HP 2020: Nutrition and Weight Status

NUTRITION AND WEIGHT STATUS

Goal

Promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights.

 Overview

The Nutrition and Weight Status objectives for Healthy People 2020 reflect strong science supporting the health benefits of eating a healthful diet and maintaining a healthy body weight. The objectives also emphasize that efforts to change diet and weight should address individual behaviors, as well as the policies and environments that support these behaviors in settings such as schools, worksites, health care organizations, and communities.

The goal of promoting healthful diets and healthy weight encompasses increasing household food security and eliminating hunger.

Americans with a healthful diet:

  • Consume a variety of nutrient-dense foods within and across the food groups, especially whole grains, fruits, vegetables, low-fat or fat-free milk or milk products, and lean meats and other protein sources.
  • Limit the intake of saturated and trans fats, cholesterol, added sugars, sodium (salt), and alcohol.
  • Limit caloric intake to meet caloric needs.1

All Americans should avoid unhealthy weight gain, and those whose weight is too high may also need to lose weight.2

Why Are Nutrition and Weight Status Important?

Diet and body weight are related to health status. Good nutrition is important to the growth and development of children. A healthful diet also helps Americans reduce their risks for many health conditions,1 including:

  • Overweight and obesity
  • Malnutrition
  • Iron-deficiency anemia
  • Heart disease
  • High blood pressure
  • Dyslipidemia (poor lipid profiles)
  • Type 2 diabetes
  • Osteoporosis
  • Oral disease
  • Constipation
  • Diverticular disease
  • Some cancers

Individuals who are at a healthy weight are less likely to:

  • Develop chronic disease risk factors, such as high blood pressure and dyslipidemia.
  • Develop chronic diseases, such as type 2 diabetes, heart disease, osteoarthritis, and some cancers.
  • Experience complications during pregnancy.
  • Die at an earlier age.2,3,4,5

Understanding Nutrition and Weight Status

Diet reflects the variety of foods and beverages consumed over time and in settings such as worksites, schools, restaurants, and the home. Interventions to support a healthier diet can help ensure that:

  • Individuals have the knowledge and skills to make healthier choices.
  • Healthier options are available and affordable.

Social Determinants of Diet

Demographic characteristics of those with a more healthful diet vary with the nutrient or food studied. However, most Americans need to improve some aspect of their diet.6,7 Social factors thought to influence diet include:

  • Knowledge and attitudes
  • Skills
  • Social support
  • Societal and cultural norms
  • Food and agricultural policies
  • Food assistance programs
  • Economic price systems8

Physical Determinants of Diet

Access to and availability of healthier foods can help people follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a person’s diet; these venues may be less available in low-income or rural neighborhoods.9

The places where people eat appear to influence their diet. For example, foods eaten away from home often have more calories and are of lower nutritional quality than foods prepared at home.10 Marketing also influences people’s—particularly children’s—food choices.11

Weight

Because weight is influenced by energy (calories) consumed and expended, interventions to improve weight can support changes in diet or physical activity. They can help change individuals’ knowledge and skills, reduce exposure to foods low in nutritional value and high in calories, or increase opportunities for physical activity.3,12,13 Interventions can help prevent unhealthy weight gain or facilitate weight loss among obese people. They can be delivered in multiple settings, including health care settings,2,14,1516 worksites,17 or schools.12,18,19

Social and Physical Determinants of Weight

The social and physical factors affecting diet and physical activity (see Physical Activity topic area) may also have an impact on weight.

Obesity is a problem throughout the population. However, among adults, the prevalence is highest for middle-aged people and for non-Hispanic black and Mexican American women.20 Among children and adolescents, the prevalence of obesity is highest among older and Mexican American children and non-Hispanic black girls.21 The association of income with obesity varies by age, gender, and race/ethnicity.22

Emerging Issues in Nutrition and Weight Status

As new and innovative policy and environmental interventions to support diet and physical activity are implemented, it will be important to identify which are most effective. A better understanding of how to prevent unhealthy weight gain is also needed.

