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Some Definitions. Joint Nutrition Monitoring Evaluation Committee, 1986Expert Panel on Nutrition Monitoring, 1989. Dietary Status. The condition of a population's or an individual's intake of foods and food components, especially nutrients.. Nutrition Assessment. Measurement of indicators of dietar
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1. Assessing the Nutritional Health of Populations
2. Some Definitions Joint Nutrition Monitoring Evaluation Committee, 1986
Expert Panel on Nutrition Monitoring, 1989
3. Dietary Status The condition of a population’s or an individual’s intake of foods and food components, especially nutrients.
4. Nutrition Assessment Measurement of indicators of dietary status and nutrition related health status to identify the possible occurrence, nature, and extent of impaired nutritional status.
5. Nutrition Monitoring Assessment of dietary or nutrition status at intermittent times with the aim of detecting changes in the dietary or nutritional status of a population
6. Nutrition Surveillance Continuous assessment of nutritional status for the purpose of detecting changes in trend or distribution in order to initiate corrective measures
7. Nutrition Monitoring in the United States
8. Brief Chronology
10. Goals of NNMS Provide foundations for improvement of nutritional status and quality and healthfulness of food supply
Collect, analyze, and disseminate timely data on nutrition and dietary status, quality of food supply, food consumption patterns, consumer knowledge and attitudes
11. NNMS Goals, cont... ID high risk groups and geographic areas and trends
Establish national baseline data and develop standards for monitoring
Provide data for evaluating implications of changes in agricultural policy
12. NNMS - Some Agencies USDA
Food and Nutrition Service
Food Safety and Inspection Service
Agricultural Research Service
Economic Research Service
Extension Service
Cooperative State Research Service
13. Department of Health and Human Services
National Center for Health Statistics
CDC-National Center for Chronic Disease Prevention and Health Promotion
Food and Drug Administration
Heath Resources and Services Administration
Indian Health Services
National Institutes of Health
Substance Abuse and Mental Health Services Administration
14. Others:
Department of Defense
Department of Education
Agency for International Development
Department of Veterans Affairs
Census Bureau
Bureau of Labor Statistics
National Marine Fisheries Service
15. Nutrition and Related Health Measurements National Health and Nutrition Examination Surveys (I-V, and continuous)
National Health Interview Survey
National Hospital Discharge Survey
Pediatric Nutrition Surveillance System
16. Food and Nutrient Composition Nationwide Food Consumption Survey
Continuing Survey of Food Intakes by Individuals – now integrated into What We Eat in America
17. Knowledge, Attitudes, and Behavior Behavioral Risk Factor Surveillance System
Youth Risk Behavior Survey
Diet and Health Knowledge Survey
18. Food Composition and Nutrient Data Bases National Nutrient Data Bank (NNDB)
19. Food Supply Determinations US Food and Nutrition Supply Series
20. Major Surveys with Nutrition Content
21. Behavioral Risk Factor Surveillance System (BRFSS) CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
Annually since 1984 (not all states at first)
Telephone interview
Data collection is conducted separately by each State. Sample design uses State-level, random-digit-dialed probability samples of the adult (aged 18 years and over) population.
State-specific sample sizes ranged from 1,499 to 6,005
22. BRFSS - Questions Behavioral risk factors (for example, alcohol and tobacco use), preventive health measures, HIV/AIDS, health status, limitation of activity, and health care access and utilization
Core of questions asked in all States
Standardized optional questions on selected topics administered at the State’s discretion
Rotating core of questions asked every other year in all States
State-added questions developed to address State-specific needs
23. BRFSS - Data National
State
Smaller units when local agencies pay for additional surveys
Data system homepage: http://www.cdc.gov/brfss/
24. BRFSS - Nutrition Self reported height and weight
Trying to loose weight?
6 fruit and vegetable intake questions
Activity
Food security
29. This slide set contains information about and data from the Youth Risk Behavior Surveillance System or YRBSS. It includes national, state, and local data from the 2005 surveys.This slide set contains information about and data from the Youth Risk Behavior Surveillance System or YRBSS. It includes national, state, and local data from the 2005 surveys.
