was revised from the standard Wald method to the Wald method on the log scale.

References

Additional resources about the objective.

  1. CDC Growth Charts
    http://www.cdc.gov/growthcharts
  2. Troiano RP and Flegal KM. Overweight children and adolescents: Description, epidemiology, and demographics. Pediatrics 101:497-504, 1998.
  3. U.S. Department of Health and Human Services. The Surgeon General’s Vision for Health and Fit Nation, Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.
NWS-10.4 Reduce the proportion of children and adolescents aged 2 to 19 years who are considered obese Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
16.1 (2005-2008)
Target
14.5
Target-Setting Method
10 percent improvement
Numerator
Number of persons aged 2 to 19 years with a body mass index (BMI) at or above the sex-and age-specific 95th percentile from the CDC Growth Charts; United States
Denominator
Number of persons aged 2 to 19 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Leading Health Indicator
Nutrition, Physical Activity, and Obesity
Methodology Notes

The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters. Children and adolescents with a BMI at or above the sex-and age-specific 95th percentile based on the 2000 CDC growth charts are considered obese.

Caveats and Limitations
Obesity is generally defined as excess body fat. However, since excess body fat is difficult to measure directly, obesity is often defined as excess body weight adjusted for height as measured by BMI or age and sex specific BMI percentiles for children and adolescents. BMI will be used as a proxy for obesity in children and adolescents until a better measure is developed. Clinical assessment and other markers should be considered when determining a child’s overall health and development. Among children, the marked BMI changes that occur with growth and development make it necessary to specify a high BMI relative to children of the same sex and age.
Trend Issues
Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Two-year estimates are generally less stable and reliable than four-year estimates.
Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 19-3c in that the age group tracked for obesity in children was expanded from 6–19 years to 2–19 years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the original baseline was revised from 16.2 to 16.1 percent due to a change in the methodology. Obesity was originally coded based on the calculated BMI variable which is rounded in NHANES and had an error in the 2007-08 dataset. To be consistent with NHANES reports, instead of using the calculated BMI variable, BMI is now computed directly from the weight and height variables. The method for computing the CI's was revised from the standard Wald method to the Wald method on the log scale. The target was proportionately adjusted from 14.6 to 14.5 percent based on the orginal target-setting method.

References

Additional resources about the objective.

  1. CDC Growth Charts
    http://www.cdc.gov/growthcharts
  2. Troiano RP and Flegal KM. Overweight children and adolescents: Description, epidemiology, and demographics. Pediatrics 101:497-504, 1998.
  3. U.S. Department of Health and Human Services. The Surgeon General’s Vision for Health and Fit Nation, Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.
NWS-11 (Developmental) Prevent inappropriate weight gain in youth and adults

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
*** Missing *** 
Numerator
TBD
Denominator
TBD
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
*** Missing *** 
Numerator
TBD
Denominator
TBD
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
*** Missing *** 
Numerator
TBD
Denominator
TBD
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
*** Missing *** 
Numerator
TBD
Denominator
TBD
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
*** Missing *** 
Numerator
TBD
Denominator
TBD
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Current Population Survey (CPS); U.S. Census Bureau and Department of Labor, Bureau of Labor Statistics (Census and DOL/BLS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
1.3 (2008)
Target
0.2
Target-Setting Method
Maintain consistency with national programs, regulations, policies, and laws.
Numerator
Number of U.S. households with very low food security among children over a 12-month period
Denominator
Number of U.S. households with children in December
Questions Used to Obtain the National Baseline Data

From the 2008 Food Security Supplement to the Current Population Survey:

[NUMERATOR:]

(I/we) relied on only a few kinds of low-cost food to feed the children because I/we were running out of money to buy food. Was that often, sometimes, or never true for (you/your household) in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

(I/we) couldn't feed the children a balanced meal because (I/we) couldn't afford that. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

The children were not eating enough because (I/we) just couldn't afford enough food. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

In the last 12 months, did you ever cut the size of any of the children's meals because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, were the children ever hungry but you just couldn't afford more food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, did any of the children ever skip a meal because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

[If yes:]

How often did this happen - almost every month, some months but not every month, or in only 1 or 2 months?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, did any of the children ever not eat for a whole day because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The U.S. Household Food Security Survey Module is a set of 18 questions developed in the early 1990s by an interagency working group led jointly by USDA's Food and Nutrition Service and CDC’s National Center for Health Statistics. Eight of the questions ask about food conditions among children in the household. All of the questions in the module focus explicitly on food inadequacy and insufficiency that result from inadequate household resources. Other sources of food insecurity, such as child abuse or neglect are not identified by the measure.

