Samer Kanaan, M.D. Healthy Hearts, Healthy Lungs: Living Longer and Living Better.
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Transcript of Samer Kanaan, M.D. Healthy Hearts, Healthy Lungs: Living Longer and Living Better.
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Samer Kanaan, M.D.
Healthy Hearts, Healthy Lungs: Living Longer and Living Better
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GoalsUnderstand the Societal impact of Smoking
Understand the Societal impact of Heart Disease
Review Americas Obesity Problem and focus on Nutrition
How to have a Healthy Heart with focus on Exercise
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Smoking
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SmokingSmoking FactsSmoking is the most important preventable cause of morbidity and premature mortality Worldwide
438,000 Americans die each year from smoking related diseasesSmoking is responsible for more than one in five US deathsAbout of all regular smokers will die from the addictionSmoking costs the United States $193 billion in 2004
Cigarette smoke contains over 4800 chemicals, of which 69 are known to cause cancer
Smoking is directly responsible for 90% of the 161,000 Lung Cancer deathsSmoking is directly responsible for 80-90% of the 127,000 COPD deathsSmoking is major risk factor for Coronary artery disease, stroke, and lower respiratory infections
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SmokingSmoking Facts
Smoking reduces the normal life expectancy by an average of 13-15 years
8.6 million Americans have a smoking related illness
This means that for every 1 American who dies from smoking related disease, there are 20 more people who suffer from a smoking related disease
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List of diseases caused by smokingCOPDCoronary Artery Disease60 % Higher Risk of dying from heart attack in smokers over 65 than non smokersStrokeMen over 65 who smoke are twice as likely to die from stroke than non smokersWomen over 65 who smoke are 1 times as likely to die from stroke than non smokersAAAAcute Myeloid LeukemiaCataracts 2-3 times the risk higher in smokersPneumoniaPeriodontitisBladder cancerEsophageal cancerLaryngeal cancerLung cancerOral cancerThroat cancerCervical cancerKidney cancerStomach cancerPancreatic cancerInfertilityPeptic Ulcer DiseaseSlow wound healingDementia / AlzheimersSmokers have far greater chance of developing dementia than nonsmokers
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SmokingWorldwide
Tobacco is leading cause of preventable death worldwideTobacco kills more than HIV/AIDS, Tuberculosis, and Malaria COMBINED
Tobacco responsible for 5 million deaths each year and will increase to 8 million / year in 2030
Tobacco was responsible for 100 million deaths in the 20th CenturyWith current usage, tobacco could kill 1 billion people in the 21st Century
48% Men versus 10% Women smoke China: 63% Men versus 3.8% Women 300 million people smoke in China which is more than the entire US population
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SmokingSmoking Facts45.3 million Americans (20.6 % of adults) were current smokers in 200645.7 million Americans were former smokers in 2006
Prevalence of smoking decreased 40% between 1965 and 1990, but has been UNCHANGED sinceMales 23.6%Females 17.8%American Indians/ Alaskan Natives 32.2%Whites 21.8%Blacks 22.6%Hispanics 15.1%Asians 10.3%
High school students smoking trend is alarming: data from 2004 Hispanics 26.2%African Americans 17.1%Whites 31.5%
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2007
20% high schoolstudents weresmokers
6% middle school students were smokers
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SmokingSmoking Facts
2005: Advertising by the 5 major tobacco companies totaled $13.1 billion $35 million / day
90% of adults who smoke start by the age of 2150% became regular smokers by the age of 18
Average youth in the US is annually exposed to 559 tobacco ads617 tobacco ads for every adult female892 tobacco ads for every adult African American
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Smoking
Smoking in Pregnancy
Smoking accounts for 20-30% of low birth weight14% of preterm deliveries10% of all infant deaths10.7% of women smoked during pregnancy in 2005 (down 45% from 1990)Neonatal health-care costs attributed to maternal smoking is $366 million per year
Mothers who smoke can pass nicotine to their children through breast milk
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Second Hand Smoke
Described by the EPA as a known human Group A carcinogen
Contains more than 250 toxic or cancer causing chemicals, including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide
Current Surgeon General report concluded that there is NO risk free level of exposure to secondhand smoke
Second hand smoke even in short exposures can cause platelets to become stickier, damage blood vessel lining, decrease coronary flow velocity, and reduce heart rate variability all of these can increase the risk of a heart attack
3,400 lung cancer deaths / year46,000 heart disease deaths / year
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SmokingSmoking by Parents
Exacerbation of asthma 400,000 1,000,000 asthma episodes per year
Increased frequency of colds and ear infection 790,000 ear infections per year
Increased risk of respiratory infections 150,000 - 300,000 lower respiratory infections per year
Increased frequency of Sudden Infant Death Syndrome 430 cases per year
21 million or 35% of children live with smokers on a regular basis
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SmokingCigar smoking5.8% or 12.8 million Americans were current cigar smokers in 200510.1% or 10.6 million of men1.7% or 2 million of women2007: 13.6% high school students(19.4% of boys and 7.6% of girls)2004: 5.3% of middle school students
Cigars contain the same addictive and carcinogenic compounds as cigarettesA single large cigar can contain as much tobacco as an entire pack of cigarettes
Cigar smoking causesLung CancerOral Cavity CancerLarynx CancerEsophageal CancerPancreatic CancerCOPD
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What to do about Smoking
WHO proven policies for effective tobacco control
Raising taxes and prices Price of cigarettes has very significant effect on youth smoking every 10% increase in price decreased youth consumption by 7%
Banning advertising, promotion and sponsorship Protecting people from secondhand smoke Warning everyone about the dangers of tobacco Offering help to people who want to quit Carefully monitoring the epidemic and prevention policies
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SmokingSmoking Cessation
Quitting often requires multiple attempts
Cutting down on cigarettes but not quitting DOES NOT reduce mortality risks from tobacco related illnesses
Only 5% long term success with quitting cold turkey
Counseling and medication in combination is more effective than either one alone
There are 7 FDA approved medications to aid in quitting smoking
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SmokingBenefits
20 minutes after last cigarette: blood pressure decreases; pulse rate drops; and body temperature increases
8 hours after quitting: carbon monoxide level in blood drops to normal; oxygen level in blood increases to normal
24 hours after quitting: chance of a heart attack decreases
48 hours after quitting: nerve endings start regrowing; ability to smell and taste is enhanced
2 weeks to 3 months after quitting: circulation improves; walking becomes easier; lung function increases
1 to 9 months after quitting: coughing, sinus congestion, fatigue, shortness of breath decreases
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SmokingBenefits
1 year after quitting: excess risk of coronary heart disease is decreased to half that of a smoker
5 to 15 years after quitting: stroke risk is reduced to that of people who have never smoked
10 years after quitting: risk of lung cancer drops to as little as one-half that of continuing smokersrisk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreasesrisk of ulcer decreases
15 years after quitting: risk of coronary heart disease is now similar to that of people who have never smokedrisk of death returns to nearly the level of people who have never smoked
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SmokingLife Expectancy Benefit
Quit at age 35 years Increase in life expectancy versus those who conitnue to smoke:6.9 to 8.5 years for men6.1 to 7.7 years for women
Quit at age 45 years Increase in life expectancy versus those who conitnue to smoke:5.6 to 7.1 years for men5.6 to 7.2 years for women
Quit at age 55 yearsIncrease in life expectancy versus those who conitnue to smoke:3.4 to 4.8 years for men4.2 to 5.6 years for women
Quit at age 65 yearsIncrease in life expectancy versus those who conitnue to smoke:1.4 to 2.0 years for men2.7 to 3.7 years for women
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Heart Disease
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PrevalenceIncidence
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Estimated 80 million Americans have one or more type of Cardiovascular Disease 1 in 3 American Adults
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Mortality
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Cardiovascular Disease accounts for 35.3% of all deaths in 2005, or one of every 2.8 deaths in the United States.
