Geographical variation in the prevalence of obesity, metabolic syndrome, and diabetes among US adults

Abstract

Cardiovascular disease (CVD) and type 2 diabetes remain significant public health concerns. Targeting of prevention efforts by geographical location has been suggested by the Institute of Medicine to coincide with the presence of area-based risk. The metabolic syndrome (MetS) is a stronger risk factor than is obesity for the prediction of future CVD and diabetes, yet its prevalence has not previously been described geographically. Our objective is to determine geographical variation in the prevalence of obesity, MetS, and diabetes among US adults. We assessed the prevalence of obesity, MetS, and diabetes by US census division, and the prevalence of obesity, MetS, and diabetes for each sex and racial/ethnic group by US region among 9826 US non-Hispanic white, non-Hispanic black, and Hispanic adults aged 20–65 years participating in the National Health and Nutrition Examination Survey 1999–2014. We also compared a sex- and race/ethnicity-specific MetS severity score by geographical area. The prevalence of obesity, MetS, and diabetes varied by US census division and region, with overall similarity by geographical area in the prevalence of each of these conditions. The prevalence of MetS was particularly high (≥35%) in the West North Central, West South Central, and East South Central and low (30%) in the Pacific, New England, and Mid-Atlantic divisions. Some of the geographical variation appeared due to differences among non-Hispanic white females, who had a high prevalence of MetS (>32%) in the Midwest and South and a low prevalence of MetS (24%) in the West and Northeast. Geographical differences in MetS imply variation in the risk for future CVD and diabetes, with more elevated risk in the center of the United States. As MetS is a stronger risk factor for prediction of CVD and T2DM than is obesity, these differences are potentially important for prompting public health efforts toward surveillance and prevention in high-risk areas.

Geographical variation in the prevalence of obesity and metabolic syndrome among US adolescents

“…Compared with a similar geographical survey of MetS among adults , we noted a wider difference for adolescents in MetS prevalence between the Midwest region and the South compared with other areas. Among adults, the difference in the divisions with the lowest and highest MetS prevalence was the Pacific at 29% and the West North Central at 40% (i.e.…”

“…These estimates of the prevalence of adolescent obesity based on in‐person measurements reflect a higher degree of obesity in the Midwest than reported in the prior survey based on parent‐reported heights and weights . A similar geographical discrepancy was previously seen among adults , who exhibited a prevalence of measured obesity that was higher in the Midwest than reported via phone surveys . This is not surprising given that self‐reported and parent‐reported height and weight estimates can result in up to 20–40% misclassification , highlighting the need for more accurate data such as these.…”

Sex differences in sympathetic activity in obesity and its related hypertension

“…The prevalence of obesity has been rapidly increasing over the past 50 years in the United States, particularly among women. [3][4][5] Body mass index (BMI) has long been used to define weight ranges. A healthy BMI is between 18.5 and 24.9 kg/m 2 , whereas obesity is defined by the National Institutes of Health as a BMI of 30 kg/m 2 and above.…”

Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US patients with haemophilia and obesity (PwHO) and their partners and caregivers

“…PwHO and their friends and families were seen as the most critical parties to improving the health of PwHO (Table S12). 25,26 An initial challenge is to ensure that PwHO understand that they are overweight or obese and that obesity can cause long-term health problems and to ensure that the diagnosis of overweight or obesity is explicitly carried forward as a medical problem on their treatment plans. For PwHO, setting realistic goals (62%) and support from family and friends (59%) were most critical to success.…”

“…Epidemiologic data suggest that the issue of obesity in the haemophilia community is at least as much of a problem as it is in the overall US population. 25,26 An initial challenge is to ensure that PwHO understand that they are overweight or obese and that obesity can cause long-term health problems and to en- In the adolescent population, strategies can be implemented to prevent further weight gain (grow into weight) and address social and family issues around eating habits. Adolescent barriers to maintaining weight were different than those of adults; adolescents were more exposed and more sensitive to food advertising.…”