Trends In Waist Circumference Research Articles

Comparing high-intensity versus moderate-intensity exercise training in coronary artery disease patients: a randomized controlled trial with 6- and 12-month follow-up

Abstract Aim This study aimed to investigate the long-term effects of two exercise-based CR programs on physical activity (PA), sedentary behavior, physical fitness, quality of life (QoL), and mental health in coronary artery disease (CAD) patients. Subject and methods Seventy-two CAD participants were randomized (1:1:1) into HIIT, MICT, and control groups. Both training programs spanned 6 weeks with three supervised treadmill exercise sessions per week. MICT targeted ≈70–75% of peak heart rate (HR), while HIIT aimed for ≈85–95% of peak HR. The control group adhered to standard medical recommendations. Assessments at 6- and 12-months post-intervention included body composition, aerobic capacity, muscle strength, PA, SB, QoL, anxiety, and depression. Results Over the 6- and 12-month follow-up periods, both exercise groups maintained the levels of aerobic capacity (HIIT ≈ 19.6 ml kg−1 min−1, MICT ≈ 17.8 ml kg−1 min−1), QoL, and PA compared to baseline (p < .001). Symptoms of anxiety and depression remained lower than baseline (p < .001). The HIIT group demonstrated a significant decreasing trend in waist circumference (∆m3−m2% −2 cm, p = .033) compared to MICT (p = .016) and control (p = .001) at 6 months of follow-up. It was maintained at 12 months of follow-up with significant differences to MICT (p = .018) and control (p = .001). In contrast, the control group experienced deteriorations in body composition, SB, symptoms of anxiety, and depression, along with a decline in aerobic capacity over time. Conclusion Encouraging CAD patients to maintain elevated PA levels can promote cardiovascular, WC, and mental health. CR exercise programs can reduce cardiovascular risk factors and induce favorable lifestyle changes. Notably, HIIT demonstrated sustained improvements surpassing those of MICT. These findings underscore the importance of structured exercise-based CR programs in optimizing long-term outcomes for CAD patients. Trial Registration https://clinicaltrials.gov/ct2/show/NCT03538119 on May 25, 2018.

Trends in abdominal obesity among Chinese children and adolescents, 1993–2015

Abstract Objectives The prevalence of general overweight and obesity defined by body mass index criteria has greatly increased in Chinese children and adolescents in recent decades. However, few studies have considered the trend in abdominal obesity in Chinese children and adolescents. This study aimed to examine the secular trends in waist circumference (WC), waist-to-height ratio (WHtR) and the prevalence of abdominal obesity among Chinese children and adolescents aged 6–17 years from 1993 to 2015. Methods A total of 11,985 children and adolescents aged 6–17 years participated in the China Health and Nutrition Survey, a continuous cross-sectional survey, conducted from 1993 to 2015. Abdominal obesity was defined as WC≥age- and sex-specific 90th percentile based on the reference from Chinese children and adolescents or WHtR≥0.50. Results After adjustment for age, sex and region, mean WC increased from 60.27 cm in 1993 to 64.31 cm in 2015 (p for trend <0.001), and mean WHtR increased from 0.430 to 0.434 (p for trend <0.05). The prevalence of abdominal obesity defined by WC reference increased from 5.0% in 1993 to 19.3% in 2015 and defined by WHtR reference increased from 6.4% in 1993 to 14.5% in 2015 (p for trend <0.001). Conclusions The prevalence of abdominal obesity among Chinese children and adolescents aged 6–17 years has increased between 1993 and 2015.

Are the Recent Secular Increases in Waist Circumference among Children and Adolescents Independent of Changes in BMI?