The Food Security Supplement is administered annually to about 45,000 households as part of the monthly, nationally representative Current Population Survey conducted by the U.S. Census Bureau. About 15,000 of the households include children age 0 to 17. The supplement has been conducted annually since 1995.

The survey responses are used to measure food insecurity in the household. A subset of child-referenced questions measure food insecurity among children in the household at various levels of severity. Both measures represent the most severe food insecurity that has occurred over the 12-month period prior to the survey. Households are classified as having high or marginal food security among children if zero or one of the child-referenced questions are answered affirmatively. Low food security is indicated by affirmative responses to 2, 3 or 4 questions, and very low food security by affirmative responses to 5 or more questions. Answers of "yes," "often," or "sometimes" are considered affirmative. Very low food security among children is a severe range of food insecurity in which children’s eating patterns are disrupted and food intake reduced below levels considered adequate by the adult respondent.

References

Additional resources about the objective.

  1. Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to Measuring Household Food Security. Revised 2000. Alexandria, VA: USDA, Food and Nutrition Service (FNS), 2000.
  2. Hamilton WL, Cook JT, Thompson WW, Buron LF, Frongillo EA, Olson CM, et al. Household Food Security in the United States in 1995: Technical Report of the Food Security measurement Project. Washington DC: Office of Analysis and Evaluation, Food and Consumer Service, USDA, 1997b.
  3. Hamilton WL, Cook JT, Thompson WW, Buron LF, Frongillo EA, Olson CM, et al. Household Food Security the United States in 1995: Summary Report of the Food Security measurement Project. Washington DC: Office of Analysis and Evaluation, Food and Consumer Service, USDA, 1997a.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Current Population Survey (CPS); U.S. Census Bureau and Department of Labor, Bureau of Labor Statistics (Census and DOL/BLS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
14.6 (2008)
Target
6.0
Target-Setting Method
Retention of Healthy People 2010 target
Numerator
Number of U.S. households classified as food insecure (including low food security and very low food security) over a 12-month period
Denominator
Number of U.S. households in December
Questions Used to Obtain the National Baseline Data

From the 2008 Food Security Supplement to the Current Population Survey:

[NUMERATOR:]

(I/we) worried whether (my/our) food would run out before (I/we) got money to buy more. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

The food that (I/we) bought just didn't last, and (I/we) didn't have money to get more. Was that often, sometimes or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

(I/we) couldn't afford to eat balanced meals. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

In the last 12 months, did you or other adults in your household ever cut the size of your meals or skip meals because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

[If yes:]

How often did this happen - almost every month, some months but not every month, or in only 1 or 2 months?

  1. Almost every month
  2. Some months but not every month
  3. In only 1 or 2 months
  4. Don't Know
  5. Refused

In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, were you ever hungry but didn't eat because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, did you lose weight because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, did you or other adults in your household ever not eat for a whole day because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

[If yes:]

How often did this happen - almost every month, some months but not every month, or in only 1 or 2 months?

  1. Almost every month
  2. Some months but not every month
  3. In only 1 or 2 months
  4. Don't Know
  5. Refused

(I/we) relied on only a few kinds of low-cost food to feed the children because (I was/we were) running out of money to buy food. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

(I/we) couldn't feed the children a balanced meal because (I/we) couldn't afford that. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

The children were not eating enough because (I/we) just couldn't afford enough food. Was that often, sometimes, or never true for you in the last 12 months?

  1. Often
  2. Sometimes
  3. Never
  4. Don't Know
  5. Refused

In the last 12 months, did you ever cut the size of any of the children's meals because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, were the children ever hungry but you just couldn't afford more food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

In the last 12 months, did any of the children ever skip a meal because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused

[If yes:]

How often did this happen - almost every month, some month but not every month, or in only 1 or 2 months?

  1. Almost every month
  2. Some months but not every month
  3. In only 1 or 2 months
  4. Don't Know
  5. Refused

In the last 12 months, did any of the children ever not eat for a whole day because there wasn't enough money for food?

