NHANES: A Potential Database for Risk

Assessment

Clifford Johnson

Centers for Disease Control and PreventionNational Center for Health Statistics

National Health and Nutrition Examination

Survey (NHANES)

Objective

To assess the health and

nutritional status of adults and

children in the United States

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National Health and NutritionExamination Surveys

NHES I 1960-62 18-79 yearsNHES II 1963-65 6-11 yearsNHES III 1966-70 12-17 yearsNHANES I 1971-75 1-74 yearsNHANES II 1976-80 6 mo.-74 yearsHHANES 1982-84 6 mo.-74 yearsNHANES III 1988-94 2 mo. +NHANES 1999- All ages

Survey Dates Ages

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• Continuous data collection beginning in 1999

• Multi-stage probability sample

• Annual national sample of 5,000 persons

• Detailed estimates of population subgroups requires two or more years

NHANES sample design

NHANES process

HomeExaminatio

n

Interview

MobileExaminatio

nCenter

Longitudinal Followup

Identification of sample persons

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• Broad range of health conditions

• Health care coverage and need

• Environmental and occupational exposures

• Health behaviors

• Nutrition and dietary supplements

NHANES household interview

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NHANES Mobile Exam Center

NHANES topics

• Cardiovascular disease

• Diabetes, lower extremity disease

• Bone status, osteoporosis

• Oral health

• Vision

• Hearing and balance

• Fitness and strengthOP96S035

NHANES topics

• Nutrition

• Anthropometry

• Mental health

• Risk behaviors

• Reproductive health

• Environmental exposures

• Infectious diseases

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• Dietary nutrient intake

• Anthropometric measurements

• Nutritional biochemistries and hematologic tests

• Physical examination

• Interview

NHANES nutrition assessments

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NHANES 1999-2001 Dietary Assessment

•24-hour dietary recall (automated )

•Second day recall on subset of persons

•Food frequency (focused)

•General questions

•Supplements/medications (detailed)

•Food security

NHANES 2002 Dietary Assessment

•24-hour dietary recall (new USDA automated system)

•Second day recall on ALL persons (telephone)

•Food frequency (focused)

•General questions

•Supplements/medications (detailed)

•Food security

MEC laboratory

•CBC and differential

•Pregnancy test

•Blood, urine and vaginal swab processing

•76 different vials of samples

•26 laboratories

•300 laboratory assays

Environmental exposure measures

•Lead

•Cadmium

•Mercury

•Pesticides

•Selenium

•Cotinine

•Urinary Iodine

•Volatile organic compounds

National Report on Human Exposure to Environmental

Chemicals

First report - 27 environmental chemicals including:

•Metals

•Cotinine

•Organophosphate pesticide metabolites

•Phthalate metabolites

Updated annually

Dietary data for future NHANES

• Continue collection of two recalls on all sample persons

• Pilot test in 2002 of a longer food frequency questionnaire

• Monitor respondent burden

• Balance competing needs --- usual intake, total intake (nutrients vs. foods), food safety, supplement use, DHKS, food programs and health components

NHANES web site

http://www.cdc.gov/nchs/nhanes.htm

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