2,400 Americans die of CVD each day one death every 37 seconds
In every year since 1900 except 1918, CVD accounted for more deaths than any other cause.
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Cardiovascular Disease claims more lives each year than Cancer, Chronic Lower Respiratory Diseases, Accidents, and Diabetes Mellitus COMBINED!
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Cost
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Cost
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Risk Factors
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Risk FactorsHealthy Lifestyle Characteristics
Non Smoking76.0 %
Healthy Weight40.1 %
Five Fruits & Vegetables per day23.3 %
Regular Physical Activity22.2 %
All 4 Above 3.0 %
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Risk FactorsFamily HistoryCardiovascular disease in parent or sibling associated with two-fold increase risk of Cardiovascular disease, independent of other risk factors
Optimal Risk Factor Profile7900 men and womenBlood pressure below 120/80 mm HgTotal cholesterol below 180 mg/dLNon smokerNo diabetesMedian life expectancy was 10 or more years longer than those with 2 or more major risk factors
Diet and ActivityPeople age 70-90 eating Mediterrean-style diet and Greater physical activity 65-73% lower rate of mortalityincluding Cardiovascular disease and Cancer
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Estimated 10-Year CVD risk in 50-54-year-old adults according to levels of various risk factors (Framingham Heart Study). Source: DAgostino et al., Circulation. 2008;117:743-753. A B C DAge50-54 50-54 50-54 50-54HDL Cholesterol, mg/dL45-49 45-49 35-44 35-44Total Cholesterol (mg/dL) 160-199 200-239 200-239 200-239Systolic BP mm/Hg, no treat. 120-129 130-139 130-139 130-139 Smoker No No No YesDiabetes No No Yes Yes
Chart1
7.94.5
11.27.3
21.615.9
3024.8
Men
Women
Estimated 10-Year Rate%
30+
Sheet1
Estimated 10-Year CVD Risk in 50-54 Year-Old Adults
According to Levels of Various Risk Factors
Framingham Heart Study
Note - add + to male 30!!
ABCD
Age50-5450-5450-5450-54
HDL Cholesterol, mg/dL45-4945-4935-3435-34
Total Cholesterol, mg/dL160-199200-239200-239200-239
Systolic BP mm/Hg, no treatment120-29130-139130-139130-139
SmokerNoNoNoYes
DiabetesNoNoYesTes
Source:D'Agostino, RB, Ramachandran SV, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General Cardiovascular Risk Profile for use in Primary
Care: The Framingham Study. Circulation. 2008;117:743-753.
Sheet1
7.94.5
11.27.3
21.615.9
3024.8
Men
Women
Estimated 10-Year Rate%
Sheet2
Sheet3
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Nutrition
Americas Obesity Problem
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Overweight and ObesityAdultsOverweight (BMI > 25)Obesity (BMI > 30)
145 million Americans are Overweight or Obese 66.7% of the Adult Population71 million Overweight74 million Obese
1999 to 2003Overweight 1.8%Obesity 3.8%Extreme Obesity (BMI >40) 1.2%
CostBetween $92 - $117 billion annually (2002)
WorldwideBy 2015,number of overweight people will be 2.3 billion and obese people will number 700 million
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Age-adjusted prevalence of obesity in Adults ages 20-74 by sex and survey. (NHES, 1960-62; NHANES, 1971-74, 1976-80, 1988-94 and 2001-2004). Source: Health, United States, 2007. NCHS.
Chart3
10.712.212.820.630.2
15.716.817.12634
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
Sheet1
HF PREVALENCECHD MortalityCVD MortalityTotal Mortality
MenWomenNo MetS or DM2.65.314.4
20-390.30.2MetS w/o DM4.37.817.1
40-592.01.5MetS w/DM4.88.621.1
60-797.25.2DM only6.311.526.1
80+11.612.4Prior CVD10.916.730.0
Prior CVD and DM17.028.144.1
Chart 7A: Prevalence of heart failure by sex and ageChart 10A: Total mortality rates in U.S. adults, ages 3075, with metabolic syndrome (MetS), with and without diabetes mellitus (DM) and pre-existing CVD
NHANES: 199904NHANES II 197680 Follow-Up Study*
Source : NCHS and NHLBI.Source: Malik et al.(10) *Average of 13 years of follow-up.
Chart 7B: Hospital discharges for heart failure by sex
United States: 19702004
Note: Hospital discharges include those inpatients discharged alive, dead or status unknown. Source: NHDS, NCHS and personal communication with NHLBI.
Hospital Discharges for HF
CHF Discharges
-----------In thousands------
MalesFemales
708074
7986
98102
107111
121113
75122131
123143
143152
157173
174203
80176224
182240
195243
208255
228303
85247310
274308
269336
277357
304339
90315386
360405
373449
394481
390484
95378494
377493
431526
438540
430532
00418581
444551
441529
471566
04524575
Chart 7C. Incidence of heart failure* by age and sex
FHS 19802003
* - HF based on physician review of medical records and strict diagnostic criteria.
Source: NHLBI.(10)
7010
7522
8057
85719
902,107
952,363
002,199
052,125
Chart 13A: Trends in heart transplants
UNOS: 19702005
Source: United Network for Organ Sharing (UNOS), scientific registry data.
est. cv oper. & proc
u.s. 1979-03 (000)
CatheterizationsOpen-HeartBypassPTCACarotid EndarterectomyPacemakers
`NH WhitesNH BlacksHispanics792991721145442
Males24.914.024.8803501971375544
Females27.011.919.28569030823010740
9010465013922666897
Chart 9A: Prevalence of high school students in grades 912 reporting current cigarette use951137722573419132136
by sex and race/ethnicity001318686519561124152
YRBS: 2005011314690516571128177
021463709515657134199
04129764642766498170
Chart 13B: Trends in cardiovascular inpatient operations and procedures
United States: 19792004
Source: MMWR.4 NH indicates non-Hispanic.
MenWomen
NH White24.120.4
NH Black23.920.2
Hispanic18.915
Asian17.811.3Source: NHDS. NCHS and NHLBI. Note: In-hospital procedures only.