  1. Yes
  2. No
  3. Don't Know
  4. Refused
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The U.S. Household Food Security Survey Module is a set of 18 questions developed in the early 1990s by an interagency working group led jointly by USDA's Food and Nutrition Service and CDC's National Center for Health Statistics. Three of the questions ask about food conditions in the household as a whole, seven ask about food conditions among adults in the household or the adult respondent, and eight ask about food conditions among children (if any) in the household. All of the questions in the module focus explicitly on food inadequacy and insufficiency that result from inadequate household resources. Other sources of food insecurity, such as child abuse or neglect are not identified by the measure.

The Food Security Supplement is administered annually to about 45,000 households as part of the monthly, nationally representative Current Population Survey conducted by the U.S. Census Bureau. The supplement has been conducted annually since 1995.

The survey responses are used to identify households that were food insecure at least some time during the year. Households are classified as food secure if none of the questions were answered affirmatively or if only one or two questions were answered affirmatively. If three or more questions are answered affirmatively, the household is classified as food insecure. Answers of "yes," "often," or "sometimes" are considered affirmative.

Changes Between HP2010 and HP2020
This objective is the complement of Healthy People 2010 objective 19-18, which tracked households with food security.

References

Additional resources about the objective.

  1. Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to Measuring Household Food Security. Revised 2000. Alexandria, VA: USDA, Food and Nutrition Service (FNS), 2000.
  2. Hamilton WL, Cook JT, Thompson WW, Buron LF, Frongillo EA, Olson CM, et al. Household Food Security in the United States in 1995: Technical Report of the Food Security measurement Project. Washington DC: Office of Analysis and Evaluation, Food and Consumer Service, USDA, 1997b.
  3. Hamilton WL, Cook JT, Thompson WW, Buron LF, Frongillo EA, Olson CM, et al. Household Food Security the United States in 1995: Summary Report of the Food Security measurement Project. Washington DC: Office of Analysis and Evaluation, Food and Consumer Service, USDA, 1997a.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
cup equivalents per 1,000 calories (age adjusted—see Comments)
Baseline (Year)
0.5 (2001-2004)
Target
0.9
Target-Setting Method
Modeling
Numerator
Daily intake of cup equivalents of total fruit from a first day 24 hour recall among persons aged 2 years and over
Denominator
Caloric intake from a first day 24 hour recall divided by 1000 among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts. Cup equivalents were calculated using the USDA MyPyramid Equivalents Database.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-5 assessed the proportion of the population who met a single daily fruit intake recommendation (i.e., at least two daily servings based on the 2000 Dietary Guidelines for Americans, DGA). Healthy People 2020 objective NWS-14 was modified to take into account the 2010 DGA recommendations for fruit consumption expressed in cup equivalents relative to caloric intake. The objective tracks mean daily intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents Database.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870
NWS-15 Increase the variety and contribution of vegetables to the diets of the population aged 2 years and older
NWS-15.1 Increase the contribution of total vegetables to the diets of the population aged 2 years and older Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
cup equivalents per 1,000 calories (age adjusted—see Comments)
Baseline (Year)
0.8 (2001-2004)
Target
1.1
Target-Setting Method
Modeling
Numerator
Daily intake of cup equivalents of total vegetables from a first day 24 hour recall among persons aged 2 years and over
Denominator
Caloric intake from a first day 24 hour recall divided by 1000 among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Leading Health Indicator
Nutrition, Physical Activity, and Obesity
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts. Cup equivalents were calculated using the USDA MyPyramid Equivalents Database.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-6 assessed the proportion of the population meeting the 2000 Dietary Guidelines for Americans (DGA) regarding the quantity and variety of vegetables consumed as a single measure. However, instead of combining the measures into one objective, Healthy People 2020 separately tracks 1) quantity and 2) variety of vegetable intake through objectives NWS-15.1 and NWS-15.2, respectively. Healthy People 2020 objective NWS-15.1 was also modified to take into account the 2010 DGA recommendations for vegetable consumption expressed in cup equivalents relative to caloric intake. The objective tracks mean daily intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents Database.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
cup equivalents per 1,000 calories (age adjusted—see Comments)
Baseline (Year)
0.1 (2001-2004)
Target
0.3
Target-Setting Method
Modeling
Numerator
Daily intake of cup equivalents of dark green or orange vegetables or legumes from a first day 24 hour recall among persons aged 2 years and over
Denominator
Caloric intake from a first day 24 hour recall divided by 1000 among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts. Cup equivalents were calculated using the USDA MyPyramid Equivalents Database (MPED) for 2001-2004 and the USDA Food Patterns Equivalents Database (FPED) starting with the 2007-2010 data.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-6 assessed the proportion of the population meeting the 2000 DGA regarding the quantity and variety of vegetables consumed as a single measure. However, instead of combining the measures into one objective, Healthy People 2020 separately tracks 1) quantity and 2) variety of vegetable intake through objectives NWS-15.1 and NWS-15.2, respectively. Healthy People 2020 objective NWS-15.2 was also modified to take into account the 2010 DGA recommendations for vegetable consumption expressed in cup equivalents relative to caloric intake. The objective tracks mean daily intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents and Food Patterns Equivalents Databases.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
ounce equivalents per 1,000 calories (age adjusted—see Comments)
Baseline (Year)
0.3 (2001-2004)
Target
0.6
Target-Setting Method
Modeling
Numerator
Daily intake of ounce equivalents of whole grains from a first day 24 hour recall among persons aged 2 years and over
Denominator
Caloric intake from a first day 24 hour recall divided by 1000 among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts. Ounce equivalents were calculated using the USDA MyPyramid Equivalents Database.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-7 assessed the proprotion of the population meeting the 2000 Dietary Guidelines for Americans (DGA) to consume six daily servings of grain products, with at least three being whole grains. Healthy People 2020 objective NWS-16 was modified to focus only on the contribution of whole grains to American diets, and to take into account the 2010 DGA recommendations for consumption of whole grains which are expressed in ounce equivalents relative to caloric intake. The objective tracks mean daily intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents Database.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870
NWS-17 Reduce consumption of calories from solid fats and added sugars in the population aged 2 years and older