BackgroundSeveral studies have shown that the waist circumference of children and adolescents has increased over the last 25 years. However, given the strong correlation between waist circumference and BMI, it is uncertain if the secular trends in waist circumference are independent of those in BMI.MethodsWe analyzed data from 6- to 19-year-olds who participated in the 1988–1994 through 2011–2012 cycles of the National Health and Nutrition Examination Survey to assess whether the trends in waist circumference were independent of changes in BMI, race-ethnicity and age.ResultsMean, unadjusted levels of waist circumference increased by 3.7 cm (boys) and 6.0 cm (girls) from 1988–94 through 2011–12, while mean BMI levels increased by 1.1 kg/m2 (boys) and 1.6 kg/m2 (girls). Overall, the proportional changes in mean levels of both waist circumference and BMI were fairly similar among boys (5.3%, waist vs. 5.6%, BMI) and girls (8.7%, waist vs. 7.7%, BMI). As assessed by the area under the curve, adjustment for BMI reduced the secular increases in waist circumference by about 75% (boys) and 50% (girls) beyond that attributable to age and race-ethnicity. There was also a race-ethnicity interaction (p < 0.001). Adjustment for BMI reduced the secular trend in waist circumference among non-Hispanic (NH) black children (boys and girls) to a greater extent (about 90%) than among other children.ConclusionsOur results indicate that among children in the U.S., about 75% (boys) and 50% (girls) of the secular increases in waist circumference since 1988–94 can be accounted for by changes in BMI. The reasons for the larger independent effects among girls and among NH blacks are uncertain.

Are the recent secular increases in the waist circumference of adults independent of changes in BMI?

Several studies showed that the waist circumference of US adults has increased over the past 25 y. However, because of the high correlation between waist circumference and body mass index (BMI; in kg/m²) (r ∼ 0.9), it is uncertain if these trends in waist circumference exceed those expected on the basis of BMI changes over this time period. We assessed whether the recent trend in waist circumference was independent of changes in BMI, age, and race-ethnicity. We analyzed data from the 1999-2000 through 2011-2012 cycles of the NHANES. The mean waist circumference increased by ∼2 cm (in men) and ∼4 cm (in women) in adults in the United States over this 12-y period. In men, this increase was very close to what would be expected because of the 0.7 increase in mean BMI over this period. However, in women, most of the secular increase in waist circumference appeared to be independent of changes in BMI (mean: 0.6), age, and race-ethnicity over the 12-y period. We estimated that, independent of changes in these covariates, the mean waist circumference increased by 0.2 cm in men and 2.4 cm in women from 1999-2000 through 2011-2012; only the latter estimate was statistically significant. Our results indicate that, in women but not men, the recent secular trend in waist circumference is greater than what would be expected on the basis of changes in BMI. Possible reasons for this secular increase, along with sex differences, are uncertain.

Waist circumference centiles by age and sex for Japanese children based on the 1978–1981 cross-sectional national survey data

Aim: The aim of this study was to establish reference values for waist circumference among Japanese youths using the 1978–1981 nationally representative data.Subject and methods: Growth charts were derived using Cole’s LMS method, which adjusts the waist circumference distribution for skewness and allows waist circumference to be expressed as centile or standard deviation score. The sample population consisted of 19 233 children aged 6–18 years. Waist circumference was measured at the level of maximum waist narrowing in girls and at the level of the top of the iliac crest in boys.Results: Comparison was made between the 1978–1981 and 1992–1994 waist circumference charts, showing a large increase in waist circumference over time; the mean difference was 1.1 and 0.5 SD score units in boys and girls, respectively. Defining cut-offs for central fatness as the 90th and 95th centiles of the 1978–1981 reference, the prevalences in 1992–1994 were, respectively, 42.3% and 25.2% in boys and 19.1% and 10.9% in girls. The corresponding prevalences in 1978–1981 were 10% and 5% by definition.Conclusion: This study showed increasing trends in waist circumference, particularly in boys during the period of the two surveys and that the 1978–1981 charts serve as better baseline references for waist circumference among Japanese youth.

A break in the obesity epidemic? Explained by biases or misinterpretation of the data?

Recent epidemiologic papers are presenting prevalence data suggesting breaks and decreases in obesity rates. However, before concluding that the obesity epidemic is not increasing anymore, the validity of the presented data should be discussed more thoroughly. We had a closer look into the literature presented in recent reviews to address the major potential biases and distortions, and to develop insights about how to interpret the presented suggestions for a potential break in the obesity epidemic. Decreasing participation rates, the use of reported rather than measured data and small sample sizes, or lack of representativeness, did not seem to explain presented breaks in the obesity epidemic. Further, available evidence does not suggest that stabilization of obesity rates is seen in higher socioeconomic groups only, or that urbanization could explain a potential break in the obesity epidemic. However, follow-ups of short duration may, in part, explain the apparent break or decrease in the obesity epidemic. On the other hand, a single focus on body mass index (BMI) ⩾25 or ⩾30 kg m(-)(2) is likely to mask a real increase in the obesity epidemic. And, in both children and adults, trends in waist circumferences were generally suggesting an increase, and were stronger than those reported for trends in BMI. Studies concluding that there is a recent break in the obesity epidemic need to be interpreted with caution. Reported studies presenting a break were mostly of short duration. Further, focusing on trends in waist circumference rather than BMI leads to a less optimistic conclusion: the public health problem of obesity is still increasing.

