1. By Michael Cochran-Boucher University of New Hampshire Manchester 2010 Spring, Undergraduate Research Symposium Source: Fall 2009, Independent Study, Case Study: BMI and Pregnancy

2. Research Question: Why should we as a society be concerned about Obesity? Introduction: The pandemic of obesity effects people from every walk of life, young and old, rich and poor (Linne 2008). The World Health Organization to designate obesity as one of the current most important global health threats facing civilization (Guelinckx 2008). Unhealthy lifestyle marked by the consumption of a high-energy, high-fat foods mixed with physical inactivity (Guelinckx 2008). Source: Fall 2009, Independent Study, Case Study: BMI and Pregnancy

3. Outline: BMI methods and problems with collection. BMI data for the United States since 1985. Gestational diabetes, PCOS, metabolic imprinting as an infant are only a few related complications. Overall figures derived from the case study research. Finally, some difficulties in the health care billing and collection of data. Source: Fall 2009, Independent Study, Case Study: BMI and Pregnancy

4. Self reporting of height and weight Body Mass Index (BMI): a measure of weight in relation to height = weight (kg) / height (m) Sq. X 703 Classification: Underweight: BMI < 18.5 Overweight: BMI 25.0-29.9 Obese: BMI > 30.0 Morbidly Obese: BMI> 39.9 Source: www.Mass.gov

5. *BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person. <10% No Data 10%–14% Source: U.S. Center for Disease Control (CDC)

6. <10% No Data 10%–14%

7. <10% No Data 10%–14%

8. <10% No Data 10%–14%

9. <10% No Data 10%–14%

10. <10% No Data 10%–14%

11. No Data <10% 10%–14% 15%–19%

17. No Data <10% 10–14% 15–19% ≥20%

18. No Data <10% 10–14% 15–19% ≥20%

19. No Data <10% 10–14% 15–19% ≥20%

20. No Data <10% 10–14% 15–19% ≥20%

21. No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

25. ≥30%

26. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% ≥30%

27. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% ≥30%

28. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% ≥30%

29. 2008 ≥30% No Data <10% 10%–14% 15%–19% 20%–24% ≥25% 1990 1999

30.  BRFSS, Behavioral Risk Factor Surveillance System http: //www.cdc.gov/brfss/  Mokdad AH, et al. The spread of the obesity epidemic in the United States, 1991—1998 JAMA 1999; 282:16:1519–22.  Mokdad AH, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001; 286:10:1519–22.  Mokdad AH, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003: 289:1: 76–9  CDC. State-Specific Prevalence of Obesity Among Adults — United States, 2007; MMWR 2008; 57(36);765-8  BRFSS, Behavioral Risk Factor Surveillance System http: //www.cdc.gov/brfss/  Mokdad AH, et al. The spread of the obesity epidemic in the United States, 1991—1998 JAMA 1999; 282:16:1519–22.  Mokdad AH, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001; 286:10:1519–22.  Mokdad AH, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003: 289:1: 76–9  CDC. State-Specific Prevalence of Obesity Among Adults — United States, 2007; MMWR 2008; 57(36);765-8

31. Definitions:  Obesity: Body Mass Index (BMI) of 30 or higher.  Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters. Definitions:  Obesity: Body Mass Index (BMI) of 30 or higher.  Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters.

32. Source of the data:  The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health departments use standard procedures to collect data through a series of telephone interviews with U.S. adults.  Prevalence estimates generated for the maps may vary slightly from those generated for the states by BRFSS (http://aps.nccd.cdc.gov/brfss) as slightly different analytic methods are used. Source of the data:  The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health departments use standard procedures to collect data through a series of telephone interviews with U.S. adults.  Prevalence estimates generated for the maps may vary slightly from those generated for the states by BRFSS (http://aps.nccd.cdc.gov/brfss) as slightly different analytic methods are used.

33. In 1990, among states participating in the Behavioral Risk Factor Surveillance System, ten states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%.  By 1999, no state had prevalence less than 10%, eighteen states had a prevalence of obesity between 20-24%, and no state had prevalence equal to or greater than 25%.  In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%. In 1990, among states participating in the Behavioral Risk Factor Surveillance System, ten states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%.  By 1999, no state had prevalence less than 10%, eighteen states had a prevalence of obesity between 20-24%, and no state had prevalence equal to or greater than 25%.  In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.