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
mean percentage of total daily calorie intake (age adjusted—see Comments)
Baseline (Year)
18.9 (2001-2004)
Target
16.7
Target-Setting Method
Modeling
Numerator
Daily energy intake of solid fats from a first day 24 hour recall among persons aged 2 years and over
Denominator
Total daily energy intake from a first day 24 hour recall among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

The 2001-04 NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts.

Estimates were calculated using the USDA MyPyramid Equivalents Database. Solid fats are defined in the MyPyramid Equivalents Database as all excess fat from milk and meat beyond what would be consumed if only the lowest fat forms were eaten and those added to foods in preparation or at the table, including cream, butter, stick margarine, regular or low-fat cream cheese, lard, meat drippings, cocoa, chocolate, hydrogenated fats, and those derived from palm or coconut oils. This definition includes dietary sources of trans as well as saturated fatty acids.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents Database.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
mean percentage of total daily calorie intake (age adjusted—see Comments)
Baseline (Year)
15.7 (2001-2004)
Target
10.8
Target-Setting Method
Modeling
Numerator
Daily energy intake of added sugars from a first day 24 hour recall among persons aged 2 years and over
Denominator
Total daily energy intake from a first day 24 hour recall among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

The 2001-04 NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts.

Estimates were calculated using the USDA MyPyramid Equivalents Database. Added sugars are defined in the MyPyramid Equivalents Database as sugars used in ingredients in processed and prepared foods, such as breads, cakes, other grain-based desserts, soft drinks, jams, jellies, candies, ice cream, and sugars reported separately by survey participants or added to foods at the table.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents Database.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
mean percentage of total daily calorie intake (age adjusted—see Comments)
Baseline (Year)
34.6 (2001-2004)
Target
29.8
Target-Setting Method
Modeling
Numerator
Daily energy intake of solid fats and added sugars from a first day 24 hour recall among persons aged 2 years and over
Denominator
Total daily energy intake from a first day 24 hour recall among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

The 2001-04 NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts.

Estimates were calculated using the USDA MyPyramid Equivalents Database. Solid fats are defined in the MyPyramid Equivalents Database as all excess fat from milk and meat beyond what would be consumed if only the lowest fat forms were eaten and those added to foods in preparation or at the table, including cream, butter, stick margarine, regular or low-fat cream cheese, lard, meat drippings, cocoa, chocolate, hydrogenated fats, and those derived from palm or coconut oils. This definition includes dietary sources of trans as well as saturated fatty acids. Added sugars are defined in the MyPyramid Equivalents Database as sugars used in ingredients in processed and prepared foods, such as breads, cakes, other grain-based desserts, soft drinks, jams, jellies, candies, ice cream, and sugars reported separately by survey participants or added to foods at the table.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline (2001-2004) data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

References

Additional resources about the objective.