30. Purposes of the YRBSS Focus the nation on behaviors among youth causing the most important health problems
Assess how risk behaviors change over time
Provide comparable data The purposes of the YRBSS are threefold:
To focus the nation on behaviors among youth causing the most important health problems;
To assess how risk behaviors change over time; and
To provide comparable data.The purposes of the YRBSS are threefold:
To focus the nation on behaviors among youth causing the most important health problems;
To assess how risk behaviors change over time; and
To provide comparable data.
31. Behaviors That Contribute to the Leading Causes of Morbidity and Mortality Behaviors that contribute to unintentional injuries and violence
Tobacco use
Alcohol and other drug use
Sexual behaviors
Unhealthy dietary behaviors
Inadequate physical activity The YRBSS measures behaviors that contribute to the leading causes of morbidity and mortality among youth and adults. These are behaviors that contribute to—
Unintentional injuries and violence;
Tobacco use;
Alcohol and other drug use;
Sexual behaviors;
Unhealthy dietary behaviors; and
Inadequate physical activity.
The YRBSS measures behaviors that contribute to the leading causes of morbidity and mortality among youth and adults. These are behaviors that contribute to—
Unintentional injuries and violence;
Tobacco use;
Alcohol and other drug use;
Sexual behaviors;
Unhealthy dietary behaviors; and
Inadequate physical activity.
32. Characteristics of the National, State, and Local School-Based YRBS 9th – 12th grade students
Probability samples of schools and students
Anonymous
Self-administered, computer-scannable questionnaire or answer sheet
Completed in one class period (45 minutes)
Conducted biennially usually during the spring The national, state, and local Youth Risk Behavior Surveys are administered to 9th through 12th grade students drawn from probability samples of schools and students. The questionnaire is anonymous and self-administered. The questionnaire booklet or answer sheet is computer-scannable. The surveys are completed in one 45-minute class period, and are conducted biennially usually during the spring.The national, state, and local Youth Risk Behavior Surveys are administered to 9th through 12th grade students drawn from probability samples of schools and students. The questionnaire is anonymous and self-administered. The questionnaire booklet or answer sheet is computer-scannable. The surveys are completed in one 45-minute class period, and are conducted biennially usually during the spring.
33. 2005 National YRBS National probability sample of public and private schools
Total sample size = 13,917
School-level response rate = 78%
Student-level response rate = 86%
Overall response rate = 67% The 2005 National YRBS survey was administered to a national probability sample of public and private schools. The sample size is 13,917 students. The school-level response rate is 78% and the student-level response rate is 86%. The school response rate multiplied by the students response rate produces an overall response rate of 67%.The 2005 National YRBS survey was administered to a national probability sample of public and private schools. The sample size is 13,917 students. The school-level response rate is 78% and the student-level response rate is 86%. The school response rate multiplied by the students response rate produces an overall response rate of 67%.
34. Policy and Program Applications Describe risk behaviors
Create awareness
Set program goals
Develop programs and policies
Support health-related legislation
Seek funding YRBS data are used at the national, state, and local levels in a variety of policy and program applications. YRBS data can be used to do the following:
Describe risk behaviors;
Create awareness;
Set program goals;
Develop programs and policies;
Support health-related legislation; and
Seek funding.YRBS data are used at the national, state, and local levels in a variety of policy and program applications. YRBS data can be used to do the following:
Describe risk behaviors;
Create awareness;
Set program goals;
Develop programs and policies;
Support health-related legislation; and
Seek funding.
35. Describe Risk Behaviors Overall and among subgroups of youth
How risk behaviors are interrelated The YRBSS describes risk behaviors that affect youth, including select subgroups of youth that may be of interest. YRBS data also are used to demonstrate how risk behaviors are interrelated.The YRBSS describes risk behaviors that affect youth, including select subgroups of youth that may be of interest. YRBS data also are used to demonstrate how risk behaviors are interrelated.
36. Create Awareness Among:
Legislators, boards of education, and school administrators
Parents
Community members
School staff
Students
Media YRBS data are useful for creating awareness about health challenges and successes for youth among such varied audiences as
Legislators, boards of education, and school administrators;
Parents;
Community members;
School staff;
Students; and
Media.YRBS data are useful for creating awareness about health challenges and successes for youth among such varied audiences as
Legislators, boards of education, and school administrators;
Parents;
Community members;
School staff;
Students; and
Media.
