National Academies Press: OpenBook

Assessing Prevalence and Trends in Obesity: Navigating the Evidence (2016)

Chapter: Appendix A: Acronyms and Glossary

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Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

Appendix A

Acronyms and Glossary

ACRONYMS

AAP American Academy of Pediatrics
ACHI Arkansas Center for Health Improvement
Add Health National Longitudinal Survey of Adolescent to Adult Health
ADP air-displacement plethysmography
AHRQ Agency for Healthcare Research and Quality
APT Assessing Prevalence and Trends (Framework)
B-24/P Dietary Guidance Development Project for Birth to 24 Months and Pregnancy
BIA bioelectrical impedance analysis
BIV biologically implausible value
BMI body mass index
BRFSS Behavioral Risk Factor Surveillance System
CARDIAC Coronary Artery Risk Detection in Appalachian Communities (Study)
CAYPOS Child and Youth Prevalence of Overweight Survey
CDC Centers for Disease Control and Prevention
CENTURY Collecting Electronic Nutrition Trajectory Data Using Records of Youth (Study)
CHAMACOS Center for the Health Assessment of Mothers and Children of Salinas
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
CHIS California Health Interview Survey
CHNA community health needs assessment
CI confidence interval
DXA dual-energy X-ray absorptiometry
EAT Eating Among Teens (Study)
ECHO Environmental Influences on Child Health Outcomes
ECLS-B Early Childhood Longitudinal Survey-Birth Cohort
EHR electronic health record
FERPA Family Educational Rights and Privacy Act
FNS Food and Nutrition Service (USDA)
FPL federal poverty level
GOe Global Observatory for eHealth
GUTS Growing Up Today Study
HEALTH-KIDS Healthy Eating and Active Lifestyles from school To Home for KIDS
HEDIS Healthcare Effectiveness Data and Information Set
HFZ Healthy Fitness Zone®1
HIPAA Health Insurance Portability and Accountability Act of 1996
HSR health service region
i3C International Childhood Cardiovascular Cohort (Consortium)
ICD International Classification of Diseases
IOM Institute of Medicine
IOTF International Obesity Task Force
IRB Institutional Review Board
ITO Indian Tribal Organization
KPSC Kaiser Permanente Southern California
MCIR Michigan Care Improvement Registry
MEPS-HC Medical Expenditure Panel Survey-Household Component
MGRS Multicentre Growth Reference Study
mHealth mobile health

___________________

1Healthy Fitness Zone®is a registered trademark of The Cooper Institute.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
NCCOR National Collaborative on Childhood Obesity Research
NCHS National Center for Health Statistics
NCQA National Committee for Quality Assurance
NHANES National Health and Nutrition Examination Survey
NHES National Health Examination Survey
NHIS National Health Interview Survey
NHPI Native Hawaiian and Pacific Islander
NICHD National Institute of Child Health and Human Development
NI–HR Needs Improvement–Health Risk
NLSY National Longitudinal Survey of Youth
NSCH National Survey of Children’s Health
NS-CSHCN National Survey of Children with Special Health Care Needs
OMB Office of Management and Budget
PC WIC Participant and Program Characteristics
PedNSS Pediatric Nutrition Surveillance System
PEDSnet PII Pediatric EHR Data Sharing Network personally identifiable information
REGARDS REasons for Geographic Differences in Stroke (Study)
RWJF Robert Wood Johnson Foundation
SAE small area estimation
SES socioeconomic status
SLAITS State and Local Area Integrated Telephone Survey
SPAN School Physical Activity and Nutrition (Survey)
USDA U.S. Department of Agriculture
WHO World Health Organization
WHR waist-to-hip ratio
WHtR waist-to-height ratio
WIC Special Supplemental Nutrition Program for Women, Infants, and Children
YRBS Youth Risk Behavior Survey
YRBSS Youth Risk Behavior Surveillance System
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

GLOSSARY

Abdominal adiposity

Fat accumulated around a person’s midsection; often assessed by measuring waist circumference or waist-to-hip ratio.

Absolute change

The simple difference between the estimated prevalence during time 2 and the estimated prevalence during time 1.

Adipose tissue

Body fat.

Adiposity

See Adipose tissue.

Adiposity rebound

The point at which body mass index begins an increasing trajectory, after decreasing in early childhood due to a more rapid increase in height than weight. Adiposity rebound typically occurs between the ages of 4 and 7.

Air-displacement plethysmography

A technique used to assess body composition by determining body volume and density.

Analytic approach

Approaches used for data preparation and statistical analysis.

Bias

Systematic deviation of results or inferences from the truth. This could result in the over- or under-estimation of the true value.

Bioelectrical impedance analysis (BIA)

A body composition assessment approach based on the principle that electrical currents travel at different speeds through lean body mass and water than through adipose tissue. In BIA, electrical currents are sent through the body and the resulting resistance (impedance) to the current is measured. The measure of impedance is used to calculate total body water, fat-free body mass, and fat mass.

Biologically implausible value (BIV)

An extreme value (high or low) falling outside of an expected range that may represent error in measuring an anthropometric factor or an error in data entry.

