Indicator Definitions – Nutrition, Physical Activity, and Weight Status

Poor nutrition and physical inactivity are significant risk factors for obesity and other chronic diseases, such as type 2 diabetes, heart disease, stroke, and certain cancers. Chronic diseases can also lead to disabilities and premature deaths. National public health efforts to prevent chronic diseases at every stage of life include promoting healthier nutrition, regular physical activity, and a healthy weight in places where people live, learn, work, and play. For example, the Active People, Healthy NationSM initiative aims to help 27 million Americans become more physically active.

Pictures of different people doing different activities, breast feeding, biking, smiling and picking veggies.

In addition to individual-level strategies to increase healthier behaviors, five action steps states and communities can take to reduce these risks for people they serve include:

1. Make physical activity safe and accessible for all.
2. Provide healthier food choices everywhere.
3. Provide breastfeeding resources.
4. Strengthen obesity prevention standards for early care and education (ECE) settings.
5. Spread and scale family healthy weight programs.

Definition Details

Consumed fruit less than one time daily among high school students
Population: Students in grades 9–12
Numerator: Number of students who reported consuming fruit (100% fruit juice and fruit – fresh, frozen, or canned) less than one time a day.
Denominator: Number of students.
Measure: Prevalence (crude)
Time Period of Case Definition: Past 7 days
Summary: Fruits and vegetables are good sources of complex carbohydrates, fiber, vitamins, minerals, and other substances that are important for good health.1 Dietary patterns with higher intakes of fruits and vegetables are associated with a decreased risk for some types of cancer, cardiovascular disease, and stroke and can help with weight management.1 However, in 2019 around 40% of high school students nationwide had eaten fruit or drunk 100% fruit juice less than one time per day.2 Strategies to help achieve this shift include choosing more whole fruits as snacks and including them in meals.
Notes: This indicator does not convey the cup equivalents of fruits consumed so these data cannot be directly compared to Healthy People 2030 targets; does not capture dietary intake of elementary and middle school students
Data Source: Youth Risk Behavior Surveillance System (YRBSS)
Related Objectives or Recommendations: Dietary Guidelines for Americans 2020-2025; Healthy People 2030 objective NWS-06. Increase fruit consumption by people aged 2 years and over
Related CDI Topic Area: Student Health
Reference 1: U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2020–2025. U.S. Department of Agriculture. U.S. Government Printing Office; 2020. https://www.dietaryguidelines.gov/.
Reference 2: Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity. Data, Trend and Maps. Centers for Disease Control and Prevention; 2022. https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html.

Consumed fruit less than one time daily among adults
Population: All adults
Numerator: Number of adults who reported consuming fruit (100% fruit juice and fruit – fresh, frozen, or canned) less than one time a day.
Denominator: Number of adults.
Measure: Prevalence (crude and age-adjusted)
Time Period of Case Definition: Past 30 days
Summary: The Dietary Guidelines for Americans, 2020-2025 recommends Americans eat more fruits and vegetables as part of a healthy diet, because they contribute important nutrients, can reduce the risk for many chronic diseases, and can also help with weight management.1  In 2021, nearly 2 out of 5 adults (39.9%) reported consuming fruit less than 1 time daily.2 Most people would benefit from increasing their intake of fruit, mostly as whole fruits in nutrient-dense forms. A wide variety of fruits are available in the U.S. marketplace, some year-round and others seasonally. Strategies to help achieve this shift include choosing more whole fruits as snacks and including them in meals.
Notes: This indicator does not convey the cup equivalents of fruits consumed so these data cannot be directly compared to Healthy People 2030 targets. The survey questions are part of the rotating core and adminstered every 4 years.
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Related Objectives or Recommendations: Healthy People 2030 objective: NWS-06. Increase fruit consumption by people aged 2 years and over
Related CDI Topic Area: None
Reference 1: U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2020–2025. U.S. Department of Agriculture. U.S. Government Printing Office; 2020. https://www.dietaryguidelines.gov/.
Reference 2: Division of Nutrition, Physical Activity, and Obesity. Data, Trend and Maps. Centers for Disease Control and Prevention; 2022. https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html.

