Press Release

FOR IMMEDIATE RELEASE: CONTACT: Roseanne Pawelec,

Tuesday, July 23, 2002 (617) 624-5006

NEARLY HALF OF ALL MASSACHUSETTS RESIDENTS OVERWEIGHT OR OBESE

New MDPH Study Finds Obesity Increasing

One out of two Massachusetts adults are either overweight or obese according tonew survey statistics released by the Massachusetts Department of Public Health todayfrom the BRFSS (Behavioral Risk Factor Surveillance System). Over 8,000Massachusetts adults responded to the random telephone survey conducted in the year2000 by MDPH’s Health Surveillance Program.

“Obesity is a preventable epidemic,” said MDPH Commissioner, Dr. HowardKoh. “It erodes our quality of life, causes death and illness and places an enormousfinancial burden on our health care system, “ Dr. Koh added.

The report released today, “Growing Concerns about Obesity Among Adults inMassachusetts: A Statistical Analysis of BRFSS Data,” also indicated:

17% of Massachusetts adults are obese. (A person 5’6” tall is considered obese ifhe/she weighs more than 185 lbs.)

Men are almost 50% more likely to be overweight than women: more than 6 out of 10men (64%) and 4 out of 10 women (42%) were overweight in Massachusetts in 2000.(A person 5’6” tall is considered overweight if he/she weighs more than 155 lbs.)

Persons with less than a high school education are twice as likely as college graduatesto be obese (24% vs. 12%).

The race-sex group with the highest rate of obesity is black women: more than 3 outof 10 black women are obese (31%). Asian men and women have the lowest rate ofobesity.

Although Massachusetts has the 4th lowest level of overweight among all US states,the trends in the Commonwealth and nationwide are alarming: in Massachusetts,overweight increased 30% in the last decade from 40% in 1990 to 52% in 2000).During this time, the increase nationwide was from 45% to 57% (a 27% increase).

In addition to the survey results, MDPH presented data from the Pregnancy andPediatric Nutrition Surveillance Systems on pregnant and postpartum women whoparticipated in the Massachusetts WIC Nutrition Program(WIC) in 1999, and childrenwho participated in WIC in 2001. That data indicated: 43% of the women were either overweight(24%) or obese (19%) prior to their current

pregnancy. 51% of the participants gained more than the recommended amount of weight during

their pregnancy. Asian women were far less likely to be overweight prior to pregnancy (17% compared

to 42% among white non-Hispanic women, 50% among black non-Hispanic womenand 45% among Hispanic women).

Among infants and children between ages 2 and 5:

More than one third of children aged 2 to 5 were either at risk for overweight oralready overweight.

The prevalence of overweight was lowest among Asian children (12% compared to14% among white non-Hispanic, 16% among black non-Hispanic and 21% amongHispanic children).

The data presented will be used by the Massachusetts Department of Public Health tofurther inform and target obesity prevention and education programs to those at greatestrisk

Growing Concerns about Obesity Among Adults in Massachusetts: A Statistical Analysis of BRFSS Data

Health Survey Program

Division of Research and Epidemiology

Bureau of Health Statistics, Research, and Evaluation

Massachusetts Department of Public Health

July 2002

Overweight and obesity may not be infectious

diseases, but they have reached epidemic proportion

in the United States. Overweight and obesity are

increasing in both genders and among all population

groups.

- David Satcher

former U.S. Surgeon General

Morbidity Associated with Obesity

• heart disease

• type 2 diabetes

• hypertension

• elevated incidence of joint and mobility problems

• some types of cancer

What is the BRFSS?

° Random-digit-dial telephone survey

° Adults ages 18 and older

° Joint collaboration between CDC and State Departments of

Health

° Massachusetts BRFSS since 1986

° Data are weighted: provide population-based estimates of

health

° N = 8,149 (year 2000)

BRFSS

TOBACCO

CANCER CONTROL

DRUG &ALCOHOL

SEXUALBEHAVIOR

DOMESTICVIOLENCE BLOOD PRESSURE

AND CHOLESTEROL

NUTRITIONAND EXERCISE

ORAL HEALTH

HEALTH CARE ACCESS

OSTEOPOROSIS

HEIGHT, WEIGHT,WEIGHT CONTROL

How is obesity measured in adults?How is obesity measured in adults?

