1. NHANES: A Potential Database for Risk Assessment Clifford Johnson Centers for Disease Control and Prevention National Center for Health Statistics

2. National Health and Nutrition Examination Survey (NHANES) Objective To assess the health and nutritional status of adults and children in the United States OP96S022

3. National Health and Nutrition Examination Surveys NHES I1960-6218-79 years NHES II1963-656-11 years NHES III1966-7012-17 years NHANES I1971-751-74 years NHANES II1976-806 mo.-74 years HHANES1982-84 6 mo.-74 years NHANES III1988-942 mo. + NHANES1999-All ages SurveyDatesAges OP96S025

4. Continuous data collection beginning in 1999 Multi-stage probability sample Annual national sample of 5,000 persons Detailed estimates of population subgroups requires two or more years NHANES sample design

5. NHANES process Home Examination Interview Mobile Examination Center Longitudinal Followup Identification of sample persons OP96S028

6. Broad range of health conditions Health care coverage and need Environmental and occupational exposures Health behaviors Nutrition and dietary supplements NHANES household interview OP96S039

7. NHANES Mobile Exam Center

8. NHANES topics Cardiovascular disease Diabetes, lower extremity disease Bone status, osteoporosis Oral health Vision Hearing and balance Fitness and strength OP96S035

9. NHANES topics Nutrition Anthropometry Mental health Risk behaviors Reproductive health Environmental exposures Infectious diseases OP96S036

10. Dietary nutrient intake Anthropometric measurements Nutritional biochemistries and hematologic tests Physical examination Interview NHANES nutrition assessments OP96S060

11. NHANES 1999-2001 Dietary Assessment 24-hour dietary recall (automated ) Second day recall on subset of persons Food frequency (focused) General questions Supplements/medications (detailed) Food security

13. NHANES 2002 Dietary Assessment 24-hour dietary recall (new USDA automated system) Second day recall on ALL persons (telephone) Food frequency (focused) General questions Supplements/medications (detailed) Food security

14. MEC laboratory CBC and differential Pregnancy test Blood, urine and vaginal swab processing 76 different vials of samples 26 laboratories 300 laboratory assays

15. Environmental exposure measures Lead Cadmium Mercury Pesticides Selenium Cotinine Urinary Iodine Volatile organic compounds

16. National Report on Human Exposure to Environmental Chemicals First report - 27 environmental chemicals including: Metals Cotinine Organophosphate pesticide metabolites Phthalate metabolites Updated annually

17. Dietary data for future NHANES Continue collection of two recalls on all sample persons Pilot test in 2002 of a longer food frequency questionnaire Monitor respondent burden Balance competing needs --- usual intake, total intake (nutrients vs. foods), food safety, supplement use, DHKS, food programs and health components

18. NHANES web site http://www.cdc.gov/nchs/nhanes.htm OP96S058