American Indian or Alaska Native37.333.4
Chart 9B: Prevalence of current smoking for Americans age 18 and older by race/ethnicity and sexEST. COST OF CV DISEASES 2007
NHIS: 2004Coronary Heart Disease142.5
Stroke57.9
Hypertensive Disease63.5
Heart Failure29.6
Chart 14A: Estimated direct and indirect costs (in billions of dollars) of major cardiovascular diseases and stroke
United States: 2007
Source: MMWR.1 NH indicates non-Hispanic.
1988-941999-022003-04
NH White206204202
NH Black204199197
Mexican American205202201Source: NHLBI
Chart 9C: Trends in mean total serum cholesterol among adults by race, sex and survey
NHANES: 198894, 199902 and 200304
Source: NCHS and NHLBI.
Note: Needs split scale.
1976-801988-941999-022003-04
White Males163163155156
Black Males171165166161
White Females170166163164
Black Females172174168161
Chart 9D: Trends in mean total serum cholesterol among adolescents ages 1217 by race, sex and survey
NHANES:1976-80,1988-94, 1999-02 and 2003-04
Source: NCHS and NHLBI.
Note: Needs split scale.
MenWomen
Total Population32.032.0
NH Whites32.034.0
NH Blacks32.030.0
Mexican Americans39.031.0
Chart 9E: Age-adjusted prevalence of Americans age 20 and older with
LDL cholesterol of 130 mg/dL or higher by race/ethnicity and sex
NHANES: 200304
Source: NCHS and NHLBI.
MenWomen
Total259
NH Whites269
NH Blacks167
Mexican Americans2813
Chart 9F: Age-adjusted prevalence of Americans age 20 and older with
HDL cholesterol under 40 mg/dL by race/ethnicity and sex
NHANES: 200304
Source: NCHS and NHLBI.
NH WhiteNH BlackHispanic
Male46.938.239
Female30.221.326.5
Chart 9G: Prevalence of students in grades 912 who met currently recommended
levels of physical activity during the past 7 days by race/ethnicity and sex
YRBS: 2005
Note: Currently recommended levels is defined as activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes/day on 5 or more of the 7 days preceding the survey. Source: MMWR.1
Source:YRBS (4)
19942004
NH White Male26.418.4
NH Black Male34.227.0
Hispanic Male37.532.5
Asian/Pacific Islander Male25.020.4
Am. Indian/Alaska Native Male34.423.8
NH White Female28.321.6
NH Black Female45.733.9
Hispanic Female44.839.6
Asian/Pacific Islander Female31.524.0
Am. Indian/Alaska Native Female36.331.8
Chart 9H: Prevalence of leisure-time physical inactivity among adults age 18 and older by race/ethnicity and sex
BRFSS: 1994 and 2004
Source: MMWR.(11) NH indicates non-Hispanic.
MalesFemales
NH Whites15.28.2
NH Blacks15.916.1
Hispanics21.312.1
Chart 9i: Prevalence of overweight among students in grades 912 by sex and race/ethnicity
YRBS: 2005
Source: BMI 95th percentile or higher by age and sex of the CDC 2000 growth chart. MMWR.(2) NH indicates non-Hispanic.
MenWomen
65-749.24.7
75-8422.314.8
85-9443.030.7
1960-621971-741976-801988-942001-2004
Men10.712.212.820.630.2
Women15.716.817.126.034.0
Chart 9J: Age-adjusted prevalence of obesity in Americans ages 2074 by sex and survey
NHES 196062; NHANES: 197174, 197680, 198894 and 200104
Note: Obesity is defined as a BMI of 30.0 or higher. Source: Health, United States, 2006; Unpublished data, NCHS.
6-1112-19
1971-744.33.6
1976-806.66.4
1988-9411.611.0
2001-200418.716.3
Chart 9K: Trends in the prevalence of overweight among U.S. children and adolescents by age and survey
NHANES: 197174, 197680; 198894 and 200104
Source: Health, United States, 2006. Unpublished data. NCHS.
NH WhitesNH BlacksMexican Americans
Men69.89.9
Women4.512.211
Chart 9L: Prevalence of physician-diagnosed diabetes in Americans age 20 and older by race/ethnicity and sex
NHANES: 19992004
NCHS and NHLBI
NH WhitesNH BlacksMexican Americans
Less than high school7.512.010.1
High school5.69.76.0
More than high school4.29.89.8
Chart 9M. Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Americans Age 18+
by Education, Race/Ethnicity and Years of Education
NHANES: 1999-2004
Source: NCHS and NHLBI.
Sheet1
10.712.212.820.630.2
15.716.817.12634
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
Sheet2
4.36.611.618.7
3.66.41116.3
1971-74
1976-80
1988-94
2001-2004
Percent of Population
Sheet3
185.303214.49
190.125240.37
194.834252.488
207.11257.35
221.391275.644
236.69317.084
258.645326.377
287.202327.978
281.616347.436
288.585374.508
312.253351.142
324.63397.288
369.68417.005
383.856455.757
403.565490.614
395.02491.788
383.917496.515
381.013496.109
436.463530.027
442.23547.189
433.785540.992
421.896585.791
446.166553.626
442.772530.311
495.774597.144
524575
Male
Female
Years
Discharges in Thousands
299172114795442
350197137805544
6903082308510740
10465013922666897
1137722573419132136
1318686519561124152
129764642766498170
Catheterizations
Open-Heart
Bypass
PCI
Carotid Endarterectomy
Pacemakers
Years
Procedures in Thousands
24.927
1411.9
24.819.2
Males
Females
Percent of Population
24.123.918.917.837.3
20.420.21511.333.4
NH White
NH Black
Hispanic
Asian
American Indian or Alaska Native
Percent of Population
46.938.239
30.221.326.5
NH White
NH Black
Hispanic
Sex and Race/Ethnicity
Percent of Population
151.6
62.7
66.4
33.2
Billions of Dollars
0.30.2
21.5
7.25.2
11.612.4
Men
Women
Percent of Population
206204202
204199197
205202201
1988-94
1999-02
2003-04
Mean Serum Total Cholesterol
2.64.34.86.310.917
5.37.88.611.516.728.1
14.417.121.126.13044.1
No MetS or DM
MetS w/o DM
MetS w/DM
DM only
Prior CVD
Prior CVD and DM
Deaths/1,000 Person Years
MBD000B3E50.xls
Chart3
15.215.921.3
8.216.112.1
NH Whites
NH Blacks
Hispanics
Percent of Population
OVERWT
1960-621971-741976-801988-942001-2004
Men10.712.212.820.630.2
Women15.716.817.126.034.0
Age-Adjusted Prevalence of Obesity* in Americans Ages 20-74 by Sex and Survey
NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 1999-2002
Source:Health US, 2004.
Obesity is defined as BMI of 30 plus.