• Self report on height and weight

• Body Mass Index (BMI): a measure of weight in relation to height

= weight (kg) / height (m) 2

• Classification:

Underweight: BMI < 18.5

Overweight: BMI 25.0-29.9

Obese: BMI > 30.0Note: classification of children is different

Overweight Obese

Height BMI 25.0-29.9 BMI > 30

5’ 128 lbs. 153 lbs.

5’2’’ 136 164

5’4’’ 145 174

5’6’’ 155 186

5’8’’ 164 197

6’ 184 221

Overweight and Obese by Height

Overweight Obese

Height BMI 25.0-29.9 BMI > 30

5’ 128 lbs. 153 lbs.

5’2’’ 136 164

5’4’’5’4’’ 145145 174174

5’6’’ 155 186

5’8’’ 164 197

6’ 184 221

Overweight and Obese by Height

Percentage Overweight/Obese

and Obese by Sex,

Massachusetts Adults BRFSS 2000

64

18

42

16

0

20

40

60

80

100

Overweight/ obese Obese

Perc

enta

ge

men women

Percentage Overweight/Obese by Sex and Race,

Massachusetts Adults, BRFSS 2000

65 6469

4341

6455

16

0

20

40

60

80

100

White Black Hispanic Asian

Perc

enta

ge

men women

Percentage Obese by Sex and Race,

Massachusetts Adults, BRFSS 2000

1821

17

8

15

31

19

00

10

20

30

40

50

White Black Hispanic Asian

Perc

enta

ge

men women

Percentage Overweight/Obese and Obese by Age,

Massachusetts Adults, BRFSS 2000

3545

5259 60 62

48

913

17 21 21 21

12

0

20

40

60

80

100

18-24 25-34 35-44 45-54 55-64 65-74 75+

perc

enta

ge

Overweight/obese

Obese

Age

Percentage Obese by Education and Income, Massachusetts Adults, BRFSS 2000

17

2420 18

12

0

10

20

30

40

50

Total < high

school

high

school

college

1-3 yrs.

college

4+ years

perc

enta

ge

Percentage Obese by Education and Income, Massachusetts Adults, BRFSS 2000

1721 19

16 15 13

0

10

20

30

40

50

Tota

l

<$25

,000

$25-3

4,99

9

$35-4

9,99

9

$50-7

4,99

9

$75,000

+

perc

enta

ge

Percentage Obese by Region, Massachusetts Adults, BRFSS 2000

17 17 19 1714

18 17

0

10

20

30

40

50

Total Western Central North

East

Metro

West

South

East

Boston

perc

enta

ge

Percentage Overweight/Obese by Fruit and Vegetable Consumption, Massachusetts Adults,

BRFSS 2000

6758

43 41

0

20

40

60

80

100

1-4 servings 5+ servings 1-4 servings 5+ servings

perc

enta

ge

men women

Percentage Overweight/Obese and Obese by Regular Physical Activity,

Massachusetts Adults, BRFSS 2000

62 65

34

46

1320

1118

0

20

40

60

80

100

regular not regular regular not regular

perc

enta

ge

overweight/ obese

obese

men women

Percentage Overweight/Obese by Smoking Status,

Massachusetts Adults BRFSS 2000

57

37

71

43

63

42

0

20

40

60

80

100

men women

perc

enta

ge

current former never

Percentage Overweight/Obese by Marital Status and Sex,

Massachusetts Adults, BRFSS 2000

61

45

67

41

0

20

40

60

80

100

men women

perc

enta

ge

single married/ unmarried couple

Percentage Overweight/Obese by Presence of Children in Household, Massachusetts Adults,

BRFSS 2000

64 65

4146

0

20

40

60

80

100

no children children no children children

perc

enta

ge

men women

Prevalence of Diabetes among Overweight/Obese,

Massachusetts, Adults BRFSS 2000

7 8

3 3

0

5

10

15

20

25

men women

perc

enta

ge

Overweight/ Obese Not overweight/ obese

Prevalence of CHD/Angina among Overweight/Obese Adults age 40+,

Massachusetts, BRFSS 2000

13

986

0

5

10

15

20

25

men women

perc

enta

ge

Overweight/Obese Not overweight/obese

Trends for Overweight for US and Massachusetts, 1990-2000

0

10

20

30

40

50

60

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

MA US

How is Massachusetts Doing?

