Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2017–2018
by Cheryl D. Fryar, M.S.P.H., Margaret D. Carroll, M.S.P.H., and Joseph Afful, M.S., Division of Health and Nutrition Examination Surveys
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This report was revised on January 29, 2021, to update Table 3 with overall estimates of obesity by race and Hispanic origin.
Results from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), using measured heights and weights, indicate that an estimated 42.5% of U.S. adults aged 20 and over have obesity, including 9.0% with severe obesity, and another 31.1% are overweight. Body mass index (BMI), expressed as weight in kilograms divided by height in meters squared (kg/m2), is used commonly to classify overweight (BMI 25.0–29.9), obesity (BMI at or above 30.0), and severe obesity (BMI at or above 40.0).
Age-adjusted trends in overweight, obesity, and severe obesity prevalence from 1960–1962 through 2017–2018 are shown in Table 1. Because surveys before 1988 did not include persons over age 74, Table 1 shows the prevalence for adults aged 20 and over since 1988, and for adults aged 20–74 for all survey periods dating back to 1960. The age-adjusted sex-specific trends of overweight, obesity, and severe obesity among adults aged 20–74 from 1960–1962 through 2017–2018 are shown in the Figure. Table 2 contains the prevalence of obesity by age for men and women since 1988–1994, and Table 3 contains the age-adjusted prevalence of obesity by race and Hispanic origin for men and women since 1988–1994.
The prevalence of obesity as measured by BMI among non-Hispanic Asian adults is consistently lower than that reported for non-Hispanic white, non-Hispanic black, and Hispanic adults. Although BMI is widely used as a measure of body fat, at a given BMI level, body fat may vary by sex, age, and race and Hispanic origin. In particular, research suggests that health risks may begin at a lower BMI among Asian persons compared with others (1,2).
NHANES, conducted by the National Center for Health Statistics, is a stratified, multistage probability sample of the civilian noninstitutionalized population of the United States. The survey began oversampling non-Hispanic Asian persons in 2011–2012 and the total Hispanic population in 2007–2008. Beginning in 2007–2008, Mexican-American persons were no longer oversampled but are included in the oversampled total Hispanic population.
A household interview and a physical examination are conducted for each survey participant. During the physical examination, conducted in a mobile examination center, height and weight are measured as part of a comprehensive set of body measurements. These measurements are taken by trained health technicians, using standardized measuring procedures and equipment. Observations for pregnant women and for persons missing a valid height or weight measurement are not included in the data analysis.
For additional information on NHANES methods, visit: https://wwwn.cdc.gov/nchs/nhanes/analyticguidelines.aspx.
For more detailed estimates, see:
- Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288(14):1723–7. 2002.
- Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295(13):1549–55. 2006.
- Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among adults in the United States—No statistically significant change since 2003–2004pdf icon. NCHS Data Brief, no 1. Hyattsville, MD: National Center for Health Statistics. 2007.
- Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303(3):235–41. 2010.
- Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 307(5):491–7. 2012.
- Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311(8):806–14. 2014.
- Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 315(21):2284–91. 2016.
- Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. JAMA 319(16):1723–5. 2018.
- Ogden CL, Fryar CD, Martin CB, Freedman DS, Carroll MD, Gu Q, Hales CM. Trends in obesity prevalence by race and Hispanic origin—1999–2000 to 2017–2018. JAMA 324(12):1208–10. 2020. doi:10.1001/jama.2020.14590.
References
1. Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 3(3):141–6. 2002.
2. Zheng W, McLerran DF, Rolland B, Zhang X, Inoue M, Matsuo K, et al. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med 364(8):719–29.
This Health E-Stat supersedes the earlier version, “Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2015–2016”.
Suggested Citation
Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.