37. Set Program Goals Strategic plans for school health programs
Healthy People 2010 objectives
CDC’s Performance Plan YRBS data also are used often to set program goals. Examples of how YRBS data have been used are
to establish and monitor strategic plans for school health programs;
to monitor progress toward national Healthy People 2010 objectives; and
to evaluate components of CDC’s Performance Plan.
YRBS data also are used often to set program goals. Examples of how YRBS data have been used are
to establish and monitor strategic plans for school health programs;
to monitor progress toward national Healthy People 2010 objectives; and
to evaluate components of CDC’s Performance Plan.
38. Develop Programs and Policies School health programs and policies
Programs and policies for youth in high risk situations
Instructional guides and materials
Professional development programs for teachers YRBS data have proven useful to help develop programs and policies, including
School health programs and policies;
Programs and policies for youth in high risk situations;
Instructional guides and materials; and
Professional development programs for teachers.YRBS data have proven useful to help develop programs and policies, including
School health programs and policies;
Programs and policies for youth in high risk situations;
Instructional guides and materials; and
Professional development programs for teachers.
39. Support Health-Related Legislation School health program requirements
School health council requirements
Drug-free or weapon-free school zone laws
Minors’ access laws
Drinking and driving laws
Bans on billboards and other advertising
Competitive food policies Data from the YRBS also are cited often to support health-related legislation. Examples include
School health program requirements;
School health council requirements;
Drug-free or weapon-free school zone laws;
Minors’ access laws;
Drinking and driving laws;
Bans on billboards and other advertising; and
Competitive food policies.Data from the YRBS also are cited often to support health-related legislation. Examples include
School health program requirements;
School health council requirements;
Drug-free or weapon-free school zone laws;
Minors’ access laws;
Drinking and driving laws;
Bans on billboards and other advertising; and
Competitive food policies.
40. Seek Funding Support funding requests to federal, state, and private agencies and foundations YRBS data are a valuable resource to support funding requests to federal, state, and private agencies and foundations.YRBS data are a valuable resource to support funding requests to federal, state, and private agencies and foundations.
41. 2005 YRBS ResultsNutrition The following slides highlight results from the 2005 YRBS.The following slides highlight results from the 2005 YRBS.
42. YRBS - Nutrition Self reported weight and height
Dieting behaviors
Eating disorder behaviors
Fruit and vegetable intake
Fat intake
43. Percentage of High School Students Who Ate Fruits and Vegetables = 5 Times/Day,* by Sex** and Race/Ethnicity,*** 2005 Nationwide in 2005, 20.1% of high school students had eaten fruits and vegetables (100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables) = 5 times/day during the seven days preceding the survey. Overall, the prevalence of having eaten fruits and vegetables = 5 times/day was higher among male than female students and higher among black and Hispanic than white students.Nationwide in 2005, 20.1% of high school students had eaten fruits and vegetables (100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables) = 5 times/day during the seven days preceding the survey. Overall, the prevalence of having eaten fruits and vegetables = 5 times/day was higher among male than female students and higher among black and Hispanic than white students.
44. Percentage of High School Students Who Ate Fruits and Vegetables = 5 Times/Day,* 1999 – 2005 This slide shows the percentage of high school students over time who had eaten fruits and vegetables (100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables) = 5 times/day during the seven days preceding the survey. During 1999 to 2005, a significant linear decrease was identified.
This slide shows the percentage of high school students over time who had eaten fruits and vegetables (100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables) = 5 times/day during the seven days preceding the survey. During 1999 to 2005, a significant linear decrease was identified.
45. Percentage of High School Students Who Drank > 3 Glasses/Day of Milk,* by Sex**and Race/Ethnicity,*** 2005 Nationwide in 2005, 16.2% of high school students had drunk three or more glasses/day of milk during the seven days preceding the survey. Overall, the prevalence of having drunk three or more glasses/day of milk was higher among male than female students, higher among white than black and Hispanic students, and higher among Hispanic than black students.Nationwide in 2005, 16.2% of high school students had drunk three or more glasses/day of milk during the seven days preceding the survey. Overall, the prevalence of having drunk three or more glasses/day of milk was higher among male than female students, higher among white than black and Hispanic students, and higher among Hispanic than black students.
