Kuczmarski · JAMA 1994 · repeated cross-sectional survey · n=24000-52000 across 4 surveys (6000-13000 per survey)

Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991.

Cited 2391 times in the scientific literature.

Level 4 - case-series / case-control

Serial cross-sectional population surveys

PubMed 8022039 · doi:10.1001/jama.272.3.205 · record verified 2026-08-27

What was done

Trends in overweight prevalence and body mass index (BMI) among US adults were examined across four nationally representative cross-sectional surveys: NHES I (1960–1962), NHANES I (1971–1974), NHANES II (1976–1980), and NHANES III Phase 1 (1988–1991). Each survey included in-person interviews and medical examinations with direct measurements of height and weight in 6,000 to 13,000 adults aged 20 through 74 years.

What was found

In 1988 to 1991, 33.4% of US adults aged 20 years or older were estimated to be overweight, with increases observed across all race/sex groups. Between the 1976–1980 and 1988–1991 surveys, overweight prevalence increased by 8%. During this interval, mean BMI among adults aged 20 through 74 increased from 25.3 to 26.3, and mean body weight increased by 3.6 kg.

Why it matters

This study provided landmark national evidence of a sharp rise in adult overweight prevalence in the United States, demonstrating that national public health targets for overweight reduction were not on track to be met.

Limits

The abstract describes serial cross-sectional surveys rather than longitudinal cohort follow-up. Specific subgroup data (by race and sex), precision estimates (confidence intervals), and underlying causal factors (dietary intake or physical activity) are not detailed in the abstract.

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