Figure
Figure. Age-adjusted trends in overweight, obesity, and severe obesity among men and women aged 20–74: United States, 1960–1962 through 2017–2018
image icon
NOTES: Data are age adjusted by the direct method to U.S. Census 2000 estimates using age groups 20–39, 40–59, and 60–74. Overweight is body mass index (BMI) of 25.0–29.9 kg/m2. Obesity is BMI at or above 30.0 kg/m2. Severe obesity is BMI at or above 40.0 kg/m2. Pregnant women are excluded from the analysis.
SOURCES: National Center for Health Statistics, National Health Examination Survey and National Health and Nutrition Examination Surveys.
Tables
Table 1. Age-adjusted prevalence of overweight, obesity, and severe obesity among adults, by sex: United States, 1960–1962 through 2017–2018
| Age group and Survey period |
Sample (n) | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| All | Men | Women | ||||||||||||||||
| Overweight | Obesity | Severe obesity |
Overweight | Obesity | Severe obesity |
Overweight | Obesity | Severe obesity |
||||||||||
| 20 and over1: | Percent (standard error) | |||||||||||||||||
| 1988–1994 | 16,235 | 33.1 (0.6) | 22.9 (0.7) | 2.8 (0.2) | 40.7 (0.8) | 20.2 (0.7) | 1.7 (0.3) | 25.9 (0.7) | 25.4 (0.9) | 3.9 (0.3) | ||||||||
| 1999–2000 | 4,117 | 34.0 (1.0) | 30.5 (1.5) | 4.7 (0.6) | 39.7 (1.4) | 27.5 (1.5) | 3.1 (0.7) | 28.6 (1.6) | 33.4 (1.7) | 6.2 (0.7) | ||||||||
| 2001–2002 | 4,413 | 35.1 (1.1) | 30.5 (1.1) | 5.1 (0.5) | 42.2 (1.3) | 27.7 (1.0) | 3.6 (0.6) | 28.2 (1.7) | 33.2 (1.5) | 6.5 (0.6) | ||||||||
| 2003–2004 | 4,431 | 34.1 (1.1) | 32.2 (1.2) | 4.8 (0.6) | 39.7 (1.5) | 31.1 (1.3) | 2.8 (0.4) | 28.6 (1.2) | 33.2 (1.7) | 6.9 (0.9) | ||||||||
| 2005–2006 | 4,356 | 32.6 (0.8) | 34.3 (1.4) | 5.9 (0.5) | 39.9 (1.3) | 33.3 (2.0) | 4.2 (0.5) | 25.5 (1.2) | 35.3 (1.4) | 7.4 (0.7) | ||||||||
| 2007–2008 | 5,550 | 34.3 (0.8) | 33.7 (1.1) | 5.7 (0.4) | 40.1 (1.4) | 32.2 (1.4) | 4.2 (0.5) | 28.6 (1.2) | 35.4 (1.1) | 7.3 (0.6) | ||||||||
| 2009–2010 | 5,926 | 33.0 (1.0) | 35.7 (0.9) | 6.3 (0.2) | 38.4 (1.1) | 35.5 (1.7) | 4.4 (0.3) | 27.9 (1.4) | 35.8 (0.9) | 8.1 (0.5) | ||||||||
| 2011–2012 | 5,181 | 33.6 (1.3) | 34.9 (1.4) | 6.4 (0.6) | 37.8 (1.5) | 33.5 (1.4) | 4.4 (0.9) | 29.7 (1.8) | 36.1 (1.7) | 8.3 (0.7) | ||||||||
| 2013–2014 | 5,455 | 32.5 (0.8) | 37.7 (0.9) | 7.7 (0.7) | 38.7 (1.2) | 35.0 (1.1) | 5.5 (0.6) | 26.5 (0.8) | 40.4 (1.3) | 9.9 (0.9) | ||||||||
| 2015–2016 | 5,337 | 31.6 (0.8) | 39.6 (1.6) | 7.7 (0.6) | 36.5 (1.6) | 37.9 (2.3) | 5.6 (0.7) | 26.9 (1.0) | 41.1 (1.6) | 9.7 (0.7) | ||||||||