Predictors of change in weight and waist circumference: 15-year longitudinal study in Australian adults

This study examines which socio-demographic and lifestyle characteristics are associated with weight and waist circumference (WC) change in a cohort of Australian adults over a 15-year period (1992-2007). Further, it tests the effect of period of birth (birth cohort) on mean weight and WC at two time points, 15 years apart. Up to three repeated measures of weight (n=1437) and WC (n=1317) were used. Self-reported data on socio-demographic and lifestyle characteristics were derived from repeated questionnaires. Multivariable models, stratified by sex, were adjusted for potential confounders. Participants born more recently were heavier, on average, than those in the same age group 15 years earlier, but there was no such secular trend in WC. Age at baseline was associated with change in weight and WC, but the pattern was different: participants gained weight up to age 55 years, while WC gain continued to 65 years. In women, higher level of recreational physical activity was associated with lower WC gain (P<0.05). Parity was also associated with WC change in women (P<0.05), but there was no linear trend. Age was the most important factor associated with change in weight and WC in both sexes, apparently reducing the influence of all potential covariates. Among women, physical activity and parity were also associated with change in weight and WC. This study provides longitudinal evidence to support public health efforts that address the continuous increases in average weight and WC of many populations around the world.

Waist circumference and abdominal obesity among older adults: patterns, prevalence and trends.

ObjectivesTo describe the patterns and trends in waist circumference and abdominal obesity for those aged 70–89 contrasting the standard and new age-related cut-points, and to investigate how they vary with time, age and educational level.MethodsThe subjects were 7129 men and 9244 women aged 70–89 years who participated in the Health Survey for England during 1993–2010. The outcome measures were the percentiles of waist circumference and standard and new indicators of abdominal obesity based on waist circumference. Binomial and quantile regression were used to investigate the relationship with key explanatory variables.ResultsThe distribution of waist circumference among community-dwelling older adults in England has shifted upwards since 1993 (an increase in median of 4.5 cm in men and 5.1 cm in women). The prevalence of abdominal obesity has increased, while those in the low-risk group have decreased. Abdominal obesity was higher in those aged 70–79 compared to 80–89, and in those who left education earlier. The prevalence of abdominal obesity varies considerably with new and standard cut-points, which makes it impractical to use the new ones on a population that includes subjects across the adult age range.ConclusionsObesity is increasing among the elderly, but more work is needed on devising age-appropriate indicators of high risk based on waist circumference.

Trends in waist circumference and central obesity in adults, northern iran.

The main aim of this study is to determine the central obesity trends during the period from 2006 to 2010 among 15-65 years old people in Northern Iran. This was a population-based cross-sectional study conducted on 6466 subjects who had been chosen by a multi stage cluster random sampling within five steps. The subjects were randomly chosen from 325 clusters and each cluster included 20 cases. Central obesity was defined as waist circumference ³102 cm and ³88 cm in men and women, respectively. Compared to 2010, the mean waist circumference in 2006 changed from 87.2 cm to 88.1 cm in men (p=0.237), and from 90.3 cm to 88.6 cm in women (p=0.045). The comparison between 2006 and 2010 revealed that the prevalence of central obesity slightly decreased, 6.8% and 2.4% in urban women and men, respectively. Generally, the mean of waist circumference significantly decreased in urban women (by 0.069 cm in each year; p=0.020); however, the decrease of waist circumference in urban men was not significant (0.006 cm decrease each year; p=0.915). The prevalence of central obesity declined among both males and females in the urban area; however, there was an attenuated increasing trend in the rural area. The disparity of trends between the two regions should be considered for further study.

