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

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

National Health and Nutrition Examination Surveys NHES I years NHES II years NHES III years NHANES I years NHANES II mo.-74 years HHANES mo.-74 years NHANES III mo. + NHANES1999-All ages SurveyDatesAges OP96S025

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

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

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

NHANES Mobile Exam Center

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

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

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

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

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

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

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

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

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

NHANES web site OP96S058