Consumed vegetables less than one time daily among high school students
Population: Students in grades 9–12
Numerator: Number of respondents who reported consuming green salad, fried potatoes, other potatoes, and other vegetables less than one time a day.
Denominator: Number of students.
Measure: Prevalence (crude)
Time Period of Case Definition: Past 7 days
Summary: Fruits and vegetables are good sources of complex carbohydrates, fiber, vitamins, minerals, and other substances that are important for good health.1 Dietary patterns with higher intakes of fruits and vegetables are associated with a decreased risk for some types of cancer, cardiovascular disease, and stroke and can help with weight management.1 However, in 2019 around 40% of high school students nationwide had eaten vegetables less than one time per day.2
Notes: This indicator does not convey the cup equivalents of vegetables consumed so these data cannot be directly compared to Healthy People 2030 targets.  This indicator does not capture dietary intake of elementary and middle school students
Data Source: Youth Risk Behavior Surveillance System (YRBSS)
Related Objectives or Recommendations: Dietary Guidelines for Americans 2020-2025; Healthy People 2030 objectives: NWS-07. Increase vegetable consumption by people aged 2 years and older; NWS-08.  Increase consumption of dark green vegetables, red and orange vegetables, and beans and peas by people aged 2 years and over
Related CDI Topic Area: Student Health
Reference 1: U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2020–2025. U.S. Department of Agriculture. U.S. Government Printing Office; 2020. https://www.dietaryguidelines.gov/.
Reference 2: Division of Nutrition, Physical Activity, and Obesity. Data, Trend and Maps. Centers for Disease Control and Prevention; 2022. https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html.

Consumed vegetables less than one time daily among adults
Population: All adults
Numerator: Number of adults who reported consuming green salad, fried potatoes, other potatoes, and other vegetables less than one time a day.
Denominator: Number of adults.
Measure: Prevalence (crude and age-adjusted)
Time Period of Case Definition: Past 30 days
Summary: The Dietary Guidelines for Americans, 2020-2025 recommends Americans eat more fruits and vegetables as part of a healthy diet, because they contribute important nutrients, can reduce the risk for many chronic diseases, and can also help with weight management.1 One in 5 adults (20.6%) reported consuming vegetables less than one time daily in 2021.2 Strategies to increase vegetable intake include increasing the vegetable content of mixed dishes or eating less of a main dish to allow for more vegetables as side dishes—keeping these nutrient dense.
Notes: This indicator does not convey the cup equivalents of vegetables consumed so these data cannot be compared to Healthy People 2030 targets. The survey questions are part of the rotating core and administered every 4 years.
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Related Objectives or Recommendations: Healthy People 2030 objective: NWS-07 Increase vegetable consumption by people aged 2 years and older
Related CDI Topic Area: None
Reference 1: U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2020–2025. U.S. Department of Agriculture. U.S. Government Printing Office; 2020. https://www.dietaryguidelines.gov/.
Reference 2: Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity. Data, Trend and Maps. Centers for Disease Control and Prevention; 2022. https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html.

Consumed regular soda at least one time daily among high school students
Population: Students in grades 9–12
Numerator: Students in grades 9–12 who report consuming 1 or more cans, bottles, or glasses of soda per day.
Denominator: Students in grades 9–12 who report consuming any cans, bottles, or glasses of soda, including zero, per day.
Measure: Prevalence (crude)
Time Period of Case Definition: Past 7 days
Summary: Nationwide in 2019, 15% of high school students had drunk a can, bottle, or glass of soda or pop (not counting diet soda or diet pop) one or more times per day during the 7 days before the survey.1 Although total sugar-sweetened beverage consumption has significantly decreased during 2003–2014, mainly due to the decrease in regular soda intake, the calorie intake from sugar-sweetened beverages remains high.2 Furthermore, sugar-sweetened beverages were a primary source of added sugars in the diet of U.S. children during 2003–2014.3 Consumption of sugar-sweetened beverages is associated with a less healthy diet,4 increased risk of dental decay5 and obesity among children,6 and the development of metabolic syndrome and type 2 diabetes.7 Limiting sugary drink intake can help individuals maintain a healthy weight and have healthy dietary patterns.
Notes: Indicator does not include all sources of sugar-sweetened beverages.
Data Source: Youth Risk Behavior Surveillance System (YRBSS)
Related Objectives or Recommendations: Healthy People 2030 objective: NWS-10. Reduce consumption of added sugars by people aged 2 years and over
Related CDI Topic Area: Student Health
Reference 1: Merlo CL, Jones SE, Michael SL, et al. Dietary and physical activity behaviors among high school students—Youth Risk Behavior Survey, United States, 2019. MMWR Suppl. 2020;69(No. Suppl 1).
Reference 2: Bleich SN, Vercammen KA, Koma JW, Li Z. Trends in beverage consumption among children and adults, 2003‒2014. Obesity. 2018;26(2):432-441.
Reference 3: Drewnowski A, Rehm CD. Consumption of added sugars among US children and adults by food purchase location and food source. Am J Clin Nutr. 2014;100(3):901–907.
Reference 4: Leung CW, DiMatteo SG, Gosliner WA, Ritchie LD. Sugar-sweetened beverage and water intake in relation to diet quality in U.S. children. Am J Prev Med. 2018;54(3):394-402.
Reference 5: Bleich, S.N., Vercammen, K.A. The negative impact of sugar-sweetened beverages on children’s health: an update of the literature. BMC Obes 5, 6 (2018). https://doi.org/10.1186/s40608-017-0178-9
Reference 6: Luger M, Lafontan M, Bes-Rastrollo M, Winzer E, Yumuk V, Farpour-Lambert N. Sugar-sweetened beverages and weight gain in children and adults: A systematic review from 2013 to 2015 and a comparison with previous studies. Obesity Facts. 2017;10(6):674-693.
Reference 7: Malik VS, Hu FB. Sugar-sweetened beverages and cardiometabolic health: An update of the evidence. Nutrients. 2019;11(8):1840.