&A
Page &P
OVERWT
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
cholchild
Estimated Percentage of Children With Serum Cholesterol of 170 mg/dl or More, United States
WhiteBlack
Males 0-9 Years2940
Females 0-9 Years3350
Males 10-19 Years2534
Females 10-19 Years2941
Estimated Percentage of Children With Serum Cholesterol of 170 mg/dL
or More, United States
Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey
NHES:1966-70; NHANES:1971-74 and 1988-94
1966-701971-741988-94
White Males163163155
Black Males171165166`
White Females170166163
Black Females172174168
`
cholchild
&A
Page &P
White
Black
Percent of Population
diabetes
1966-70
1971-74
1988-94
Mean Total Blood Cholesterol
Strokerace
NH WhitesNH BlacksMexican Americans
Men6.210.310.4
Women4.712.611.3
Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Americans Age 20 and Older by Sex and Race/Ethnicity
NHANES: 1999-2002
WhitesBlacksMexican Americans
122.95.46.4
Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Women Ages 25-64
by Education and Race/Ethnicity
NHANES III: 1988-94
&A
Page &P
Strokerace
NH Whites
NH Blacks
Mexican Americans
Percent of Population
Hdl&Ldl
Whites
Blacks
Mexican Americans
Years of Education
Percent of Population
smokhschool
Relative Risk of Deaths due to StrokeCompared to Non-Hispanic Whites, by Race/Ethnicity and Age Groups, U.S., 1997
Non-Hispanic BlacksAmerican Indians/ Alaska NativesAsian/Pacific IslandersHispanics
35-444.01.91.31.3
45-543.91.31.31.3
55-643.01.51.41.2
65-741.90.91.10.9
75-841.20.81.00.6
85+0.90.40.70.5
Risk for Stroke Mortality Among Racial/Ethnic Groups Compared With Non-Hispanic Whites,
by Age Groups
United States: 1997
smokhschool
35-44
45-54
55-64
65-74
75-84
85+
Race/Ethnicity
Relative Risk
Metsyndr.
Estiamted % of Americans Age 20 and Over with High-Risk LDL-Cholesterol of 130 mg/dL or More by Race and Sex
MenWomen
Total Population43.135.8
NH Whites43.836.9
NH Blacks36.034.5
Mexican Americans43.731.3
Age-Adjusted Prevalence of Americans Age 20 and Older With
LDL-Cholesterol of 130 mg/dL or Higher by Race/Ethnicity and Sex
United States:1999-2002
MenWomen
Total33.612.6
NH Whites34.512.4
NH Blacks22.711.3
Mexican Americans34.415.4
Estimated Age-Adjusted (2000) Prevalence of Adults Age 20 and Over With
HDL-Cholesterol Under 40 mg/dL by Race and Sex
United States: NHANES 1999-2002
Metsyndr.
Men
Women
Percent of Population
PhysicAct.
Men
Women
Percent of Population
smokmf
`NH WhitesNH BlacksHispanics
Males24.914.024.8
Females27.011.919.2
Prevalence of High School Students in Grades 9-12 Reporting Current Cigarette Use
Within the last 30 days by Race/Ethnicity and Sex
YRBS: 2005
&A
Page &P
smokmf
Males
Females
Percent of Population
NHANESrf
CHD MortalityCVD MortalityTotal Mortality
No MetS or DM2.65.314.4
MetS w/o DM4.37.817.1
MetS w/DM4.88.621.1
DM only6.311.526.1
Prior CVD10.916.730.0
Prior CVD and DM17.028.144.1
Total Mortality Rates in US Adults Age 30-75, with Metabolic Syndrome, With and Without Diabetes and Pre-Existing CVD
NHANES1976-80 Follow-Up Study
NHANESrf
No MetS or DM
MetS w/o DM
MetS w/DM
DM only
Prior CVD
Prior CVD and DM
Deaths/1,000 Person Years
oweight hs
% of high school students who participated in vigorous or moderate physical physical activity in past 7 days
NH WhiteNH BlackHispanicBMI
-
Overweight and ObesityYouthOverweight (BMI > 25)Obesity (BMI > 30)
23 million children & adolescents are Overweight or Obese 31.9% of the Population11 million Overweight12 million Obese
1971-1974 to 2003-2006Overweight from 4.0% to 17.0% (ages 6-11)Overweight from 6.1% to 17.6% (ages 12-19)
WorldwideIn 2005,number of overweight children under the age of 5 was 20 million
-
Trends in prevalence of overweight among U.S. children and adolescents by age and survey. (NHANES, 1971-74, 1976-80, 1988-94 and 2001-2004). Source: Health, United States, 2007. NCHS.
Chart1
46.511.317.5
6.1510.517
1971-74
1976-80
1988-94
2001-2004
Percent of Population
OVERWT
1960-621971-741976-801988-942001-2004
Men10.712.212.820.630.2
Women15.716.817.126.034.0
Age-Adjusted Prevalence of Obesity* in Adults Ages 20-74 by Sex and Survey
NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 2001-2004
Source:Health US, 2004.
Obesity is defined as BMI of 30 plus.
&A
Page &P
OVERWT
00000
00000
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
cholchild
Estimated Percentage of Children With Serum Cholesterol of 170 mg/dl or More, United States
WhiteBlack
Males 0-9 Years2940
Females 0-9 Years3350
Males 10-19 Years2534
Females 10-19 Years2941
Estimated Percentage of Children With Serum Cholesterol of 170 mg/dL
or More, United States
Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey
NHANES:1976-80,1988-94, 1999-02 and 2003-04
1976-801988-941999-022003-04
White Males163163155156
Black Males171165166161`
White Females170166163164
Black Females172174168161
`
cholchild
00
00
00
00
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White
Black
Percent of Population
diabetes
0000
0000
0000
0000
1976-80
1988-94
1999-02
2003-04
Mean Total Blood Cholesterol
Strokerace
NH WhitesNH BlacksMexican Americans
Men6.710.711.0
Women5.613.210.9
Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Adults Age 20 and Older by Sex and Race/Ethnicity
NHANES: 1999-2004
WhitesBlacksMexican Americans
122.95.46.4
Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Women Ages 25-64
by Education and Race/Ethnicity
NHANES III: 1988-94
OLD
Winkleby et al.
NH WhitesNH BlacksMexican Americans
Less than high school7.512.010.1
High school5.69.76.0
More than high school4.29.89.8
Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Americans Age 18+
by Education, Race/Ethnicity and Years of Education
NHANES: 1999-2004
`
NCHS and NHLBI.
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Strokerace
000
000
NH Whites
NH Blacks
Mexican Americans
Percent of Population
Hdl&Ldl
000
000
000
000
Whites
Blacks
Mexican Americans
Years of Education
Percent of Population
smokhschool
000
000
000
Less than high school
High school
More than high school
Percent of Population
Metsyndr.
Relative Risk of Deaths due to StrokeCompared to Non-Hispanic Whites, by Race/Ethnicity and Age Groups, U.S., 1997
Non-Hispanic BlacksAmerican Indians/ Alaska NativesAsian/Pacific IslandersHispanics
35-444.01.91.31.3
45-543.91.31.31.3
55-643.01.51.41.2
65-741.90.91.10.9
75-841.20.81.00.6
85+0.90.40.70.5
Risk for Stroke Mortality Among Racial/Ethnic Groups Compared With Non-Hispanic Whites,
by Age Groups
United States: 1997
Metsyndr.
000000
000000
000000
000000
35-44
45-54
55-64
65-74
75-84
85+
Race/Ethnicity
Relative Risk
PhysicAct.