| 2017–2018 | 5,120 | 30.7 (1.1) | 42.4 (1.8) | 9.2 (0.9) | 34.1 (1.8) | 43.0 (2.7) | 6.9 (1.0) | 27.5 (1.0) | 41.9 (2.0) | 11.5 (1.3) | ||||||||
| 20–742: | ||||||||||||||||||
| 1960–1962 | 6,126 | 31.5 (0.5) | 13.4 (0.5) | 0.9 (0.1) | 38.7 (0.7) | 10.7 (0.7) | 0.3 (0.1) | 24.7 (0.8) | 15.8 (0.6) | 1.4 (0.2) | ||||||||
| 1971–1974 | 12,911 | 32.7 (0.6) | 14.5 (0.4) | 1.3 (0.2) | 41.7 (1.1) | 12.1 (0.6) | 0.6 (0.2) | 24.3 (0.7) | 16.6 (0.6) | 2.0 (0.3) | ||||||||
| 1976–1980 | 11,765 | 32.1 (0.6) | 15.0 (0.4) | 1.4 (0.1) | 39.9 (0.8) | 12.7 (0.6) | 0.4 (0.1) | 24.9 (0.8) | 17.0 (0.6) | 2.2 (0.3) | ||||||||
| 1988–1994 | 14,319 | 32.6 (0.6) | 23.2 (0.7) | 3.0 (0.3) | 40.3 (0.8) | 20.5 (0.7) | 1.8 (0.3) | 25.1 (0.8) | 25.9 (1.0) | 4.1 (0.3) | ||||||||
| 1999–2000 | 3,603 | 33.6 (1.1) | 30.9 (1.6) | 5.0 (0.6) | 39.2 (1.5) | 27.7 (1.6) | 3.3 (0.7) | 28.0 (1.7) | 34.0 (1.8) | 6.6 (0.8) | ||||||||
| 2001–2002 | 3,916 | 34.4 (1.1) | 31.2 (1.1) | 5.4 (0.5) | 41.5 (1.4) | 28.3 (1.1) | 3.9 (0.7) | 27.3 (1.6) | 34.1 (1.6) | 6.8 (0.6) | ||||||||
| 2003–2004 | 3,756 | 33.4 (1.2) | 32.9 (1.3) | 5.1 (0.6) | 39.4 (1.5) | 31.7 (1.4) | 3.0 (0.4) | 27.3 (1.3) | 34.0 (1.9) | 7.3 (1.0) | ||||||||
| 2005–2006 | 3,835 | 32.2 (0.9) | 35.1 (1.5) | 6.2 (0.5) | 39.7 (1.3) | 33.8 (2.2) | 4.3 (0.5) | 24.7 (1.3) | 36.3 (1.5) | 7.9 (0.8) | ||||||||
| 2007–2008 | 4,876 | 33.6 (0.8) | 34.3 (1.2) | 6.0 (0.4) | 39.4 (1.4) | 32.5 (1.5) | 4.4 (0.5) | 27.9 (1.2) | 36.2 (1.3) | 7.6 (0.6) | ||||||||
| 2009–2010 | 5,279 | 32.7 (1.0) | 36.1 (0.9) | 6.6 (0.2) | 38.0 (1.2) | 35.9 (1.7) | 4.6 (0.4) | 27.5 (1.5) | 36.1 (0.9) | 8.5 (0.5) | ||||||||
| 2011–2012 | 4,674 | 33.3 (1.4) | 35.3 (1.4) | 6.6 (0.6) | 37.3 (1.5) | 33.9 (1.5) | 4.5 (1.0) | 29.5 (2.0) | 36.6 (1.6) | 8.6 (0.7) | ||||||||
| 2013–2014 | 4,940 | 31.9 (0.8) | 38.2 (1.0) | 8.1 (0.8) | 38.2 (1.3) | 35.5 (1.2) | 5.7 (0.7) | 25.8 (0.9) | 41.0 (1.4) | 10.5 (1.0) | ||||||||
| 2015–2016 | 4,778 | 31.0 (0.8 | 40.0 (1.8) | 8.0 (0.6) | 35.8 (1.8) | 38.3 (2.4) | 5.9 (0.8) | 26.3 (1.1) | 41.6 (1.7) | 10.1 (0.7) | ||||||||
| 2017–2018 | 4,536 | 30.3 (1.2) | 42.8 (1.9) | 9.6 (1.0) | 33.7 (1.9) | 43.5 (2.7) | 7.3 (1.0) | 26.9 (0.9) | 42.1 (2.1) | 12.0 (1.5) | ||||||||
1Age adjusted by the direct method to the U.S. Census 2000 estimates using the age groups 20–39, 40–59, and 60 and over. Crude estimates (not age adjusted) for 2017–2018 are 31.1% for overweight, 42.5% for obesity, and 9.0% for severe obesity categories.