MA % MA Rank HP 2010%

overweight 52 4th N/ A

obese 17 5th 15

Any exercise in past month 76 13th NA

f ruit and vegetable consumption 31 4th NA

current smoker 20 8th 12

Rank: 1=Best, 50=Worst

Summary of Adult Data

• Current obesity epidemic in Massachusetts mirrors national trends

• groups at greater risk include:

– persons with low income or education

– certain racial ethnic groups

– more sedentary adults

• BRFSS data should be used to inform policy and develop

prevention and treatment approaches

Growing Concerns about Obesity in Massachusetts during Pregnancy and

Early Childhood: A Statistical Analysis of

WIC PNSS and PedNSS Data

Bureau of Family and Community Health,

Massachusetts Department of Public HealthJuly 23, 2002

Massachusetts WIC Program

• Preventive nutrition program with benefits that include supplemental nutritious foods, nutrition education, and referrals to health care

• Pregnant or postpartum women, infants, and children up to age 5 who are at "nutritional risk" and meet income guidelines are eligible

• Massachusetts WIC Program annually serves approx. 33,000 women, and 120,000 infants and children, using federal and state funds

Goals of PNSS and PedNSS

Pregnancy Nutrition Surveillance System (PNSS,1979 - present)

To monitor behavioral and nutritional risk factors among moderate- to low-income U.S. pregnant & postpartum women participating in public health programs

Pediatric Nutrition Surveillance System (PedNSS,1973 - present)

To monitor the general health and nutritional status of moderate- to low-income U.S. children served by public health programs

Nutrition Surveillance Data Components

PedNSS Demographics

HT & WT

Hgb or Hct

Birthweight

Infant feeding (<24 months)

PNSS Demographics

Pre-pregnancy WT

Pregnancy WT gain

Hgb or Hct

Smoking and Alcohol use

Medical care

Infant feeding

Massachusetts WIC/PNSS Demographic Characteristics

Age: 20% age < 20

54% age 20-29

26% age >= 30

Race/Hispanic Ethnicity:50% White non-Hispanic

18% Black non-Hispanic

25% Hispanic

6% Asian

Education: 22% < 12 y completed

71% >= 12 y completed

7% unknown

18.325.3

5.87.2 5.1

50.4

10.9

74.7

0

20

40

60

80

100

White Non-Hispanic Black Non-Hispanic Hispanic Asian

Race/Hispanic Ethnicity

Pe

rce

nt

WIC Participants MA Statewide Birth Data

Race/Hispanic ethnicity among MA WIC participants compared to

MA statewide birth data1999 MA WIC/PNSS

Source: Massachusetts WIC Program, 1999 (n=33,176); Massachusetts Births 1999, MDPH, 2001 (n=80,866)

18.823.8

7.1

50.3

0

20

40

60

80

100

Underweight Normal weight Overweight Obese

Pre-Pregnancy Weight Status

Pe

rce

nt

Pre-pregnancy weight status 1999 MA WIC/PNSS

Source: Massachusetts WIC Program, 1999 (n=26,856)

42.6% combined

Pre-pregnancy weight statusby maternal age 1999 MA WIC/PNSS

Source: Massachusetts WIC Program, 1999 (n=26,855)

4.6 3.6

43.6

9.9

7.3

58.749.3

45.4

31.4

43.450.0 52.8

0

20

40

60

80

100

< 20 20-29 30-34 >=35

Maternal Age Category

Pe

rce

nt

Underweight Normal Weight Overweight or Obese

5.7

66.9

7.5

5.4

16.5

50.7

44.649.8

16.6

41.850.0 44.5

0

20

40

60

80

100

White, Non-Hispanic Black, Non-Hispanic Hispanic Asian

Race/Hispanic Ethnicity

Pe

rce

nt

Underweight Normal Weight Overweight or Obese

Pre-pregnancy weight statusby race/Hispanic ethnicity

1999 MA WIC/PNSS

Source: Massachusetts WIC Program, 1999 (n=26,856)

6.3 4.4 5.3

43.3 40.445.7

9.2

48.057.0 54.352.3

33.8

0

20

40

60

80

100

0 children 1 child 2 children >= 3 children

Parity

Pe

rce

nt

Underweight Normal Weight Overweight or Obese

Pre-pregnancy weight status by parity

1999 MA WIC/PNSS

Source: Massachusetts WIC Program, 1999 (n=25,883)