Estiamted % of Americans Age 20 and Over with High-Risk LDL-Cholesterol of 130 mg/dL or More by Race and Sex
MenWomen
Total Population32.032.0
NH Whites32.034.0
NH Blacks32.030.0
Mexican Americans39.031.0
Age-Adjusted Prevalence of Americans Age 20 and Older With
LDL-Cholesterol of 130 mg/dL or Higher by Race/Ethnicity and Sex
United States: 2003-04
MenWomen
Total259
NH Whites269
NH Blacks167
Mexican Americans2813
Estimated Age-Adjusted (2000) Prevalence of Adults Age 20 and Over With
HDL-Cholesterol Under 40 mg/dL by Race and Sex
United States: NHANES 2003-2004
PhysicAct.
00
00
00
00
Men
Women
Percent of Population
smokmf
00
00
00
00
Men
Women
Percent of Population
NHANESrf
`NH WhitesNH BlacksHispanics
Males24.914.024.8
Females27.011.919.2
Prevalence of High School Students in Grades 9-12 Reporting Current Cigarette Use
Within the last 30 days by Race/Ethnicity and Sex
YRBS: 2005
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NHANESrf
00
00
00
Males
Females
Percent of Population
oweight hs
CHD MortalityCVD MortalityTotal Mortality
No MetS or DM2.65.314.4
MetS w/o DM4.37.817.1
MetS w/DM4.88.621.1
DM only6.311.526.1
Prior CVD10.916.730.0
Prior CVD and DM17.028.144.1
Total Mortality Rates in US Adults Age 30-75, with Metabolic Syndrome, With and Without Diabetes and Pre-Existing CVD
NHANES1976-80 Follow-Up Study
oweight hs
000000
000000
000000
No MetS or DM
MetS w/o DM
MetS w/DM
DM only
Prior CVD
Prior CVD and DM
Deaths/1,000 Person Years
RFNHANES
% of high school students who participated in vigorous or moderate physical physical activity in past 7 days
NH WhiteNH BlackHispanicBMI
-
Prevalence of overweight among students in grades 9-12 by race/ethnicity and sex (YRBS: 2007). Source: MMWR. 2008 57: No. SS-4. BMI 95th percentile or higher by age and sex of the CDC 2000 growth chart. NH non-Hispanic.
Chart13
15.716.618.3
12.821.417.9
NH Whites
NH Blacks
Hispanics
Percent of Population
OVERWT
1960-621971-741976-801988-942001-2004
Men10.712.212.820.630.2
Women15.716.817.126.034.0
Age-Adjusted Prevalence of Obesity* in Adults Ages 20-74 by Sex and Survey
NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 2001-2004
Source:Health US, 2007
Obesity is defined as BMI of 30 plus.
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OVERWT
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
cholchild
Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey
NHANES:1976-80,1988-94, 1999-02, 2003-04 and 2005-06
1976-801988-941999-022003-042005-06
White Males163163155156151
Black Males171165166161161
White Females170166163164163
Black Females172174168161160
Mex. Am. Males157158
Mex. Am. Females158161
cholchild
2940
3350
2534
2941
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White
Black
Percent of Population
diabetes
1976-80
1988-94
1999-02
2003-04
2005-06
Mean Total Blood Cholesterol
Hdl&Ldl
NH WhitesNH BlacksMexican Americans
Men5.814.911.3
Women6.113.114.2
Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Adults Age 20 and Older by Sex and Race/Ethnicity
NHANES: 2005-2006
NH WhitesNH BlacksMexican Americans
Less than high school8.115.313.0
High school6.117.512.2
More than high school5.410.812.0
Prevalence of Physician Diagnosed Type 2 Diabetes in Americans Age 18+
by Education, Race/Ethnicity and Years of Education
NHANES: 2005-2006
`
NCHS and NHLBI.
MaleFemale
Physician diagnosed 1988-945.45.4
Undiagnosed 1988-943.42.5
Physician diagnosed 2005-067.48.0
Undiagnosed 2005-063.82.1
Trends in Diabetes Prevalence in Adults Age 20 and Older, By Sex
NHANES: 1988-94 and 2005-2006
Source: NCHS and NHLBI.
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Hdl&Ldl
000
000
NH Whites
NH Blacks
Mexican Americans
Percent of Population
smokhschool
000
000
000
Less than high school
High school
More than high school
Percent of Population
Metsyndr.
00
00
00
00
Male
Female
Percent of Population
PhysicAct.
Estiamted % of Americans Age 20 and Over with High-Risk LDL-Cholesterol of 130 mg/dL or More by Race and Sex
MenWomen
Total Population32.032.0
NH Whites32.034.0
NH Blacks32.030.0
Mexican Americans39.031.0
Age-Adjusted Prevalence of Americans Age 20 and Older With
LDL-Cholesterol of 130 mg/dL or Higher by Race/Ethnicity and Sex
United States: 2003-04
MenWomen
Total259
NH Whites269
NH Blacks167
Mexican Americans2813
Estimated Age-Adjusted (2000) Prevalence of Adults Age 20 and Over With
HDL-Cholesterol Under 40 mg/dL by Race and Sex
United States: NHANES 2003-2004
PhysicAct.
00
00
00
00
Men
Women
Percent of Population
smokmf
00
00
00
00
Men
Women
Percent of Population
NHANESrf
`NH WhitesNH BlacksHispanics
Males23.814.918.7
Females22.58.414.6
Prevalence of High School Students in Grades 9-12 Reporting Current Cigarette Use
Within the last 30 days by Race/Ethnicity and Sex
YRBS: 2007
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NHANESrf
Males
Females
Percent of Population
oweightchild
CHD MortalityCVD MortalityTotal Mortality
No MetS or DM2.65.314.4
MetS w/o DM4.37.817.1
MetS w/DM4.88.621.1
DM only6.311.526.1
Prior CVD10.916.730.0
Prior CVD and DM17.028.144.1
Total Mortality Rates in US Adults Age 30-75, with Metabolic Syndrome, With and Without Diabetes and Pre-Existing CVD
NHANES1976-80 Follow-Up Study
oweightchild
000000
000000
000000
No MetS or DM
MetS w/o DM
MetS w/DM
DM only
Prior CVD
Prior CVD and DM
Deaths/1,000 Person Years
RFNHANES
NH WhiteNH BlackHispanic
Male46.141.338.6
Female27.921.021.9
Prevalence of Students in Grades 9-12 Who Met Currently Recommended Levels of
Physical Activity During the Past 7 Days by Race/Ethnicity and Sex
YRBS: 2007Centers for disease control and Prevention. Youth risk Behavior Surveillance - United States, 2007. MMWR 2008;57(ss#4)
Men '01Women '01Men '05Women '05
NH White50.646.052.349.6
NH Black40.331.445.336.1
Hispanic42.036.341.940.5
Other race43.141.245.746.6
Prevalence of Leisure-Time Physical Activity Among Adults Age 18+ by Race/Ethnicity, and Sex
BRFSS: 2001, 2005
MMWR, vol.56, no.46, 11/23/07.