  1. WWEIA, NHANES, and the MyPyramid Equivalents Database.
    http://www.ars.usda.gov/Services/docs.htm?docid=23870

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
mean percentage of total daily calorie intake (age adjusted—see Comments)
Baseline (Year)
11.3 (2003-2006)
Target
9.5
Target-Setting Method
Modeling
Numerator
Daily energy intake from saturated fat from a first day 24 hour recall among persons aged 2 years and over
Denominator
Total daily energy intake from a first day 24 hour recall among persons aged 2 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

What We Eat in America (WWEIA) is the dietary intake interview component of NHANES. WWEIA is conducted as a partnership between the Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). DHHS is responsible for the sample design and data collection, and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the databases used to code and process the data, and data review and processing. USDA also funds the collection and processing of Day 2 dietary intake data, which are used to develop variance estimates and calculate usual nutrient intakes.

NHANES included the collection of 1 day of dietary data for all respondents through in-person 24 hour recalls and collection of a 2nd day 24-hour recall by telephone. For the analyses of mean intakes, only the first 24 hour recall is used. Each respondent was asked to recall the kinds and amounts of foods eaten at home and away from home during the previous day. Amounts of foods reported in household measures were then converted to gram amounts, and saturated fat intake estimated with the use of food composition files.

Breast-fed children are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-8 assessed the proportion of the population who met a specific daily intake recommendation for saturated fat (i.e., less than 10 percent of calories based on the 2000 Dietary Guidelines for Americans, DGA), while Healthy People 2020 objective NWS-18 tracks the population's mean percentage of daily energy intake from saturated fat so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the baseline (2003-2006) and 2007-2010 data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
milligrams (age adjusted—see Comments)
Baseline (Year)
3,640 (2003-2006)
Target
2,300
Target-Setting Method
Modeling
Numerator
Total one day intake of sodium (in mg) among persons aged 2 years and over
Denominator
Number of persons aged 2 years and over
Questions Used to Obtain the National Baseline Data

From the 2003-04 and 2005-06 National Health and Nutrition Examination Survey:

[NUMERATOR:]

Foods and beverages:

The 2003-04 and 2005-06 NHANES included the collection of 1 day of dietary data for all respondents through in-person 24-hour recalls1 and collection of a 2nd-day 24-hour recall by telephone. For these analyses, sodium intake from only the first 24 hour recall will be used. Each respondent was asked to recall the kinds and amounts of foods and beverages consumed at home and away from home during the previous day (midnight to midnight). Amounts of foods and beverages reported in household measures were then converted to gram amounts, and sodium intake from foods and beverages was estimated with the use of food composition files.

Plain Drinking Water:

Plain drinking water intakes were collected directly as part of the dietary intake collection of foods and beverages beginning with the 2005-2006 NHANES. Thus, the dietary intake records from the 2005-2006 NHANES include the sodium provided by drinking water. The 2003-2004 NHANES collected plain drinking water intake through questions about the total amount of water drunk on the previous day (same period as the dietary intake). These amounts of water are provided in the NHANES dataset in gram units separately for tap and bottled water but the sodium from drinking water is not included in the dietary intake files.

Additional questions used to assess total sodium intake include:

Dietary supplement use:

Has (Person) taken any vitamins or minerals in the past month? Please include those that are prescribed by a doctor or dentist and those that are not prescribed.

  1. Yes
  2. No
  3. Refused
  4. Don’t Know

Has (Person) taken or used any medicines for which a doctor's or dentist's prescription is needed, in the past month? This includes any products which cannot be obtained without a doctor's or dentist's prescription. Include those medicines which you may have already mentioned.

  1. Yes
  2. No
  3. Refused
  4. Don’t Know

[If yes:]

May I see the containers for all of the (vitamins and minerals/prescription medicines) (Person) took in the past month?

Enter complete name of vitamin/mineral from label, or probe respondent:

  • Container seen
  • Container not seen
  • Product furnished by respondent
  • Product name not on container
  • Enter manufacturer's or distributor's name and address (city and State)

How often did (Person) take (product) in the past month?

  1. ______ Days (Number from 1 to 30)
  2. Refused
  3. Don’t Know

How much (product) did (Person) take each time (Person) took it?

