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NHANES: A Potential Database for Risk Assessment Clifford Johnson Centers for Disease Control and Prevention National 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 OP96S022 National Health and Nutrition Examination Surveys Survey NHES I NHES II NHES III NHANES I NHANES II HHANES NHANES III NHANES Dates 1960-62 1963-65 1966-70 1971-75 1976-80 1982-84 1988-94 1999- Ages 18-79 years 6-11 years 12-17 years 1-74 years 6 mo.-74 years 6 mo.-74 years 2 mo. + All ages OP96S025 NHANES sample design • 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 process Identification of sample persons Interview Mobile Examination Center Home Examination Longitudinal Followup OP96S028 NHANES household interview • Broad range of health conditions • Health care coverage and need • Environmental and occupational exposures • Health behaviors • Nutrition and dietary supplements OP96S039 NHANES Mobile Exam Center NHANES topics • • • • • • • Cardiovascular disease Diabetes, lower extremity disease Bone status, osteoporosis Oral health Vision Hearing and balance Fitness and strength OP96S035 NHANES topics • • • • • • • Nutrition Anthropometry Mental health Risk behaviors Reproductive health Environmental exposures Infectious diseases OP96S036 NHANES nutrition assessments • Dietary nutrient intake • Anthropometric measurements • Nutritional biochemistries and hematologic tests • Physical examination • Interview OP96S060 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 OP96S058
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