No leisure-time physical activity among adults
Population: All adults
Numerator: Adults who answered, “No”, to the following question: “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?”
Denominator: Adults who report any or no physical activity within the previous month.
Measure: Prevalence (crude and age-adjusted)
Time Period of Case Definition: Past month
Summary: Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability.1 Among adults and older adults, physical activity can lower the risk of early death, coronary heart disease, stroke, high blood pressure, type 2 diabetes, breast and colon cancer, falls, and depression.1 The second edition of the Physical Activity Guidelines for Americans states that adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefts.1 Despite the benefits, in 2021, 23.7% of adults reported engaging in no leisure-time physical activity.2
Notes: Indicator captures information only about non-occupational physical activity.
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Related Objectives or Recommendations: Healthy People 2030 objective: PA-01. Reduce the proportion of adults who do no physical activity in their free time
Related CDI Topic Area: None
Reference 1: U.S. Department of Health and Human Services.  Physical Activity Guidelines for Americans, 2nd edition. U.S. Department of Health and Human Services; 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Reference 2: Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity. Data, Trend and Maps. Centers for Disease Control and Prevention; 2022. https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html.

Children and adolescents aged 6-13 years meeting aerobic physical activity guideline
Population: Children and adolescents aged 6-13 years
Numerator: Number of children aged 6 to 13 years who exercised, played a sport, or participated in physical activity for at least 60 minutes every day during the past week.
Denominator: Number of children aged 6 to 13 years.
Measure: Prevalence (crude) from a 2-year cycle
Time Period of Case Definition: Past week
Summary: Children need at least 60 minutes of physical activity a day. Physical activity improves heart, muscle, bone, and mental health in children 1, however, less than 1 in 4 (23.6%) children ages 6 to 13 years met the current aerobic physical activity guideline in 2020–2021.2 Strategies at the community and family level — and in schools and childcare centers — can promote physical activity in children. For example, CDC and many other federal and national partners are promoting Comprehensive School Physical Activity Programs (CSPAP) to create school environments that offer many opportunities for students to be physically active throughout the school day.3
Notes: None
Data Source: National Survey of Children’s Health (NSCH)
Related Objectives or Recommendations: Healthy People 2030 objective: PA-09. Increase the proportion of children who do enough physical activity
Related CDI Topic Area: Student Health
Reference 1: 2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. U.S. Department of Health and Human Services; 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Reference 2: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/physical-activity
Reference 3: Centers for Disease Control and Prevention. Comprehensive School Physical Activity Programs: A Guide for Schools. US Department of Health and Human Services; 2013. https://www.cdc.gov/healthyschools/physicalactivity/pdf/13_242620-A_CSPAP_SchoolPhysActivityPrograms_Final_508_12192013.pdf