  1. ______ Number of capsules, tablet/pills; teaspoons; tablespoons; fluid ounces/ounces; drops/droppers; packets/packs/packages; ml.; wafers; other
  2. Refused
  3. Don’t Know

Antacid use:

Antacid use:

Enter complete name of antacid from label or probe respondent:

  1. Antacid seen
  2. Antacid not seen. Product name furnished by respondent.

How often did you take (antacid) in the past month?

  1. ______ Days (Number from 1 to 30)
  2. Refused
  3. Don’t Know

How much (antacid) did you take each time you took it?

  1. ______ Number of capsules, tablet/pills; teaspoons; tablespoons; fluid ounces/ounces; drops/droppers; packets/packs/packages; ml.; wafers; other
  2. Refused
  3. Don’t Know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Estimates include consideration of several sources of sodium intake: foods, dietary supplements, antacids, tap water, and salt use at the table.

Estimation of Sodium Intake from Salt Use at the Table:

Regarding salt use at the table, sea salt, flavored salts such as garlic, onion, and celery salt, and seasoning salts were counted as ordinary salts. Lite salt was labeled as such and has a reduced sodium content of at least 50%. Salt substitutes do not contain sodium. To obtain a daily amount for each person, the amount of sodium depending on salt type was multiplied by the frequency value. (Sodium in type of salt x frequency amount of sodium from table salt added per day. See table below).

Type of salt:

For “ordinary salt,” sodium intake from salt use at the table was estimated based on a 1991 study that estimated mean sodium intake for adults to be about 580 mg. Specifically, 580 mg of sodium (which is about 1500 mg or ¼ teaspoon of salt) for the “very often” code was assigned for persons aged 2 years and older. For “lite” salt which contains at least half the amount of sodium as “ordinary salt”, 290 mg of sodium was assigned. A zero sodium value was assigned for “salt substitute”, “other” or “don’t use”.

Frequency of salt use:

For “rarely”, the sodium value was multiplied by 0.25; for “occasionally,” the sodium value was multiplied by 0.50; for “very often,” the sodium value was multiplied by 1. The frequency question was not asked if response to type of salt was “don’t use” or “don’t know”. For “don’t use” responses, a zero value was assigned; for “don’t know” responses, ordinary salt was assumed and 290 mg of sodium was assigned based on an assumed frequency of “occasionally”.

The following table summarizes the amount of sodium added:

Assignment of Sodium Values

TypeRarelyOccasionallyVery oftenDK*Missing**
Ordinary145290580290--
Lite 73145290145--
Salt Substitute 0000--
Other145290580290--
Don't use00000
Don’t know0000290

* DK= Don’t Know
** Missing= Not Asked

Breast-feeding children aged 2 years and older are excluded from the analysis.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-10 assessed the proportion of the population who met a specific daily intake recommendation for sodium (i.e., less than 2400 mg based on the 2000 Dietary Guidelines for Americans, DGA), while Healthy People 2020 objective NWS-19 tracks the population's mean sodium daily intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the baseline (2003-2006) and 2007-2010 data for this objective were revised due to a change in methodology. The baseline was revised from 3,641 to 3,640 mg, which did not impact the calculated target. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched. In 2014, the 2007-2010 data were removed from public display because they are not comparable with the baseline data due to a methodology change in 2009-10. The NHANES data are no longer adjusted for salt added in cooking/food preparation.

References

Additional resources about the objective.

  1. Mattes RD, Donnelly D. Relative Contributions of Dietary Sodium Sources. J Amer College Nutr. 10 (4):383-393.1991.
  2. U.S. Code of Federal Regulations. 21 CFR § 101.56 (c)(1)(i).

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
milligrams (age adjusted—see Comments)
Baseline (Year)
1,119 (2003-2006)
Target
1,300
Target-Setting Method
Modeling
Numerator
Total one day intake of calcium (in mg) among persons aged 2 years and over
Denominator
Number of persons aged 2 years and over
Questions Used to Obtain the National Baseline Data

From the 2003-04 and 2005-06 National Health and Nutrition Examination Survey:

[NUMERATOR:]

Foods and beverages:

The 2003-04 and 2005-06 NHANES included the collection of 1 day of dietary data for all respondents through in-person 24-hour recalls1 and collection of a 2nd-day 24-hour recall by telephone. For these analyses, calcium intake from only the first 24 hour recall will be used. Each respondent was asked to recall the kinds and amounts of foods and beverages consumed at home and away from home during the previous day (midnight to midnight). Amounts of foods and beverages reported in household measures were then converted to gram amounts, and calcium intake from foods and beverages was estimated with the use of food composition files.