BMI-for-age percentile

Describes how a child’s body mass index ranks compared to a reference population of the same sex and age. A BMI-for-age at the 95th percentile, for example, means that 95 percent of the reference population of the same sex and age had a BMI below that value, while 5 percent had a BMI above that value.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

BMI-for-age z-score

The number of standard deviations an individual’s BMI falls above or below the sex- and age-specific reference population’s mean. For example, a BMI z-score of +3 indicates a BMI that is 3 standard deviations higher than the mean BMI value in the reference population of the same sex and age.

Body composition

The distribution of body fat, lean muscle tissue, water, and bone in an individual.

Body mass index (BMI)

An index commonly used to classify an individual’s weight status. BMI is calculated using the following equation:

BMI (kg/m2) = weight (kilograms) ÷ height (meters)2

Adults with a BMI of 30 kg/m2 or more are classified as having obesity. Children’s BMIs, in contrast, vary by sex and age. To be classified, a child’s BMI must be compared to a sex-specific, age-based distribution that has been determined in a reference population.

Central adiposity

See Abdominal adiposity.

Change

In this report, “change” describes the difference in obesity prevalence in a given population between two points in time. Change can be expressed as absolute or relative change (see Absolute change and Relative change).

Cohort study

An analytic epidemiologic study in which a defined population has been followed over time and the exposure of interest precedes the outcome variable. The main feature of a cohort study is the comparison of incidence rates in groups that differ in exposure levels.

Confidence interval (CI)

When a dataset does not include every individual in the population, the values that are produced are estimates of the true population parameter (e.g., prevalence of obesity). A CI can be constructed around the estimate, providing a range of values likely to include the true population parameter (e.g., actual prevalence of obesity in the population) and over unlimited repetitions of the study the CI will contain the true parameter with a frequency no less than its confidence level (often 95 percent is the stated level). Wider CIs indicate less precision around the estimate than narrower CIs.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

Cross-sectional study

An observational study that examines participants at one point in time. The temporal sequence of exposure and outcome (i.e., cause and effect) cannot be assured.

Demographic shift

Significant changes to the demographic landscape of a population over time. Demographic shifts occurring in the U.S. population include increasing median age of the population, and changes in the racial and ethnic majority and minority groups.

Dual-energy X-ray absorptiometry (DXA)

A body composition assessment approach. Bone mineral density, fat mass, and lean body mass are determined based on the attenuation of two x-rays of differing energy levels as they pass through the body. Body composition estimates are derived from system-specific algorithms, which can differ between DXA machine manufacturers.

End user

In this report, “end user” refers to an individual, group, or organization that uses one or multiple reports on obesity prevalence and trends to inform a decision.

Estimate

In this report, “estimate (of obesity prevalence or trend)” describes a statistic about the proportion or number of individuals affected with obesity at one point in time (prevalence) or over time (trend). Estimates are known, believed, or suspected to incorporate some degree of error.

Estimate of obesity prevalence or trend

See Estimate.

Growth reference

Distribution of growth among a reference population; the 2000 Centers for Disease Control and Prevention sex-specific BMI-for-age growth charts are an example of a growth reference. See Reference population.

Growth standard

Distribution of growth parameters among a reference population that exemplifies optimal growth. The World Health Organization has developed growth standards for children birth to age 5 years. See Reference population.

Health disparities

Systemic and preventable differences in the burden of disease and disability or opportunities to achieve optimal health between particular population groups due to economic, racial, cultural, geographic, social factors, or other determinants.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

Immunization registry

An online population-based database to record and monitor all immunizations administered by health care providers; immunization registries are not required for all health care providers.

Intervention study

An experimental study designed to test a specific hypothesis in which one or multiple factors are modified to determine the factor’s effect(s) on outcomes of interest.

Investigators

In this report, “investigators” describes anyone who designs studies or performs data collection, analyses, or reporting.

Lean body mass

Body mass not including adipose tissue.

Longitudinal study

An observational study that examines a selected population at multiple points over time. A cohort study is a longitudinal study. See Cohort study.

Methodology

In this report, “methodology” describes elements related to study design and data collection.

Mobile health (mHealth)

The use of mobile devices and the development of applications for medical and public health purposes.

Morbidity

Disease or illness in a population. Morbidity is frequently measured as prevalence of a disease.

Mortality

Deaths in a population.

Obesity

A state of excess adiposity. For more information on how obesity is commonly assessed in population-based assessments, see Body mass index.

Oversampling

Sampling procedure used to increase the number of individuals from a specific subgroup included in a dataset. Population groups that represent a small portion of the overall target population can be intentionally oversampled in order to generate a reliable estimate of obesity prevalence or trend.

Population

In this report, “population” refers to the total set of individuals about whom inferences are being made in a study. A sample is the subset of people included in the analysis.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

Prevalence

In this report, “prevalence” describes the number of individuals in a sample or subgroup classified as having obesity in relation to the total sample or subgroup at a given point in time.

Proxy-report

In this report, “proxy-report” refers to data provided by someone other than the child of interest. This may be a parent, guardian, or other adult who is knowledgeable about the child.