References

  1. US Department of Health and Human Services and US Department of Agriculture (USDA). Dietary guidelines for Americans, 2005. 6th ed. Washington: US Government Printing Office, 2005 Jan.
  2. National Institutes of Health (NIH); National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. Bethesda, MD: NIH; 1998.
  3. World Health Organization (WHO). Obesity: Preventing and managing the global epidemic. Geneva: WHO; 1999.
  4. Dietz WH. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics. 1998;101:518-24.
  5. Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obes. 1999;23:S2-S11.
  6. US Department of Agriculture (USDA), Center for Nutrition Policy and Promotion. Diet quality of low-income and higher-income Americans in 2003–04 as measured by the Healthy Eating Index, 2005. Nutrition Insight, 2008 December, no. 42.
  7. Healthy People 2010 midcourse review [Internet]. Washington: Department of Health and Human Services, Office of Disease Prevention and Health Promotion; 2007. Available from: http://www.healthypeople.gov/2010/Data/midcourse/html/focusareas /FA19ProgressHP.htm
  8. Story M, Kaphingst KM, Robinson-O’Brien R, et al. Creating healthy food and eating environments: Policy and environmental approaches. Annu Rev Public Health. 2008;29:253-72.
  9. Larson NI, Story MT, Nelson MC. Neighborhood environments: Disparities in access to healthy foods in the US. Am J Prev Med. 2009 Jan;36(1):74-81.
  10. Guthrie JF, Lin BH, Frazao E. Role of food prepared away from home in the American diet, 1977–78 versus 1994–96: Changes and consequences. J Nutr Educ Behav. 2002 May–Jun;34(3):140-50.
  11. Institute of Medicine. Food marketing to children and youth. McGinnis JM, Gootman J, Kraak VI, editors. Washington: National Academies Press; 2006.
  12. Institute of Medicine. Preventing childhood obesity: Health in the balance. Koplan JP, Liverman CT, Kraak VI, editors. Washington: National Academies Press; 2005.
  13. US Department of Health and Human Services (HHS), Public Health Service, Office of the Surgeon General. The Surgeon General’s vision for a healthy and fit nation. Rockville, MD: HHS, 2010 Jan.
  14. US Preventive Services Task Force. Screening for obesity in adults: Recommendations and rationale. Ann Intern Med. 2003 Dec 2;139(11):930-2.
  15. US Preventive Services Task Force, Barton M. Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. Pediatrics. 2010 Feb;125(2):361-7.
  16. Barlow SE; Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics. 2007 Dec;120(suppl 4):S164-92.
  17. Anderson LM, Quinn TA, Glanz K, et al. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: A systematic review. Am J Prev Med. 2009 Oct;37(4):340-57. Review. Erratum in: Am J Prev Med. 2010 Jul;39(1):104.
  18. Summerbell CD, Waters E, Edmunds LD, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD001871. Review.
  19. Wechsler H, McKenna ML, Lee SM, et al. The role of schools in preventing childhood obesity. State Educ Standard. 2004 Dec;5:4-12.
  20. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010 Jan 20;303(3):235-41.
  21. Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA. 2010 Jan 20;303(3):242-9.
  22. Ogden CL, Yanovski SZ, Carroll MD, et al. The epidemiology of obesity. Gastroenterology. 2007 May;132(6):2087-102. Review.

Healthy People 2020 Summary of Objectives Nutrition and Weight Status

Number Objective Short Title

Healthier Food Access

  • NWS–1 State nutrition standards for child care
  • NWS–2 Nutritious foods and beverages offered outside of school meals
  • NWS–3 State-level incentive policies for food retail
  • NWD–4 Retail access to foods recommended by Dietary Guidelines for Americans

Health Care and Worksite Settings

  • NWS–5 Primary care physicians who measure patients’ body mass index (BMI)
  • NWS–6 Physician office visits with nutrition or weight counseling or education
  • NWS–7 Worksite nutrition and weight management classes and counseling