Plain Drinking Water:

Plain drinking water intakes were collected directly as part of the dietary intake collection of foods and beverages beginning with the 2005-2006 NHANES. Thus, the dietary intake records from the 2005-2006 NHANES include the calcium provided by drinking water. The 2003-2004 NHANES collected plain drinking water intake through questions about the total amount of water drunk on the previous day (same period as the dietary intake). These amounts of water are provided in the NHANES dataset in gram units separately for tap and bottled water but the calcium from drinking water is not included in the dietary intake files.

Additional questions used to assess total calcium intake include:

Dietary supplement use:

Has (Person) taken any vitamins or minerals in the past month? Please include those that are prescribed by a doctor or dentist and those that are not prescribed.

  1. Yes
  2. No
  1. Yes
  2. No
  3. Refused
  4. Don’t Know

Has (Person) taken or used any medicines for which a doctor's or dentist's prescription is needed, in the past month? This includes any products which cannot be obtained without a doctor's or dentist's prescription. Include those medicines which you may have already mentioned.

  1. Yes
  2. No
  1. Yes
  2. No
  3. Refused
  4. Don’t Know

[If yes:]

May I see the containers for all of the (vitamins and minerals/prescription medicines) (Person) took in the past month?

Enter complete name of vitamin/mineral from label, or probe respondent:

  • Container seen
  • Container not seen
  • Product furnished by respondent
  • Product name not on container
  • Enter manufacturer's or distributor's name and address (city and State)

How often did (Person) take (product) in the past month?

  1. ______ Days (Number from 1 to 30)
  2. Refused
  3. Don’t Know

How much (product) did (Person) take each time (Person) took it?

  1. ______ Number of capsules, tablet/pills; teaspoons; tablespoons; fluid ounces/ounces; drops/droppers; packets/packs/packages; ml.; wafers; other
  2. Refused
  3. Don’t Know

Antacid use:

Enter complete name of antacid from label or probe respondent:

  1. Antacid seen
  2. Antacid not seen. Product name furnished by respondent.

How often did you take (antacid) in the past month?

  1. ______ Days (Number from 1 to 30)
  2. Refused
  3. Don’t Know

How much (antacid) did you take each time you took it?

  1. ______ Number of capsules, tablet/pills; teaspoons; tablespoons; fluid ounces/ounces; drops/droppers; packets/packs/packages; ml.; wafers; other
  2. Refused
  3. Don’t Know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

To determine total calcium intake, several sources of calcium were considered, including foods, dietary supplements, antacids, and drinking water.

Plain drinking water:

For 2003-2004 only, 0.03mg of sodium per gram of tap water and 0.10mg of calcium per gram of plain bottled water from the USDA’s FNDDS v3 survey nutrient data base was used. The calcium contributions of tap and bottled water were computed by multiplying the amount of each in grams by the respective factors and adding the two resulting products. This calculation was not done for 2005-2006 as the calcium from water is already included with the dietary intake data.

Antacids:

If antacids data were missing, it was assumed that no calcium was provided by antacids, but the individual was kept in the calculation.

Breast-feeding children were excluded from the analysis.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 2-5, 6-11, 12-19, 20-29, 30-39, 40-49, 50-59, 60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 17-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status, Adults: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
Changes Between HP2010 and HP2020
Healthy People 2010 objective 19-11 assessed the proportion of the population with intakes greater than or equal to 100 percent of the AI (based on calcium Adequate Intake (AI) values established by the National Academy of Sciences), while Healthy People 2020 objective NWS-20 tracks the population's mean daily calcium intake so that the objective will not need to be modified with changes in the guidelines.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the baseline (2003-2006) and 2007-2010 data for this objective were revised due to a change in methodology. The data by age group and childhood obesity status are no longer age adjusted. The age adjustment groups were revised from those matching the age specific groups to the one listed above under Age Adjustment for consistency with other objectives using NHANES data. These changes did not affect the baseline value for the overall population so the target remains the same. In addition, the data by obesity status were revised due to an error in reading the initial baseline data into DATA2020 database. The data for children and adults had accidentally been switched. In 2014, the 2007-2010 data were revised due to a programming error. The calcium intake from dietary supplements for the original estimates was accidentally calculated based on the 24-hour recall instead of questions about use in the past month.