2Age adjusted by the direct method to the U.S. Census 2000 estimates using the age groups 20–39, 40–59, and 60–74. The 1960–1962 National Health Examination Survey included adults aged 18–79, and the 1971–1974 and 1976–1980 National Health and Nutrition Examination Surveys did not include individuals over age 74.
NOTES: Overweight is body mass index (BMI) of 25.0–29.9 kg/m2, obesity is BMI at or above 30.0 kg/m2, and severe obesity is BMI at or above 40.0 kg/m2. Pregnant women are excluded from the analysis.
SOURCES: National Center for Health Statistics, National Health Examination Survey, 1960–1962; and National Health and Nutrition Examination Surveys, 1971–1974, 1976–1980, 1988–1994, and 1999–2018.
Table 2. Prevalence of obesity among adults aged 20 and over, by sex and age: United States, 1988–1994 through 2017–2018
| Survey period | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| All | Men | Women | ||||||||||||||||
| 20–39 | 40–59 | 60 and over | 20–39 | 40–59 | 60 and over | 20–39 | 40–59 | 60 and over | ||||||||||
| Percent (standard error) | ||||||||||||||||||
| 1988–1994 | 17.7 (0.7) | 27.9 (1.1) | 23.7 (0.9) | 14.8 (0.8) | 25.4 (1.2) | 21.2 (1.4) | 20.7 (1.3) | 30.3 (1.5) | 25.6 (1.1) | |||||||||
| 1999–2000 | 26.0 (1.3) | 33.5 (3.0) | 33.5 (1.7) | 23.7 (1.6) | 28.8 (2.9) | 31.7 (2.2) | 28.3 (2.0) | 37.7 (3.3) | 35.0 (2.2) | |||||||||
| 2001–2002 | 26.1 (1.4) | 33.9 (1.5) | 32.8 (1.6) | 22.3 (1.5) | 32.2 (1.7) | 29.9 (2.0) | 29.8 (2.1) | 35.7 (2.1) | 35.0 (2.0) | |||||||||
| 2003–2004 | 28.5 (1.5) | 36.8 (1.8) | 31.0 (1.3) | 28.0 (2.2) | 34.8 (2.5) | 30.4 (1.9) | 28.9 (2.3) | 38.8 (2.7) | 31.5 (1.7) | |||||||||
| 2005–2006 | 29.1 (2.0) | 40.4 (2.0) | 33.4 (1.1) | 27.9 (2.8) | 39.6 (2.9) | 32.2 (2.1) | 30.5 (2.3) | 41.1 (2.3) | 34.4 (2.3) | |||||||||
| 2007–2008 | 30.7 (2.0) | 36.2 (1.7) | 35.1 (1.0) | 27.4 (1.9) | 34.2 (2.3) | 37.0 (2.0) | 34.0 (2.5) | 38.1 (2.2) | 33.5 (1.7) | |||||||||
| 2009–2010 | 32.6 (1.7) | 36.6 (1.0) | 39.7 (1.5) | 33.2 (2.7) | 37.2 (1.8) | 36.6 (2.4) | 31.9 (1.6) | 36.0 (1.7) | 42.3 (1.9) | |||||||||
| 2011–2012 | 30.3 (1.9) | 39.5 (1.6) | 35.4 (2.0) | 29.0 (2.6) | 39.4 (1.6) | 32.0 (2.2) | 31.8 (1.7) | 39.5 (2.2) | 38.1 (2.9) | |||||||||