Published report

In this report, “published report” refers to a publication, peer-reviewed or otherwise, with original analysis that produces an estimate of obesity prevalence or trend.

Reference population

A group of individuals that serve as a comparison for growth and development. See Growth reference and Growth standard.

Relative change

The change in the estimated prevalence in percentage terms (i.e., the absolute change as a percentage of the estimated prevalence during time 1).

Reliability

The extent to which results obtained through a specific measurement protocol or assessment technique can be replicated or reproduced.

Repeated cross-sectional study

A cross-sectional study conducted at multiple points in time. The sample of individuals is different at each assessment (as opposed to a longitudinal study, where the participants remain the same over time).

Report on prevalence or trends

In this report, describes a publication, peer-reviewed or otherwise, with original analysis that produces a value of magnitude and/or a directionality of the magnitude over time of the issue of obesity within a defined population group.

Sampling

The process used for selection of individuals to be included in a dataset.

School-based assessment

In this report, “school-based assessment” refers to any data collection effort conducted in the school setting (a single school or multiple schools), specifically those that collect height and weight data.

Screening

Any tool used to identify potential signs of illness or disease before symptoms are apparent. In the context of this report, BMI serves as a screening tool for excess adiposity.

Secular trends

Long-term trends, usually over 10 years or more.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

Self-report

In this report, “self-report” refers to information reported by individuals about themselves.

Severe obesity

A further classification of obesity status. Adults with a BMI of 40 kg/m2 or greater are classified as having severe obesity. Children’s BMIs, in contrast, vary by sex and age, so a single BMI cut point cannot be used. Instead, a child’s BMI must be compared to an age-based distribution that has been assessed in a reference population.

Skinfold thickness

Skinfold thickness is an assessment of body fat based on a measure of a double fold of the skin and subcutaneous fat at various selected sites on the body. Skinfold thickness measurement can be used in predictive equations to determine an individual’s percent body fat.

Standard deviation

A measure used to quantify the amount of variation or dispersion in a dataset. The standard deviation is the square root of the variance.

Standard error

An estimate of the standard deviation of the sampling distribution of a statistic, most commonly of the mean. See Standard deviation.

Statistical analysis

In this report, “statistical analysis” specifically refers to the analytic procedures that result in an estimate of obesity prevalence or trend.

Statistical approach

See Statistical analysis.

Subcutaneous fat

Adipose tissue directly under the skin.

Surveillance

In this report, surveillance refers to the process of ongoing and systematic data collection, analysis, and interpretation, and subsequent disclosure of results.

Target population

The population group an estimate from the study population is intended to reflect.

Total adiposity

Total body fat; does not describe the location and distribution of adipose tissue.

Trend

In this report, a trend is the change in prevalence of obesity in a given population over three or more points in time.

Underwater weighing

A body composition assessment calculated by measuring body weight (as taken on land), body weight underwater, and the amount of dis-

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×

placed water when an individual is submerged in a water tank. The protocol for underwater weighing requires an individual to be fully submerged, to have blown out as much air from their lungs as possible, and to remain still while the measurement is being taken.

Validity

The extent to which an assessment measures what it is intended to measure. Or, the relative absence of bias or systematic error.

Visceral fat

Fat surrounding body organs.

Waist circumference

A measure of abdominal adiposity; standard protocol for measuring waist circumference varies.

Waist-to-height ratio

Calculated by dividing waist circumference by height; often used in relation to obesity-related comorbidities.

Waist-to-hip ratio

Calculated by dividing waist circumference by hip circumference; often used in relation to obesity-related comorbidities.

Weighting

With respect to obesity prevalence and trends estimates representative of a target population, assigning each participant a value (“weight”) corresponding to their probability of selection. Those having higher probabilities of selection (e.g., being from a group that was oversampled) would be assigned smaller weights.

Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
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Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 200
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 201
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 202
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 203
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 204
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 205
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 206
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 207
Suggested Citation:"Appendix A: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Assessing Prevalence and Trends in Obesity: Navigating the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/23505.
×
Page 208
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Obesity has come to the forefront of the American public health agenda. The increased attention has led to a growing interest in quantifying obesity prevalence and determining how the prevalence has changed over time. Estimates of obesity prevalence and trends are fundamental to understanding and describing the scope of issue. Policy makers, program planners, and other stakeholders at the national, state, and local levels are among those who search for estimates relevant to their population(s) of interest to inform their decision-making. The differences in the collection, analysis, and interpretation of data have given rise to a body of evidence that is inconsistent and has created barriers to interpreting and applying published reports. As such, there is a need to provide guidance to those who seek to better understand and use estimates of obesity prevalence and trends.

Assessing Prevalence and Trends in Obesity examines the approaches to data collection, analysis, and interpretation that have been used in recent reports on obesity prevalence and trends at the national, state, and local level, particularly among U.S. children, adolescents, and young adults. This report offers a framework for assessing studies on trends in obesity, principally among children and young adults, for policy making and program planning purposes, and recommends ways decision makers and others can move forward in assessing and interpreting reports on obesity trends.

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