NWS-21 Reduce iron deficiency among young children and females of childbearing age

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
15.9 (2005-2008)
Target
14.3
Target-Setting Method
10 percent improvement
Numerator
Number of children aged 1 to 2 years with body iron less than zero.
Denominator
Number of children aged 1 to 2 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Body iron is defined as follows: Body iron (mg/kg) = -[log10 (sTfR X1000/ferritin)-2.8229]/0.1207, where sTfr is serum transferrin receptor in milligrams per liter and ferritin is serum ferritin in micrograms per liter.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 19-12a in that the model used to determine iron deficiency was changed from the ferritin model to the body iron stores model.

References

Additional resources about the objective.

  1. Cook JD, Flowers CH, Skikne BS. The qualitative assessment of body iron. Blood 2003; 101:3359-34.
  2. Skikne BS, Flowers CH, Cook JD. Serum transferrin receptor: a qualitative measure of tissue iron deficiency. Blood 1990; 75:1870-1876.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
5.3 (2005-2008)
Target
4.3
Target-Setting Method
Maintain consistency with national programs, regulations, policies, and laws.
Numerator
Number of children aged 3 to 4 years with body iron less than zero.
Denominator
Number of children aged 3 to 4 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Body iron is defined as follows: Body iron (mg/kg) = -[log10 (sTfR X1000/ferritin)-2.8229]/0.1207, where sTfr is serum transferrin receptor in milligrams per liter and ferritin is serum ferritin in micrograms per liter.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 19-12a in that the model used to determine iron deficiency was changed from the ferritin model to the body iron stores model.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the baseline data for the race/ethnicity group Black or African American only, not Hispanic or Latino was revised due to a programming error in the original estimate from 10.2 percent (SE 2.717) to a new estimate which is now supressed because it is statitistically unreliable.

References

Additional resources about the objective.

  1. Cook JD, Flowers CH, Skikne BS. The qualitative assessment of body iron. Blood 2003; 101:3359-34.
  2. Skikne BS, Flowers CH, Cook JD. Serum transferrin receptor: a qualitative measure of tissue iron deficiency. Blood 1990; 75:1870-1876.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
10.5 (2005-2008)
Target
9.4
Target-Setting Method
10 percent improvement
Numerator
Number of women aged 12 to 49 years with body iron less than zero.
Denominator
Number of women aged 12 to 49 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Body iron is defined as follows: Body iron (mg/kg) = -[log10 (sTfR X1000/ferritin)-2.8229]/0.1207, where sTfr is serum transferrin receptor in milligrams per liter and ferritin is serum ferritin in micrograms per liter.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 19-12a in that the model used to determine iron deficiency was changed from the ferritin model to the body iron stores model.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the baseline was revised from 10.4 to 10.5 percent due to a programming error in the original estimate. The target remained the same.

References

Additional resources about the objective.

  1. Cook JD, Flowers CH, Skikne BS. The qualitative assessment of body iron. Blood 2003; 101:3359-34.
  2. Skikne BS, Flowers CH, Cook JD. Serum transferrin receptor: a qualitative measure of tissue iron deficiency. Blood 1990; 75:1870-1876.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
16.1 (2003-2006)
Target
14.5
Target-Setting Method
10 percent improvement
Numerator
Number of pregnant women with body iron less than zero.
Denominator
Number of pregnant women
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Body iron is defined as follows: Body iron (mg/kg) = -[log10 (sTfR X1000/ferritin)-2.8229]/0.1207, where sTfr is serum transferrin receptor in milligrams per liter and ferritin is serum ferritin in micrograms per liter.

Caveats and Limitations
Iron deficiency status varies by trimester. Future analyses of overall prevalence of iron deficiency will need to standardize to the trimester distribution in 2003-2006 NHANES.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2014, the baseline data for the age group 25-44 was revised from 13.9 to 13.8 percent due to a programming error in the original estimate.

References

Additional resources about the objective.

  1. Cook JD, Flowers CH, Skikne BS. The qualitative assessment of body iron. Blood 2003; 101:3359-34.
  2. Skikne BS, Flowers CH, Cook JD. Serum transferrin receptor: a qualitative measure of tissue iron deficiency. Blood 1990; 75:1870-1876.