| 2013–2014 | 34.3 (1.5) | 41.0 (2.1) | 38.5 (1.6) | 31.6 (2.1) | 37.2 (2.4) | 37.5 (3.0) | 37.0 (1.3) | 44.6 (2.6) | 39.4 (1.9) | |||||||||
| 2015–2016 | 35.7 (1.9) | 42.8 (2.6) | 41.0 (1.9) | 34.8 (2.8) | 40.8 (2.9) | 38.5 (1.8) | 36.5 (1.6) | 44.7 (3.1) | 43.1 (2.8) | |||||||||
| 2017–2018 | 40.0 (2.6) | 44.8 (1.9) | 42.8 (2.5) | 40.3 (3.8) | 46.4 (3.2) | 42.2 (3.3) | 39.7 (2.7) | 43.3 (2.7) | 43.3 (3.0) | |||||||||
NOTES: Obesity is body mass index at or above 30.0 kg/m2. Pregnant women are excluded from the analysis.
SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2018.
Table 3. Age-adjusted prevalence of obesity among adults aged 20 and over, by sex and race and Hispanic origin: United States, 1988–1994 through 2017–2018
| Survey period | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-Hispanic white | Non-Hispanic black | Non-Hispanic Asian | Hispanic | Mexican American | |||||||||||||||
| All | Percent (standard error) | ||||||||||||||||||
| 1988–1994 | 21.6 (0.8) | 30.7 (0.9) | – – – | – – – | 29.4 (0.9) | ||||||||||||||
| 1999–2000 | 28.7 (1.8) | 39.7 (1.6) | – – – | – – – | 34.3 (2.5) | ||||||||||||||
| 2001–2002 | 30.2 (1.2) | 39.0 (1.8) | – – – | – – – | 31.0 (2.1) | ||||||||||||||
| 2003–2004 | 30.6 (1.3) | 45.0 (2.2) | – – – | – – – | 36.8 (1.8) | ||||||||||||||
| 2005–2006 | 32.9 (1.6) | 45.8 (1.7) | – – – | – – – | 33.9 (1.0) | ||||||||||||||
| 2007–2008 | 32.4 (1.8) | 43.9 (2.0) | – – – | 38.7 (2.6) | 40.3 (3.1) | ||||||||||||||
| 2009–2010 | 34.3 (1.2) | 49.5 (2.3) | – – – | 39.1 (1.9) | 40.4 (1.8) | ||||||||||||||
| 2011–2012 | 32.6 (1.8) | 47.8 (1.6) | 10.8 (1.4) | 42.5 (1.7) | 46.6 (2.1) | ||||||||||||||
| 2013–2014 | 36.4 (1.1) | 48.4 (2.0) | 12.6 (1.3) | 42.6 (2.1) | 46.4 (2.1) | ||||||||||||||
| 2015–2016 | 37.9 (1.8) | 46.8 (2.3) | 12.7 (1.1) | 47.0 (2.1) | 49.4 (1.9) | ||||||||||||||
| 2017–2018 | 42.2 (2.5) | 49.6 (1.5) | 17.4 (1.3) | 44.8 (1.6) | 50.4 (2.0) | ||||||||||||||
| Men | |||||||||||||||||||
| 1988–1994 | 20.3 (0.9) | 21.1 (1.0) | – – – | – – – | 23.9 (1.0) | ||||||||||||||
