Post on 14-Jan-2016
Pat Crawford, DrPH, RDDirector, Atkins Center for Weight &
HealthCooperative Extension Nutrition and
Obesity Specialist University of California at Berkeley
An Overview of the Obesity Epidemic in California
Senate Committee on Health February 12, 2014
Synthesizing the science
Atkins Center for Weight & Health Funded in 1999
Evaluating programs
and policies
Conducting research to
answer critical
questions
Working in partnerships
with communities,
government and organizations
Translation and
dissemination
3
Rates of obesity/overweight
Context of rates
Obesity Trends* Among U.S. AdultsBRFSS, 1985
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1986
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1987
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1988
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1989
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Change in Adult Obesity* in California
Years % ObeseNumber of
years
1985-1990 < 10% 6 years
1991-1996 10-14% 6 years
1997 -2002 ** 15-19% 6 years
2003 -2011 20-24% 9 years
2012*** 25-<30% 1 year
* Obesity defined as Body Mass Index wt(kg)/m2 > 30** 2001-20—24%*** Methodological changes make comparisons not possible with those before 2011Ref: BRFSS, 1985-2012
Obesity in Adults
US CA
All 28% 25%
Men 28% 26%
Women 28% 24%
Ref: BRFSS, 2012
Overweight (and obesity) in adults
US CA
All 60% 64%
Men 67% 70%
Women 54% 58%
Ref: BRFSS, 2012
Overweight (and obesity) in adults by race
US CA
White 63% 58%
Black 71% 74%
Hispanic 67% 70%
Other 53% 40%
Ref: BRFSS, 2012
Obesity in low-income children
US CA
All 14% 16%
Ref: PedNSS, 2011Note: Hispanic rate of obesity 50% higher
Overweight (and obesity) in low-income children
US CA
All 30% 33%
Ref: PedNSS, 2011
Overweight (and obesity) in children by race*
All girls 30% All boys 33%
White 26% White 30%
Black 41% Black 37%
Hispanic 39% Hispanic 40%
* Ages 2-19Ref: Ogden, NHANES, 2012
Adults* United States California
Total population
316,128,839 38,332,521
% White 78% 74%
% African-American
13% 7%
% Hispanic 17% 38%Children+ United States California
% White 52% 27%
% African-American
14% 6%
% Hispanic 24% 52%
Race/Ethnicity – US vs. CA
*U.S. Census Bureau: State and County QuickFacts.
+ kidsdata.org
Adults* United States California
% Below federal poverty level
14.9% 15.3%
Children+ United States California
% Below federal poverty level
22.6% 23.8%
Poverty level – US vs. CA
*U.S. Census Bureau: State and County QuickFacts.
+ kidsdata.org
Fitnessgram testing
2001 2005 2008 200910
15
20
25
30
35
All Boys BMI > 95th percentile
BMI
2001 2005 2008 200910
15
20
25
30
35
Hispanic boys BMI > 95th percentile
BMI
2001 2003 2008 200910
15
20
25
30
35
Asian boys BMI > 95th percentile
BMI
2001 2007 2008 200910
15
20
25
30
35
American Indian boys BMI > 95th percentile
BMI
2001 2005 2008 200910
15
20
25
30
35
Non-Hispanic White boys BMI > 95th percentile
BMI
2001 2005 2008 200910
15
20
25
30
35
All girls BMI > 95th percentile
BMI
2001 2008 2008 200910
15
20
25
30
35Black girls BMI > 95th percentile
BMI
2001 2005 2008 200910
15
20
25
30
35
Hispanic girls BMI > 95th percentileBM
I
2001 2008 200910
15
20
25
30
35
American Indian girls BMI > 95th percentile
BMI
2001 2005 2008 200910
15
20
25
30
35
Non-Hispanic White girls BMI > 95th percentile
BMI
Policy Evaluation in Student BMI
Ref: Sanchez-Vaznaugh, Crawford, 2010
Ref: CCPHA
• Annualize the adjusted decrease in prevalence
from peak to 2008
• Assume that annual decrease continues until
2015
• Apply this to ALL kids in CA
• ~ 100,000 kids DROP OUT of the obese
category
• Assuming a savings of $220 per child**
• Savings of about $20 million
Medical cost savings per child*
* Madsen K, UC Berkeley, personal communication**(based on MEPS data from 2001 to 2003, as reported in NY state comptroller report from Oct 2012)
GIRLS
Remission 2008 to 2015
SAVINGS
White 11,024 $2,425,337
African American - -
Latina 8,772 $1,929,798
Asian 2,443 $537,360
American Indian - -
TOTAL (By race) 22,239 $4,892,495
BOYSRemission: 2008 to 2015
Savings*
White 27,165 $5,976,209
African American 7,971 $1,753,643
Latino 30,373 $6,682,012
Asian 4,419 $972,107
American Indian 3,881 $853,816
TOTAL (By race) 73,808 $16,237,787
The human cost of obesity: diabetes and pre-diabetes in adolescence
2001 20090
5
10
15
20
25
Human cost - Adult
or pictorially NowThen
Key messages
Invest in prevention
Create a culture of health
Utilize the resources of the University
THANK YOU