22.6 26.2

51.2

0

20

40

60

80

100

Less than Recommended Recommended More than Recommended

Weight Gain Status

Pe

rce

nt

Source: Massachusetts WIC Program, 1999 (n=22,876)

Weight gain status during pregnancy 1999 MA WIC/PNSS

25.331.6

17.324.8 26.725.0 26.227.7

43.147.5

57.7

47.1

0

20

40

60

80

100

0 children 1 child 2 children >= 3 children

Parity

Pe

rce

nt

Less than Recommended Recommended More than Recommended

Weight gain status during pregnancy by parity

1999 MA WIC/PNSS

Source: Massachusetts WIC Program, 1999 (n=25,094)

Pediatric Nutrition Surveillance System (PedNSS)

• Short Stature• height-for-age < 5th percentile1

• Underweight• weight-for-age < 5th percentile

• Risk for Overweight• 85th percentile < weight-for-height2 < 95th percentile

• Overweight• >= 95th percentile weight-for-height

• Anemia

1 All percentiles given are relative to the 2000 CDC growth chart reference2 Substituted here for BMI-for-age; both measures are interchangeable in this age range

A Note about Terminology...

Pediatric Terms Adult TermsUnderweight Underweight

Normal Normal

At Risk for Overweight Overweight

Overweight Obese

Terminology for roughly equivalent categories is different in children than in adults. The term “obesity” is not recommended for use when describing children. The term “overweight” reflects a different category in children than in adults.

Massachusetts2001 PedNSS (%)

National 2000PedNSS (%)

Age< 12 months 26 3812 - 24 months 25 22> 24 months 49 40

Race/Hispanic Ethnicity

White Non-Hispanic 45 43Black Non-Hispanic 19 22Hispanic 30 29Asian 6 3All Other 4

PedNSS Demographic Characteristics

6.55.5

3.9 3.8 3.74.9

8.26.4

4.4 4.6 4.0

6.2

0

5

10

15

0-11 months

12-23months

24-35months

36-47months

48-59months

All Age Grps

Age in Months

Pe

rce

nt

2001 MA WIC PedNSS 2000 National PedNSS

Source: Massachusetts WIC Program, 2001 (n= 117,270).

Prevalence of short stature by age 2001 MA WIC/PedNSS

5.5

2.83.03.83.3

12.5

5.44.34.54.8

3.5

7.5

0

5

10

15

0-11months

12-23months

24-35months

36-47months

48-59months

All Age Grps

Age in Months

Pe

rce

nt

2001 MA WIC PedNSS 2000 National PedNSS

Prevalence of underweight by age 2001 MA WIC/PedNSS

Source: Massachusetts WIC Program, 2001 (n= 117,423).

17.8 16.4 15.017.017.115.7

0

10

20

30

40

24-35 months 36-47 months 48-59 months

Age in Months

Pe

rce

nt

At Risk for Overweight Overweight

Prevalence of risk for overweight and overweight by age

2001 MA WIC/PedNSS

Source: Massachusetts WIC Program, 2001 (n= 55,896). Children >= 2 years old.

33.5% 33.5% 32.0%

13.916.0

20.7

12.216.0 16.7 18.0

13.1

0

10

20

30

40

White Non-Hispanic Black Non-Hispanic Hispanic Asian

Race/Hispanic Ethnicity

Pe

rce

nt

At Risk for Overweight Overweight

Source: Massachusetts WIC Program, 2001 (n= 55,896). Children >= 2 years old.

29.9% 32.7% 38.7% 25.3%

Prevalence of risk for overweight and overweight by

race/Hispanic ethnicity 2001 MA WIC/PedNSS

16.412.9

15.116.6

0

10

20

30

40

MA WIC PedNSS National PedNSS

Age in Months

Pe

rce

nt

At Risk for Overweight Overweight

Prevalence of risk for overweight and overweight: Massachusetts PedNSS

compared to National PedNSS 2001 MA WIC/PedNSS

Source: Massachusetts WIC Program, 2001 (n= 55,896). Children >= 2 years old.

33% 28%

Key Findings

PNSS:• 43% of women were either overweight or obese prior to their

current pregnancy• 51% of women gained more than the recommended amount of

weight during pregnancy

PedNSS:• More than one-third of children aged 2-5 were either at risk or

already overweight• Prevalence of risk for overweight and overweight was high

among all ethnic groups; although the prevalence was lowest among Asian children, it approached that found among other ethnic groups