| 1999–2000 | 27.3 (1.8) | 27.9 (1.6) | – – – | – – – | 28.9 (1.9) | ||||||||||||||
| 2001–2002 | 29.0 (1.3) | 27.9 (2.0) | – – – | – – – | 25.9 (2.0) | ||||||||||||||
| 2003–2004 | 31.1 (1.5) | 34.0 (3.5) | – – – | – – – | 31.6 (2.5) | ||||||||||||||
| 2005–2006 | 33.0 (2.2) | 37.0 (2.4) | – – – | – – – | 27.0 (1.9) | ||||||||||||||
| 2007–2008 | 31.9 (1.9) | 37.2 (2.5) | – – – | 34.2 (3.0) | 35.8 (3.5) | ||||||||||||||
| 2009–2010 | 36.2 (2.1) | 38.8 (2.3) | – – – | 37.0 (2.2) | 38.6 (2.4) | ||||||||||||||
| 2011–2012 | 32.4 (1.3) | 37.1 (1.9) | 10.0 (1.6) | 40.1 (2.1) | 44.0 (2.6) | ||||||||||||||
| 2013–2014 | 34.7 (1.6) | 38.0 (2.5) | 12.6 (1.8) | 37.9 (2.8) | 42.2 (2.5) | ||||||||||||||
| 2015–2016 | 37.9 (2.7) | 36.9 (2.5) | 10.1 (1.3) | 43.1 (2.9) | 46.2 (2.6) | ||||||||||||||
| 2017–2018 | 44.7 (3.7) | 41.1 (2.2) | 17.5 (2.1) | 45.7 (1.8) | 51.1 (2.4) | ||||||||||||||
| Women | |||||||||||||||||||
| 1988–1994 | 22.9 (1.1) | 38.4 (1.4) | – – – | – – – | 35.4 (1.4) | ||||||||||||||
| 1999–2000 | 30.1 (2.1) | 49.5 (3.0) | – – – | – – – | 39.5 (3.9) | ||||||||||||||
| 2001–2002 | 31.2 (1.6) | 48.2 (2.7) | – – – | – – – | 37.0 (3.2) | ||||||||||||||
| 2003–2004 | 30.2 (2.1) | 53.9 (3.0) | – – – | – – – | 42.3 (2.7) | ||||||||||||||
| 2005–2006 | 32.9 (1.8) | 52.9 (2.1) | – – – | – – – | 42.1 (2.8) | ||||||||||||||
| 2007–2008 | 33.0 (1.8) | 49.4 (2.0) | – – – | 43.0 (2.6) | 45.1 (3.1) | ||||||||||||||
| 2009–2010 | 32.2 (1.4) | 58.5 (2.8) | – – – | 41.4 (2.0) | 44.9 (1.6) | ||||||||||||||
| 2011–2012 | 32.8 (2.7) | 56.6 (2.1) | 11.4 (2.2) | 44.4 (2.1) | 49.2 (3.4) | ||||||||||||||
| 2013–2014 | 38.2 (1.6) | 57.2 (1.7) | 12.4 (2.1) | 46.9 (2.7) | 50.9 (3.1) | ||||||||||||||
| 2015–2016 | 38.0 (1.9) | 54.8 (2.3) | 14.8 (1.3) | 50.6 (2.1) | 52.3 (2.1) | ||||||||||||||
| 2017–2018 | 39.8 (2.9) | 56.9 (1.9) | 17.2 (1.3) | 43.7 (2.0) | 49.6 (4.0) | ||||||||||||||
– – – Data not available.
NOTES: Obesity is body mass index at or above 30.0 kg/m2. Age adjusted by the direct method to U.S. Census 2000 estimates using the age groups 20–39, 40–59, and 60 and over. Pregnant women are excluded from the analysis.
SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2018.