NH WhiteNH BlackHispanic
Male16.721.818.8
Female28.242.135.2
Prevalence of Students in Grades 9-12 Who Did Not Meet Currently Recommended Levels of
Moderate-to-Vigorous Physical Activity During the Past 7 Days by Race/Ethnicity and Sex
YRBS: 2007"Currently recommended levels" are defined as activity that increases heart rates and made them breathe hard some of the time for a total of >60 or more minutes/day on >5 or more out of 7 days predeeding the survey.
6-1112-1516-19
Male48.911.910.020-2930-3940-4950-5960-6970+
Female34.73.45.4Male10.39.99.37.16.53.5
Female7.46.56.65.75.82.2
Prevalence of Children Ages 6-19 Who Attained sufficient MVPA to Meet Public Health Recommendations of >60 or More
Minutes/Day on >5 or more of 7 Days by Sex and AgeMean Minutes/Day of MVPA in Bouts of 10+ Minutes by Sex and Age
NHANES 2003-2004
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical Activity in the United States Measured by Accerometer. MSSE 2008; 40: 181-188.
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical Activity in the United States Measured by Accerometer. MSSE 2008; 40: 181-188.
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RFNHANES
NH White
NH Black
Hispanic
Percent of Population
choladults
Men '01
Women '01
Men '05
Women '05
Percent of Population
Hispanicrisk
NH White
NH Black
Hispanic
Percent of Population
CHDlowrisk
6-11
12-15
16-19
Percent of Population
SubclinicalDLJ
20-29
30-39
40-49
50-59
60-69
70+
Mean Minutes/Day
Subclinical
1212
Under 89-111213-1516 and UpWhites76.644.218.2Whites60.649.120.1
Men27.739.731.526.611.5Blacks26.724.116.4Blacks34.314.112.8
Women16.734.324.122.811.2Mexican Americans34.317.317.5Mexican Americans12.219.510.3
Prevalence of Current Smoking for Men Ages 18-24 by Education and Race/EthnicityPrevalence of Current Smoking for Women Ages 18-24 by Education and Race/Ethnicity
Current Cigarette Smoking for Adults Age 18 and Over by Education and SexUnited States: 1988-94United States: 1988-94
United States: 1998
Non-Hispanic White MenNon-Hispanic White WomenNon-Hispanic Black MenNon-Hispanic Black WomenHispanic MenHispanic WomenMenWomen
-
Nutrition
-
Average consumption: Whole Grains Vegetables Fruits Meat Adults0.5-0.7 to 2.0 1.2 to 2.1 1.1 to 1.81.5 to 3.7(rec: 6 8) (rec: 4 5) (rec: 4 5)
Children0.4 to 0.5 0.8 to 0.9 0.8 to 0.92.1 to 3.4(rec: 6) (rec: 3 4) (rec: 4) servings per day servings per day servings per day servings per week
Sugar Sweetened Beverages: Adults 6 18 servings (8 ounces) per weekChildren 8 23 servings per weekSweets and Bakery Desserts: Adults 4 8 servings per dayChildren 9 10 servings per week (rec: less than 5 per week) (rec: 0 per week)
-
Figure 16-1. Age-Adjusted Trends in Macronutrients and Total Calories Consumed by U.S. Adults (20-74 years), 1971-2004.Source: National Center for Health Statistics. Health, United States 2007, With Chartbook on Trends in the Health of Americans. Hyattsville, Md: National Center for Health Statistics; 2007 Men Women
-
Figure 16-3. Total U.S. Food Expenditures Away from Home and At Home, 1977 and 2007. Source: United States Department of Agriculture Economic Research Service
-
RecommendationsChoose lean meats and poultryPrepare without added saturated or trans fatRemove visible fat from meat and skin from poultryChoose white meat when eating poultryGrill, bake or broil meats and poultry
Select fat-free, 1 percent fat, and low-fat dairy products
Reduce trans fatCut back on foods containing partially hydrogenated vegetable oilsLimit cakes, cookies, crackers, pastries, pies, muffins, doughnuts, and French fries
Eat less than 300 milligrams of cholesterol each day200mg per egg yolk, Shellfish 50-100mg per cup, 30mg per cup whole milk
Cut back on beverages and foods with added sugars
Eat less than 2,300 milligrams of sodium per day
Drink in moderationone drink per day for womentwo drinks per day for men
-
Lipid GoalsTotal Cholesterol 40 at leastEliminate Saturated FatUse Unsaturated Fat insteadReduce alcohol consumptionIncrease exercise
-
Lipid Goals
LDL Cholesterol
-
Trans FatHydrogenated
Saturated FatAnimal FatPalm oil / Palm kernel oilCoconut oil
Monounsaturated Fat(may decrease LDL)(may maintain HDL)
Olive oilPeanut oilCanola oilAvocado, Nuts, Seed
Polyunsaturated Fat(may decrease LDL and HDL)
Safflower oilSunflower oilCorn oilSoybean oilOmega 3 and Omega 6
-
Exercise
-
Recommendations
-
Recommendations
-
Physical InactivityAdults2007 Prevalence of regular physical activity is 30.8%Males 33.9%Females 28.9%66.3% of Women report NEVER engaging in vigorous physical activity56.0% of Men report NEVER engaging in vigorous physical activity
-
Physical Inactivity
Youth61.5% of children ages 9-13 DO NOT participate in any organized physical activity during non-school hours
22.6% DO NOT engage in any free-time physical activity
Girls by the age of 16 or 17:31% white girls and 56% of black girls have NO habitual leisure-time activity
Students grades 9-12:24.9% spent 3 or more hours per day using computers outside of school
35.4% spent 3 or more hours per day watching TV
-
*Note: Currently recommended levels is defined as activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes/day on 5 or more of the 7 days preceding the survey. Prevalence of students in grades 9-12 who met currently recommended levels of physical activity during the past 7 days by race/ ethnicity and sex (YRBS: 2007). Source: MMWR. 2008;57:No. SS-4. NH non-Hispanic.
Chart9
46.141.338.6
27.92121.9
NH White
NH Black
Hispanic
Percent of Population
OVERWT
1960-621971-741976-801988-942001-2004
Men10.712.212.820.630.2
Women15.716.817.126.034.0
Age-Adjusted Prevalence of Obesity* in Adults Ages 20-74 by Sex and Survey
NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 2001-2004
Source:Health US, 2007
Obesity is defined as BMI of 30 plus.
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OVERWT
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
cholchild
Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey
NHANES:1976-80,1988-94, 1999-02, 2003-04 and 2005-06
1976-801988-941999-022003-042005-06
White Males163163155156151
Black Males171165166161161
White Females170166163164163
Black Females172174168161160
Mex. Am. Males157158
Mex. Am. Females158161
cholchild
11
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#REF!
#REF!
Percent of Population
diabetes
1976-80
1988-94
1999-02
2003-04
2005-06
Mean Total Blood Cholesterol
Hdl&Ldl
NH WhitesNH BlacksMexican Americans
Men5.814.911.3
Women6.113.114.2
Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Adults Age 20 and Older by Sex and Race/Ethnicity
NHANES: 2005-2006
NH WhitesNH BlacksMexican Americans
Less than high school8.115.313.0
High school6.117.512.2
More than high school5.410.812.0
Prevalence of Physician Diagnosed Type 2 Diabetes in Americans Age 18+
by Education, Race/Ethnicity and Years of Education
NHANES: 2005-2006
`
NCHS and NHLBI.