Sixteen‐year longitudinal trends in waist circumference and their impact on blood pressure in China Cohort

To evaluate the association among waist circumference (WC), changes in waist circumference (ΔWC) and changes in blood pressure, we used prospective data from the China Health and Nutrition Survey of 3077 subjects aged 18–45 years old, whose blood pressure was normal at baseline and who did not take anti‐hypertension drugs and was reexamined at least one more time in follow‐up years. Controlled for age, BMI, blood pressure at baseline and changes in BMI, we used multivariate analysis of variance for longitudinal, repeated‐measures and random effects linear model to analyze changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) among WC and ΔWC groups. SBP increased 8.9 mmHg in low WC group compared with 14.9 mmHg in high WC group (P&lt;0.001) in men and 11.3 mmHg and 20.6 mmHg, respectively (P&lt;0.001) in women. For DBP, the same results showed an increase of 5.9 mmHg in low WC group vs. 9.9 mmHg in high WC group (P&lt;0.001) in men and 5.8 mmHg vs. 11.1mmHg in women, respectively. SBP and DBP increased higher in both high and low ΔWC gain groups than in WC stable or decrease groups. Association between WC or ΔWC and blood pressure was statistically significant. Independent of BMI, among Chinese adults central distributed body fat at baseline and an increase in central body fat can independently increase SBP and DBP in both men and women.Supported by NIH (R01‐HD30880) and Fogarty International Center, NIH (5D43TW007709).

Trends of Waist Circumference Distribution and Abdominal Adiposity among Chinese Adults, 1993‐2004

Waist circumference (WC) is a strong predictor of hypertension and other noncommunicable diseases in China. This study examines temporal trends in waist circumference and the prevalence of abdominal adiposity trends among Chinese adults aged 20–65 from 1993 to 2004. We use data of the China Health and Nutrition Survey collected in 1993, 1997, 2000 and 2004. Compared with 1993, the 2004 waist circumference distribution curves flattened and shifted rightwards in males and females. Mean waist circumference increased from 76.8cm to 82.8cm among males and from 75.1cm to 79.3cm among females. A gradient of increasing prevalence of abdominal obesity was also observed in males and females. Similar trends of increasing waist circumference and abdominal obesity were observed in underweight, normal weight, overweight and obesity subjects defined by WHO recommended cutoff points of body mass index (BMI). These results demonstrate the rapid increase in obesity, especially abdominal obesity, among Chinese adults. Primary prevention of abdominal obesity should be a major public health problem in China.

Waist Circumference Values Are Increasing Beyond Those Expected From BMI Increases

The objective of this investigation was to examine the relationship between BMI and waist circumference (WC) by gender and race subgroups from U.S. population-based data from 1959 to 2004 and to investigate the trend in WC over calendar time. Demographic and anthropometric cross-sectional data on 30,730 participants 18 to 79 years old across five national surveys were included. We regressed WC on BMI while controlling for age in each time period for blacks and whites by gender. The relationship between BMI and WC as characterized by the slope of the linear regression of WC on BMI does not seem to be changing significantly over time. A small (range, 0.08 to 0.27 cm/yr) increase in WC over time was observed. The implications of these findings for public health and for understanding any extant changes in the BMI-mortality rate relationship remain to be elucidated.

Predicting glucose intolerance with normal fasting plasma glucose by the components of the metabolic syndrome

BACKGROUNDSurprisingly, it is estimated that about half of type 2 diabetics remain undetected. The possible causes may be partly attributable to people with normal fasting plasma glucose (FPG) but abnormal postprandial hyperglycemia. We attempted to develop an effective predictive model by using the metabolic syndrome (MeS) components as parameters to identify such persons.SUBJECTS AND METHODSAll participants received a standard 75-g oral glucose tolerance test, which showed that 106 had normal glucose tolerance, 61 had impaired glucose tolerance, and 6 had diabetes-on-isolated postchallenge hyperglycemia. We tested five models, which included various MeS components. Model 0: FPG; Model 1 (clinical history model): family history (FH), FPG, age and sex; Model 2 (MeS model): Model 1 plus triglycerides, high-density lipoprotein cholesterol, body mass index, systolic blood pressure and diastolic blood pressure; Model 3: Model 2 plus fasting plasma insulin (FPI); Model 4: Model 3 plus homeostasis model assessment of insulin resistance. A receiver-operating characteristic (ROC) curve was used to determine the predictive discrimination of these models.RESULTSThe area under the ROC curve of the Model 0 was significantly larger than the area under the diagonal reference line. All the other 4 models had a larger area under the ROC curve than Model 0. Considering the simplicity and lower cost of Model 2, it would be the best model to use. Nevertheless, Model 3 had the largest area under the ROC curve.CONCLUSIONWe demonstrated that Model 2 and 3 have a significantly better predictive discrimination to identify persons with normal FPG at high risk for glucose intolerance.