46. Percentage of High School Students Who Drank > 3 Glasses/Day of Milk,* 1999 – 2005 This slide shows the percentage of high school students over time who had drunk three or more glasses/day of milk during the seven days preceding the survey. During 1999 to 2005, no significant change was identified.
This slide shows the percentage of high school students over time who had drunk three or more glasses/day of milk during the seven days preceding the survey. During 1999 to 2005, no significant change was identified.
47. Rising Rates of Childhood Overweight in Lewis County
48. Continuing Survey of Food Intake by Individuals (CSFII) USDA
1994-1996
in-person interviews
24-hour dietary recall: 2 nonconsecutive days of food intake data collected 3-10 days apart
2 weeks later, one adult from each household asked questions about knowledge and attitudes toward dietary guidance, health, and use of food labels.
49. CFSII - Sample Nationally representative stratified multistage area probability sample of U.S. noninstitutionalized civilian population, all ages.
Oversampling of low-income households
For 1994–96, sample size for 1-day dietary data was 16,103; for 2-day dietary data, it was 15,303.
50. CFSII - Data kinds and amounts of foods consumed
sources of foods
time, name of each eating occasion
food expenditures, shopping practices
pregnancy, lactation, nursing status,
height and weight
income, poverty status, household size,
participation in Food Stamp and WIC programs
51. CFSII - Data Availability National; four U.S. Census Bureau regions; Standard Metropolitan Statistical Areas
http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm
52. CFSII - Nutrition food intakes in grams of 71 USDA-defined food groups and subgroups
nutrient intakes of 28 nutrients and food components
nutrient intakes expressed as percentages of the 1989 Recommended Dietary Allowance
Pyramid servings from 30 food groups
53. Trends in Beverage Consumption – Youth aged 11-18 years
59. National Health and Nutrition Examination Survey (NHANES) CDC, National Center for Health Statistics (NCHS)
In-person interview in household and mobile examination center
stratified multistage probability sample, nationally representative of the U.S. civilian noninstitutionalized population
Approximately 5,000 people are examined at 15 locations each year
All ages beginning in 1999
60. NHANES - Continuous Periodic (1960–94);
annual beginning in 1999
after 1999 annual sample size too small to provide reliable estimates for many measures and for most subgroups. Most analyses require 3 years of data for reliable estimates.
63. NHANES - Content Chronic disease prevalence and conditions (including undiagnosed conditions
immunization status
infectious disease prevalence
health insurance
measures of environmental exposures
hearing
vision
mental health
64. NHANES - Content anemia
diabetes
cardiovascular disease
osteoporosis
obesity
oral health
physical fitness
65. NHANES - New in 1999 cardiorespiratory fitness
physical functioning
lower extremity disease
full body DXA for body fat as well as bone density
tuberculosis
66. NHANES - Data National; four U.S. Census Bureau regions
Demographics: Gender, age, education, race/ethnicity, place of birth, income, occupation, and industry
http://www.cdc.gov/nchs/nhanes.htm
67. NHANES - Nutrition Food Security
Dietary supplements
Weight history
Dietary Recall - one 24 hour
68. NHANES III Anthropometric Procedures Video Body weight
Standing height
Sitting height
Upper leg length
Recumbent length
Upper arm length
Knee height
Arm circumference
Waist circumference Buttocks circumference
Thigh circumference
Head circumference
Skinfolds (including thighs, triceps, subscapular, and suprailiac)
Wrist breadth
Elbow breadth
70. WHAT WE EAT IN AMERICA: NHANES-CFSII Integration Staged integration of the two surveys
2001 a year of testing, 2002 full integration
Goals: continuous data collection, linkage of diet and health data, 2 days of dietary data collection (second day by phone 3 to 10 days after initial exam)
DHKS not part of integrated efforts at this time, but under consideration
71. What We Eat in America Food intake data can be linked to health status data from other NHANES components
HHS is responsible for the sample design and data and USDA is responsible for the survey’s dietary data collection methodology, maintenance of the database used to code and process the data, and data review and processing
73. History of the Food Security Measurement Project
74. Sample of Other Population Surveillance Systems Breastfeeding: National Immunization Survey
Growth in Low Income Children: Pediatric Nutrition Surveillance System