MaleFemale
Physician diagnosed 1988-945.45.4
Undiagnosed 1988-943.42.5
Physician diagnosed 2005-067.48.0
Undiagnosed 2005-063.82.1
Trends in Diabetes Prevalence in Adults Age 20 and Older, By Sex
NHANES: 1988-94 and 2005-2006
Source: NCHS and NHLBI.
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Hdl&Ldl
NH Whites
NH Blacks
Mexican Americans
Percent of Population
smokhschool
Less than high school
High school
More than high school
Percent of Population
Metsyndr.
Male
Female
Percent of Population
PhysicAct.
Estiamted % of Americans Age 20 and Over with High-Risk LDL-Cholesterol of 130 mg/dL or More by Race and Sex
MenWomen
Total Population32.032.0
NH Whites32.034.0
NH Blacks32.030.0
Mexican Americans39.031.0
Age-Adjusted Prevalence of Americans Age 20 and Older With
LDL-Cholesterol of 130 mg/dL or Higher by Race/Ethnicity and Sex
United States: 2003-04
MenWomen
Total259
NH Whites269
NH Blacks167
Mexican Americans2813
Estimated Age-Adjusted (2000) Prevalence of Adults Age 20 and Over With
HDL-Cholesterol Under 40 mg/dL by Race and Sex
United States: NHANES 2003-2004
PhysicAct.
Men
Women
Percent of Population
smokmf
Men
Women
Percent of Population
NHANESrf
`NH WhitesNH BlacksHispanics
Males23.814.918.7
Females22.58.414.6
Prevalence of High School Students in Grades 9-12 Reporting Current Cigarette Use
Within the last 30 days by Race/Ethnicity and Sex
YRBS: 2007
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NHANESrf
Males
Females
Percent of Population
oweightchild
CHD MortalityCVD MortalityTotal Mortality
No MetS or DM2.65.314.4
MetS w/o DM4.37.817.1
MetS w/DM4.88.621.1
DM only6.311.526.1
Prior CVD10.916.730.0
Prior CVD and DM17.028.144.1
Total Mortality Rates in US Adults Age 30-75, with Metabolic Syndrome, With and Without Diabetes and Pre-Existing CVD
NHANES1976-80 Follow-Up Study
oweightchild
No MetS or DM
MetS w/o DM
MetS w/DM
DM only
Prior CVD
Prior CVD and DM
Deaths/1,000 Person Years
RFNHANES
NH WhiteNH BlackHispanic
Male46.141.338.6
Female27.921.021.9
Prevalence of Students in Grades 9-12 Who Met Currently Recommended Levels of
Physical Activity During the Past 7 Days by Race/Ethnicity and Sex
YRBS: 2007Centers for disease control and Prevention. Youth risk Behavior Surveillance - United States, 2007. MMWR 2008;57(ss#4)
Men '01Women '01Men '05Women '05
NH White50.646.052.349.6
NH Black40.331.445.336.1
Hispanic42.036.341.940.5
Other race43.141.245.746.6
Prevalence of Leisure-Time Physical Activity Among Adults Age 18+ by Race/Ethnicity, and Sex
BRFSS: 2001, 2005
MMWR, vol.56, no.46, 11/23/07.
NH WhiteNH BlackHispanic
Male16.721.818.8
Female28.242.135.2
Prevalence of Students in Grades 9-12 Who Did Not Meet Currently Recommended Levels of
Moderate-to-Vigorous Physical Activity During the Past 7 Days by Race/Ethnicity and Sex
YRBS: 2007"Currently recommended levels" are defined as activity that increases heart rates and made them breathe hard some of the time for a total of >60 or more minutes/day on >5 or more out of 7 days predeeding the survey.
6-1112-1516-19
Male48.911.910.020-2930-3940-4950-5960-6970+
Female34.73.45.4Male10.39.99.37.16.53.5
Female7.46.56.65.75.82.2
Prevalence of Children Ages 6-19 Who Attained sufficient MVPA to Meet Public Health Recommendations of >60 or More
Minutes/Day on >5 or more of 7 Days by Sex and AgeMean Minutes/Day of MVPA in Bouts of 10+ Minutes by Sex and Age
NHANES 2003-2004
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical Activity in the United States Measured by Accerometer. MSSE 2008; 40: 181-188.
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical Activity in the United States Measured by Accerometer. MSSE 2008; 40: 181-188.
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RFNHANES
NH White
NH Black
Hispanic
Percent of Population
choladults
Men '01
Women '01
Men '05
Women '05
Percent of Population
Hispanicrisk
NH White
NH Black
Hispanic
Percent of Population
CHDlowrisk
6-11
12-15
16-19
Percent of Population
SubclinicalDLJ
20-29
30-39
40-49
50-59
60-69
70+
Mean Minutes/Day
Subclinical
1212
Under 89-111213-1516 and UpWhites76.644.218.2Whites60.649.120.1
Men27.739.731.526.611.5Blacks26.724.116.4Blacks34.314.112.8
Women16.734.324.122.811.2Mexican Americans34.317.317.5Mexican Americans12.219.510.3
Prevalence of Current Smoking for Men Ages 18-24 by Education and Race/EthnicityPrevalence of Current Smoking for Women Ages 18-24 by Education and Race/Ethnicity
Current Cigarette Smoking for Adults Age 18 and Over by Education and SexUnited States: 1988-94United States: 1988-94
United States: 1998
Non-Hispanic White MenNon-Hispanic White WomenNon-Hispanic Black MenNon-Hispanic Black WomenHispanic MenHispanic WomenMenWomen
-
*Prevalence of children ages 6-19 who attained sufficient moderate-to-vigorous physical activity to meet public health recommendations of >60 minutes/day on >5 of 7 days by sex and age. (NHANES: 2003-04). Source: MSSE 2008;40:181-8.
Chart12
48.911.910
34.73.45.4
6-11
12-15
16-19
Percent of Population
OVERWT
1960-621971-741976-801988-942001-2004
Men10.712.212.820.630.2
Women15.716.817.126.034.0
Age-Adjusted Prevalence of Obesity* in Adults Ages 20-74 by Sex and Survey
NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 2001-2004
Source:Health US, 2007
Obesity is defined as BMI of 30 plus.
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OVERWT
1960-62
1971-74
1976-80
1988-94
2001-2004
Percent of Population
cholchild
Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey
NHANES:1976-80,1988-94, 1999-02, 2003-04 and 2005-06
1976-801988-941999-022003-042005-06
White Males163163155156151
Black Males171165166161161
White Females170166163164163
Black Females172174168161160
Mex. Am. Males157158
Mex. Am. Females158161
cholchild
11
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#REF!
#REF!