Central adiposity in Brazilian schoolchildren aged 7–10 years

Waist circumference (WC) is a measure of central adiposity related to elevated risk factor levels in children and adolescents. The aim of the present study was to describe WC percentiles in 7- to 10-year-old Brazilian children and to compare frequencies of obesity and overweight as defined by BMI and frequencies of excess and at risk of abdominal adiposity as defined by WC to the corresponding age and sex data from British references. A representative sample of 2919 schoolchildren of the city of Florianopolis (southern Brazil) was examined. Smoothed WC percentiles were derived using the least mean square method. Frequencies of overweight and obesity and of excess and at risk of abdominal adiposity were assessed using the 91st and 98th centiles of the British references as cut-off points. WC increased with age in both boys and girls, with higher values for boys at every age and percentile level. Nutritional status categories of children assessed by the 91st and 98th British BMI and WC centiles showed moderate agreement (weighted kappa = 0.58). Overweight was more frequent in Brazilian than British children: 15.1 % of girls and 20.1 % of boys were above the 91st percentile of the 1990 BMI for age British references. About one-quarter (22.0 % of girls and 26.9 % of boys) exceeded the 91st percentile of WC British references. The present data could be used to compare WC in children in other populations and may serve as a baseline for future studies of temporal trends in WC in Brazil.

Increasing Trends in Waist Circumference and Abdominal Obesity among U.S. Adults

Some studies have shown that abdominal obesity may be a better predictor than overall obesity for disease risks and all-cause mortality. This study sought to examine the recent trends in waist circumference (WC) among adults in the United States. Data from the National Health and Nutrition Examination Survey during 1988-1994, 1999-2000, 2001-2002, and 2003-2004 were analyzed to estimate the trends in the mean WC and the prevalence of abdominal obesity. Pooled t tests were used to test the differences in estimates between two time periods. Between the periods of 1988-1994 and 2003-2004, the age-adjusted mean WC increased from 96.0 cm to 100.4 cm among men (p < 0.001) and from 89.0 cm to 94.0 cm among women (p < 0.001); the age-adjusted prevalence of abdominal obesity increased from 29.5% to 42.4% among men (p < 0.001) and from 47.0% to 61.3% among women (p < 0.001). Between the periods of 1999-2000 and 2003-2004, a significant increase occurred in mean WC only among men (from 99.0 cm to 100.4 cm; p = 0.03) and in the prevalence of abdominal obesity among both men (from 37.0% to 42.2%; p = 0.03) and women (from 55.3% to 61.3%; p = 0.04). People with a BMI of 25 to 29 kg/m2 had a greater relative increase in abdominal obesity. The mean WC and the prevalence of abdominal obesity among U.S. adults have increased continuously during the past 15 years. Over one-half of U.S. adults had abdominal obesity in the period of 2003-2004.

Recent Trends in Waist Circumference and Waist-Height Ratio Among US Children and Adolescents

Recent Trends in Waist Circumference and Waist-Height Ratio Among US Children and Adolescents

Reported food intake and distribution of body fat: a repeated cross-sectional study

BackgroundBody mass, as well as distribution of body fat, are predictors of both diabetes and cardiovascular disease. In Northern Sweden, despite a marked increase in average body mass, prevalence of diabetes was stagnant and myocardial infarctions decreased. A more favourable distribution of body fat is a possible contributing factor.This study investigates the relative importance of individual food items for time trends in waist circumference (WC) and hip circumference (HC) on a population level.MethodsIndependent cross-sectional surveys conducted in 1986, 1990, 1994 and 1999 in the two northernmost counties of Sweden with a common population of 250000. Randomly selected age stratified samples, altogether 2982 men and 3087 women aged 25–64 years. Questionnaires were completed and anthropometric measurements taken. For each food item, associations between frequency of consumption and waist and hip circumferences were estimated. Partial regression coefficients for every level of reported intake were multiplied with differences in proportion of the population reporting the corresponding levels of intake in 1986 and 1999. The sum of these product terms for every food item was the respective estimated impact on mean circumference.ResultsTime trends in reported food consumption associated with the more favourable gynoid distribution of adipose tissue were increased use of vegetable oil, pasta and 1.5% fat milk. Trends associated with abdominal obesity were increased consumption of beer in men and higher intake of hamburgers and French fried potatoes in women.ConclusionFood trends as markers of time trends in body fat distribution have been identified. The method is a complement to conventional approaches to establish associations between food intake and disease risk on a population level.