Met aerobic physical activity guideline among high school students
Population: Students in grades 9–12
Numerator: Number of students in grades 9 through 12 who were physically active for at least 60 minutes on all 7 days of the past week.
Denominator: Number of students in grades 9 through 12.
Measure: Prevalence (crude)
Time Period of Case Definition: Past 7 days
Summary: The second edition of the  Physical Activity Guidelines for Americans states that children and adolescents ages 6–17 years of age should do 60 minutes or more of moderate-to-vigorous intensity physical activity each day.1 Among children and adolescents, physical activity can improve bone health, improve cardiorespiratory and muscular fitness, decrease levels of body fat, and reduce symptoms of depression.1  Despite the benefits, only 1 in 4 (23.2%) of students in grades 9 through 12 were physically active for at least 60 minutes on all 7 days in 2019.2
Notes: There may be error associated with determining each day’s activities and then considering this across the week. The indicator also does not capture the full physical activity guideline for children and adolescents.
Data Source: Youth Risk Behavior Surveillance System (YRBSS)
Related Objectives or Recommendations: Healthy People 2030 objective: PA-06. Increase the proportion of adolescents who do enough aerobic physical activity
Related CDI Topic Area: Student Health
Reference 1: U.S. Department of Health and Human Services.  Physical Activity Guidelines for Americans, 2nd edition. U.S. Department of Health and Human Services; 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Reference 2: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/physical-activity

Met aerobic physical activity guideline for substantial health benefits, adults
Population: All adults
Numerator: Number of adults who reported at least 150 minutes per week of moderate-intensity physical activity, or at least 75 minutes per week of vigorous-intensity physical activity, or a combination of moderate-intensity and vigorous-intensity physical activity (multiplied by two) totaling at least 150 minutes per week.
Denominator: Adults who report any or no moderate or vigorous physical activity within the previous month.
Measure: Prevalence (crude and age-adjusted)
Time Period of Case Definition: Past month
Summary: Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability. Among adults and older adults, regular physical activity can lower the risk of early death, coronary heart disease, stroke, high blood pressure, type 2 diabetes, breast and colon cancer, falls, and depression.1 The second edition of the Physical Activity Guidelines for Americans states that for substantial health benefits, adults should do at least 150 minutes) a week of moderate-equivalent intensity to achieve substantial benefits.1 Despite the benefits of regular physical activity, only about half (47.9%) of adults engaged in enough physical activity to reap substantial health benefits in 2020.2
Notes: Indicator captures information only about non-occupational physical activity. The survey questions are part of the rotating core and adminstered every 4 years.
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Related Objectives or Recommendations: Healthy People 2030 objective: PA-02. Increase the proportion of adults who do enough aerobic physical activity for substantial health benefits
Related CDI Topic Area: Student Health
Reference 1: U.S. Department of Health and Human Services.  Physical Activity Guidelines for Americans, 2nd edition. U.S. Department of Health and Human Services; 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Reference 2: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/physical-activity

Infants who were breastfed at 12 months
Population: Infants
Numerator: Number of caregivers of children born in a cohort year who indicate their child was breastfed any amount at 12 months of age.
Denominator: Number of children aged 19-35 months born in the same cohort year.
Measure: Prevalence (crude)
Time Period of Case Definition: At 12 months of age
Summary: Breastfeeding has many health benefits for infants, children, and mothers1,2 and is a key strategy to improve public health. Mothers who breastfeed have a reduced risk of developing breast and ovarian cancer, and infants who are breastfed may be less likely to experience a variety of infections and to develop chronic conditions, including obesity during childhood.3 The 2020–2025 Dietary Guidelines for Americans (Dietary Guidelines) and the American Academy of Pediatrics (AAP) recommend that infants be exclusively breastfed for about the first 6 months, with continued breastfeeding alongside the introduction of complementary foods for at least 1 year (Dietary Guidelines) or at least 2 years (AAP), or longer if desired.1,2 Despite the benefits, 35.9% of infants born in 2019 were breast fed to any extent at 1 year.4
Notes: None
Data Source: National Immunization Survey (NIS)
Related Objectives or Recommendations: Healthy People 2030 objective: MICH-16. Increase the proportion of infants who are breastfed at 1 year
Related CDI Topic Area: None
Reference 1: U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2020–2025. U.S. Department of Agriculture. U.S. Government Printing Office; 2020. https://www.dietaryguidelines.gov/.
Reference 2: Meek JY, Noble L. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. doi:10.1542/peds.2022-057988
Reference 3: U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. U.S. Department of Health and Human Services, Office of the Surgeon General; 2011. https://www.cdc.gov/breastfeeding/resources/calltoaction.htm
Reference 4: US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/infants/increase-proportion-infants-who-are-breastfed-1-year-mich-16