Percent of Population
diabetes
1976-80
1988-94
1999-02
2003-04
2005-06
Mean Total Blood Cholesterol
Hdl&Ldl
NH WhitesNH BlacksMexican Americans
Men5.814.911.3
Women6.113.114.2
Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Adults Age 20 and Older by Sex and Race/Ethnicity
NHANES: 2005-2006
NH WhitesNH BlacksMexican Americans
Less than high school8.115.313.0
High school6.117.512.2
More than high school5.410.812.0
Prevalence of Physician Diagnosed Type 2 Diabetes in Americans Age 18+
by Education, Race/Ethnicity and Years of Education
NHANES: 2005-2006
`
NCHS and NHLBI.
MaleFemale
Physician diagnosed 1988-945.45.4
Undiagnosed 1988-943.42.5
Physician diagnosed 2005-067.48.0
Undiagnosed 2005-063.82.1
Trends in Diabetes Prevalence in Adults Age 20 and Older, By Sex
NHANES: 1988-94 and 2005-2006
Source: NCHS and NHLBI.
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Hdl&Ldl
NH Whites
NH Blacks
Mexican Americans
Percent of Population
smokhschool
Less than high school
High school
More than high school
Percent of Population
Metsyndr.
Male
Female
Percent of Population
PhysicAct.
Estiamted % of Americans Age 20 and Over with High-Risk LDL-Cholesterol of 130 mg/dL or More by Race and Sex
MenWomen
Total Population32.032.0
NH Whites32.034.0
NH Blacks32.030.0
Mexican Americans39.031.0
Age-Adjusted Prevalence of Americans Age 20 and Older With
LDL-Cholesterol of 130 mg/dL or Higher by Race/Ethnicity and Sex
United States: 2003-04
MenWomen
Total259
NH Whites269
NH Blacks167
Mexican Americans2813
Estimated Age-Adjusted (2000) Prevalence of Adults Age 20 and Over With
HDL-Cholesterol Under 40 mg/dL by Race and Sex
United States: NHANES 2003-2004
PhysicAct.
Men
Women
Percent of Population
smokmf
Men
Women
Percent of Population
NHANESrf
`NH WhitesNH BlacksHispanics
Males23.814.918.7
Females22.58.414.6
Prevalence of High School Students in Grades 9-12 Reporting Current Cigarette Use
Within the last 30 days by Race/Ethnicity and Sex
YRBS: 2007
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NHANESrf
Males
Females
Percent of Population
oweightchild
CHD MortalityCVD MortalityTotal Mortality
No MetS or DM2.65.314.4
MetS w/o DM4.37.817.1
MetS w/DM4.88.621.1
DM only6.311.526.1
Prior CVD10.916.730.0
Prior CVD and DM17.028.144.1
Total Mortality Rates in US Adults Age 30-75, with Metabolic Syndrome, With and Without Diabetes and Pre-Existing CVD
NHANES1976-80 Follow-Up Study
oweightchild
No MetS or DM
MetS w/o DM
MetS w/DM
DM only
Prior CVD
Prior CVD and DM
Deaths/1,000 Person Years
RFNHANES
NH WhiteNH BlackHispanic
Male46.141.338.6
Female27.921.021.9
Prevalence of Students in Grades 9-12 Who Met Currently Recommended Levels of
Physical Activity During the Past 7 Days by Race/Ethnicity and Sex
YRBS: 2007Centers for disease control and Prevention. Youth risk Behavior Surveillance - United States, 2007. MMWR 2008;57(ss#4)
Men '01Women '01Men '05Women '05
NH White50.646.052.349.6
NH Black40.331.445.336.1
Hispanic42.036.341.940.5
Other race43.141.245.746.6
Prevalence of Leisure-Time Physical Activity Among Adults Age 18+ by Race/Ethnicity, and Sex
BRFSS: 2001, 2005
MMWR, vol.56, no.46, 11/23/07.
NH WhiteNH BlackHispanic
Male16.721.818.8
Female28.242.135.2
Prevalence of Students in Grades 9-12 Who Did Not Meet Currently Recommended Levels of
Moderate-to-Vigorous Physical Activity During the Past 7 Days by Race/Ethnicity and Sex
YRBS: 2007"Currently recommended levels" are defined as activity that increases heart rates and made them breathe hard some of the time for a total of >60 or more minutes/day on >5 or more out of 7 days predeeding the survey.
6-1112-1516-19
Male48.911.910.020-2930-3940-4950-5960-6970+
Female34.73.45.4Male10.39.99.37.16.53.5
Female7.46.56.65.75.82.2
Prevalence of Children Ages 6-19 Who Attained sufficient MVPA to Meet Public Health Recommendations of >60 or More
Minutes/Day on >5 or more of 7 Days by Sex and AgeMean Minutes/Day of MVPA in Bouts of 10+ Minutes by Sex and Age
NHANES 2003-2004
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical Activity in the United States Measured by Accerometer. MSSE 2008; 40: 181-188.
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical Activity in the United States Measured by Accerometer. MSSE 2008; 40: 181-188.
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RFNHANES
NH White
NH Black
Hispanic
Percent of Population
choladults
Men '01
Women '01
Men '05
Women '05
Percent of Population
Hispanicrisk
NH White
NH Black
Hispanic
Percent of Population
CHDlowrisk
6-11
12-15
16-19
Percent of Population
SubclinicalDLJ
20-29
30-39
40-49
50-59
60-69
70+
Mean Minutes/Day
Subclinical
1212
Under 89-111213-1516 and UpWhites76.644.218.2Whites60.649.120.1
Men27.739.731.526.611.5Blacks26.724.116.4Blacks34.314.112.8
Women16.734.324.122.811.2Mexican Americans34.317.317.5Mexican Americans12.219.510.3
Prevalence of Current Smoking for Men Ages 18-24 by Education and Race/EthnicityPrevalence of Current Smoking for Women Ages 18-24 by Education and Race/Ethnicity
Current Cigarette Smoking for Adults Age 18 and Over by Education and SexUnited States: 1988-94United States: 1988-94
United States: 1998
Non-Hispanic White MenNon-Hispanic White WomenNon-Hispanic Black MenNon-Hispanic Black WomenHispanic MenHispanic WomenMenWomen
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SummarySmoking is the most important preventable cause of morbidity and premature mortality Worldwide
Smoking reduces the normal life expectancy by an average of 13-15 years
20% high school students were smokers
6% middle school students were smokers
2,400 Americans die of Cardiovascular disease each day one death every 37 seconds
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Summary145 million Americans are Overweight or Obese 66.7% of the Adult Population
23 million children & adolescents are Overweight or Obese 31.9% of the Population
66.3% of Women report NEVER engaging in vigorous physical activity
56.0% of Men report NEVER engaging in vigorous physical activity
61.5% of children ages 9-13 DO NOT participate in any organized physical activity during non-school hours
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Take Home MessageDO NOT SMOKE
Eat a Heart Healthy Diet
Eat and Drink in Moderation
Be ACTIVE for you, for your heart, and for your children!
*********************************************sometimes we think of heart conditions our own area of interestmolecular biology and pathophysiologyother aspects fuzzy
goal: replace black box with information
four components
wont discuss valvular conditions***************