Recent Trends in Waist Circumference and Waist-Height Ratio Among US Children and Adolescents

Abdominal obesity may be a better predictor than overall obesity for the risk of cardiovascular disease and type 2 diabetes. Waist circumference and waist-height ratio are 2 simple, yet effective, surrogate measures of abdominal obesity. We sought to examine the recent trends in mean waist circumference and waist-height ratio and prevalence of abdominal obesity among children and adolescents aged 2 to 19 years in the United States. Representative samples of the civilian, noninstitutionalized US population from the National Health and Nutrition Examination Survey conducted during 4 time periods, 1988-1994 (ie, National Health and Nutrition Examination Survey III), 1999-2000, 2001-2002, and 2003-2004, were examined to estimate the mean waist circumference and waist-height ratio of boys and girls in 4 different age groups. Data from the 3 most recent National Health and Nutrition Examination Surveys were combined to establish a National Health and Nutrition Examination Survey 1999-2004 category. Categorized by age group, the unadjusted mean waist circumference for boys increased between National Health and Nutrition Examination Survey III and National Health and Nutrition Examination Survey 1999-2004 from 50.7 cm (aged 2-5 years), 61.9 cm (aged 6-11 years), 76.8 cm (aged 12-17 years), and 81.3 cm (aged 18-19 years) to 51.9, 64.5, 79.8, and 86.6 cm, respectively. During the same time periods and within the same age groups, the unadjusted mean waist circumference for girls increased from 51.0, 61.7, 75.0, and 77.7 cm to 51.8, 64.7, 78.9, and 83.9 cm, respectively. The relative change in waist-height ratio was similar to waist circumference at each age group for both boys and girls. Using the 90th percentile values of waist circumference for gender and age, the prevalence of abdominal obesity increased by 65.4% (from 10.5% to 17.4%) and 69.4% (from 10.5% to 17.8%) for boys and girls, respectively. Mean waist circumference and waist-height ratio and the prevalence of abdominal obesity among US children and adolescents greatly increased between 1988-1994 and 1999-2004.

Waist circumference percentiles for Canadian youth 11-18y of age.

To develop age- and sex-specific waist circumference reference data for Canadian youth. Cross-sectional population survey. 1981 Canada Fitness Survey. Nationally representative sample of 3064 youth (1540 boys and 1524 girls) 11-18 y of age. Waist circumference was measured with a flexible anthropometric tape. Smoothed and weighted 5th, 10th, 25th, 50th, 75th, 90th, and 95th waist circumference percentiles derived from LMS regression. Waist circumference increases with age in both boys and girls, and boys have higher values of waist circumference than girls at every age and percentile level. These reference data can be used to identify youth with an elevated risk of developing obesity-related disorders and can serve as a baseline for future studies of temporal trends in waist circumference. This research was funded by the Heart and Stroke Foundation of Ontario (Grant #T4946).

Trends in waist circumference among U.S. adults.

Waist circumference has been proposed as a measure of obesity or as an adjunct to other anthropometric measures to determine obesity. Our objective was to examine temporal trends in waist circumference among adults in the U.S. We used data from 15,454 participants >/=20 years old in National Health and Nutrition Examination Survey (NHANES) III (1988 to 1994) and 4024 participants >/=20 years old from National Health and Nutrition Examination Survey 1999 to 2000. The unadjusted waist circumference increased from 95.3 (age-adjusted, 96.0 cm) to 98.6 (age-adjusted, 98.9 cm) cm among men and from 88.7 (age-adjusted 88.9 cm) to 92.2 (age-adjusted 92.1 cm) cm among women. The percentiles from the two surveys suggest that much of the waist circumference distribution has shifted. Statistically significant increases occurred among all age groups and racial or ethnic groups except men 30 to 59 years old, women 40 to 59 and >/=70 years old, and women who were Mexican American or of "other" race or ethnicity. These results demonstrate the rapid increase in obesity, especially abdominal obesity, among U.S. adults. Unless measures are taken to slow the increase in or reverse the course of the obesity epidemic, the burden of obesity-associated morbidity and mortality in the U.S. can be expected to increase substantially in future years.