Infants who were exclusively breastfed through 6 months
Population: Infants
Numerator: Number of caregivers of children born in a cohort year who indicate their child was exclusively breastfed through 6 months of age. Exclusive breastfeeding is defined as ONLY breast milk – No solids, no water, and no other liquids.
Denominator: Number of children aged 19-35 months born in the same cohort year.
Measure: Prevalence (crude)
Time Period of Case Definition: At 6 months of age
Summary: Breastfeeding has many health benefits for infants, children, and mothers and is a key strategy to improve public health.1,2 Mothers who breastfeed have a reduced risk of developing breast and ovarian cancer, and infants who are breastfed may be less likely to experience a variety of infections and to develop chronic conditions, including obesity during childhood.3 The 2020–2025 Dietary Guidelines for Americans and the American Academy of Pediatrics recommend that infants be exclusively breastfed for about the first 6 months.1,2 Despite the benefits, only 24.9% of infants born in 2019 were breastfed exclusively through 6 months of age.3
Notes: None
Data Source: National Immunization Survey (NIS)
Related Objectives or Recommendations: Healthy People 2030 objectives: MICH-15. Increase the proportion of infants who are breastfed exclusively through age 6 months
Related CDI Topic Area: Maternal Health
Reference 1: U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2020–2025. U.S. Department of Agriculture. U.S. Government Printing Office; 2020. https://www.dietaryguidelines.gov/.
Reference 2: Meek JY, Noble L. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. doi:10.1542/peds.2022-057988
Reference 3: U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. U.S. Department of Health and Human Services, Office of the Surgeon General; 2011. https://www.cdc.gov/breastfeeding/resources/calltoaction.htm
Reference 4: US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/infants/increase-proportion-infants-who-are-breastfed-exclusively-through-age-6-months-mich-15

Obesity among WIC children aged 2 to 4 years
Population: Children aged 2-4 years old enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Numerator: Number of children with body mass index (BMI)-for-age and sex ≥95th percentile based on the 2000 CDC growth chart; BMI was calculated from measured weight and height (weight [kg]/ height [m²]).
Denominator: Number of children with no missing values of height, weight, BMI.  Children with biological implausible values for height, weight, and BMI defined as the following z-scores values, were excluded from the analyses: height-for-age < -5.0 or > 4.0, weight-for-age < -5.0 or > 8.0, and BMI-for-age < -4.0 or > 8.0.
Measure: Prevalence (crude)
Time Period of Case Definition: Current
Summary: Many children and adolescents in the United States have obesity.1 Obesity is linked to a higher risk for diseases and conditions like high blood pressure, high cholesterol, diabetes, asthma, anxiety, and depression.2-5 Obesity affects children from families with low incomes more than children from families with higher income.6 Half of all infants born in the United States are served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).7 To support healthy infant growth among all US children and to reduce disparities in obesity risk, comprehensive approaches are needed to support caregivers of infants and young children. In addition, multiple community stakeholders have opportunities to maintain and broaden their support of low-income families and WIC participants, including federally qualified health centers and community centers, WIC clinics, Head Start and other ECE settings, and food retailers that accept WIC cards and vouchers.
Notes: None
Data Source: Women, Infants, and Children Participant and Program Characteristics (WIC-PC)
Related Objectives or Recommendations: Healthy People 2030 objective: NWS-04. Reduce the proportion of children and adolescents with obesity
Related CDI Topic Area: None
Reference 1: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services; 2022.  https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity
Reference 2: Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics1998; 102: E29.https://www.nhlbi.nih.gov/sites/default/files/media/docs/obesity-evidence-review.pdf
Reference 3: Morrison KM, Shin S, Tarnopolsky M, et al. Association of depression and health related quality of life with body composition in children and youth with obesity. Journal of Affective Disorders. 2015;172:18–23.
Reference 4: Halfon N, Kandyce L, Slusser W. Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17. Academic Pediatrics. 2013;13.1:6–13.
Reference 5: Beck AR. Psychosocial aspects of obesity. NASN Sch Nurse. 2016;31(1):23–27.
Reference 6: Stierman B, Afful J, Carroll MD, et al. National Health and Nutrition Examination Survey 2017–March 2020 Prepandemic Data Files Development of Files and Prevalence Estimates for Selected Health Outcomes. National Health Statistics Reports. 2021; 158:1–20.
Reference 7: Kline N, Zvavitch P, Wroblewska K, Worden M, Mwombela B, Thorn B. WIC Participant and Program Characteristics 2020. U.S. Department of Agriculture, Food and Nutrition Service; 2022. https://www.fns.usda.gov/wic/participant-program-characteristics-2020

Obesity among high school students
Population: Students in grades 9–12
Numerator: Students in grades 9–12 with a body mass index (BMI) at or above the sex- and age-specific 95th percentile from CDC Growth Charts: United States.
Denominator: Students in grades 9–12 who answer height, weight, sex and age questions.
Measure: Prevalence (crude)
Time Period of Case Definition: Current
Summary: Many children and adolescents in the United States have obesity.1 Obesity is linked to a higher risk for diseases and conditions like high blood pressure, high cholesterol, diabetes, asthma, anxiety, and depression.2-5 In addition, children with obesity are more likely to be bullied and to have obesity as adults.4,5 Evidence suggests that intensive behavioral programs that use more than 1 strategy are an effective way to reduce childhood obesity. Policy and school curriculum changes that make it easier for children and adolescents to eat healthy and get physical activity can also help reduce obesity.
Notes: Self-reported data underestimate obesity prevalence among adolescents.6
Data Source: Youth Risk Behavior Surveillance System (YRBSS)
Related Objectives or Recommendations: Healthy People 2030 objective: NWS-04. Reduce the proportion of children and adolescents with obesity
Related CDI Topic Area: Student Health
Reference 1: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services; 2022.  https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity
Reference 2: Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics1998; 102: E29.
Reference 3: Morrison KM, Shin S, Tarnopolsky M, et al. Association of depression and health related quality of life with body composition in children and youth with obesity. J Affect Disord. 2015;172:18–23.
Reference 4: Overweight & Obesity. Why It Matters. Centers for Disease Control and Prevention. Updated July 14, 2022. Accessed April 26, 2023. https://www.cdc.gov/obesity/about-obesity/why-it-matters.html
Reference 5: Beck AR. Psychosocial aspects of obesity. NASN Sch Nurse. 2016;31(1):23–27.
Reference 6: Allison C, Colby S, Opoku-Acheampong A, et al. Accuracy of self-reported BMI using objective measurement in high school students. J Nutr Sci. 2020 Aug 12; 9:e35. doi: 10.1017/jns.2020.28.

Obesity among adults
Population: All adults
Numerator: Non-pregnant adults who have a body mass index (BMI) 30.0 kg/m² or higher calculated from self-reported weight and height.
Denominator: Number of non-pregnant adults.
Measure: Prevalence (crude and age-adjusted)
Time Period of Case Definition: Current
Summary: Many adults in the United States have obesity.1 Adults with obesity have higher risks for stroke, many types of cancer, premature death, and mental illness such as clinical depression and anxiety.2-5 Obesity-related stigma and discrimination can also lead to health problems. Evidence suggests that intensive behavioral interventions that use more than 1 strategy — like group sessions and changes in both diet and physical activity — are an effective way to address obesity.6
Notes: Self-reports of height and weight lead to lower BMI estimates compared to estimates obtained when height and weight are measured.7
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Related Objectives or Recommendations: Healthy People 2030 objective: NWS-03. Reduce the proportion of adults with obesity
Related CDI Topic Area: None
Reference 1: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services; 2022.  https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity
Reference 2: Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.
Reference 3: Kasen S, Cohen P, Chen H, Must A. Obesity and psychopathology in women: a three decade prospective study. Int J Obes (Lond). 2008;32:558-566.
Reference 4: Luppino FS, de Wit LM, Bouvy PF, et al.l. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220-229.
Reference 5: National Heart, Lung and Blood Institute. Managing Overweight and Obesity in Adults: Systematic Evidence Review from the Obesity Expert Panel. NHLBI; 2013. https://www.nhlbi.nih.gov/sites/default/files/media/docs/obesity-evidence-review.pdf
Reference 6: United States Preventive Services Task Force. Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions. USPSTF; 2022. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/obesity-in-adults-interventions
Reference 7: Hodge JM, Shah R, McCullough ML, et al. Validation of self-reported height and weight in a large, nationwide cohort of U.S. adults. PLoS ONE. 2020; 15(4): e0231229. https://doi.org/10.1371/journal.pone.0231229

Additional Data Sources