Weight Status

  • NWS–8 Healthy weight in adults
  • NWS–9 Obesity in adults
  • NWS–10 Obesity in children and adolescents
  • NWS–11 Inappropriate weight gain

Food Insecurity

  • NWS–12 Food insecurity among children
  • NWS–13 Food insecurity among households

Food and Nutrient Consumption

  • NWS–14 Fruit intake
  • NWS–15 Vegetable intake
  • NWS–16 Whole grain intake
  • NWS–17 Solid fat and added sugar intake
  • NWS–18 Saturated fat intake
  • NWS–19 Sodium intake
  • NWS–20 Calcium intake

Iron Deficiency

  • NWS–21 Iron deficiency in young children and in females of childbearing age
  • NWS–22 Iron deficiency in pregnant females

 

Healthier Food Access

NWS–1: Increase the number of States with nutrition standards for foods and beverages provided to preschool-aged children in child care.

Target: 34 States (can include the District of Columbia).

Baseline: 24 States had nutrition standards for foods and beverages provided to preschool-aged children in child care in 2006.

Target setting method: 1 State per year improvement (can include the District of Columbia).

Data sources: National Resource Center for Health and Safety in Child Care and Early Education, and child care licensing websites from each State government and the District of Columbia.

NWS–2: Increase the proportion of schools that offer nutritious foods and beverages outside of school meals.

NWS–2.1 Increase the proportion of schools that do not sell or offer calorically sweetened beverages to students.

Target: 21.3 percent.

Baseline: 9.3 percent of schools did not sell or offer calorically sweetened beverages to students in 2006.

Target setting method: Modeled on previous data: 12 percentage point increase.

Data source: School Health Policies and Programs Study, CDC.

NWS–2.2 Increase the proportion of school districts that require schools to make fruits or vegetables available whenever other food is offered or sold.

Target: 18.6 percent.

Baseline: 6.6 percent of school districts required schools to make fruits or vegetables available whenever other foods are offered or served in 2006.

Target setting method: 12.0 percentage point increase.

Data source: School Health Policies and Program Study, CDC.

NWS–3: Increase the number of States that have State-level policies that incentivize food retail outlets to provide foods that are encouraged by the Dietary Guidelines.

Target: 18 States (including the District of Columbia).

Baseline: 8 States (including the District of Columbia) had State-level policies that incentivized food retail outlets to provide foods that are encouraged by the Dietary Guidelines in 2009.

Target setting method: Modeled on previous data; 1 State per year improvement.

Data sources: CDC State Indicator Report on Fruits and Vegetables. The report gathers data from three data sources: (1) CDC Nutrition, Physical Activity, and Obesity Legislative Database, (2) National Conference of State Legislatures Health Community Design and Access to Healthy Food Legislative Database, (3) The Food Trust.

NWS–4: (Developmental) Increase the proportion of Americans who have access to a food retail outlet that sells a variety of foods that are encouraged by the Dietary Guidelines for Americans.

Proposed data source: To be determined.

 

Health Care and Worksite Settings

NWS–5: Increase the proportion of primary care physicians who regularly measure the body mass index of their patients.

NWS–5.1 Increase the proportion of primary care physicians who regularly assess body mass index (BMI) in their adult patients.

Target: 53.6 percent.

Baseline: 48.7 percent of primary care physicians regularly assessed body mass index (BMI) in their adult patients in 2008.

Target setting method: 10 percent improvement.

Data source: National Survey on Energy Balance Related Care among Primary Care Physicians.

NWS–5.2 Increase the proportion of primary care physicians who regularly assess body mass index (BMI) for age and sex in their child or adolescent patients.

Target: 54.7 percent.

Baseline: 49.7 percent of primary care physicians regularly assessed body mass index (BMI) for age and sex in their child or adolescent patients in 2008.

Target setting method: 10 percent improvement.

Data source: National Survey on Energy Balance Related Care Among Primary Care Physicians.

NWS–6: Increase the proportion of physician office visits that include counseling or education related to nutrition or weight.

NWS–6.1 Increase the proportion of physician office visits made by patients with a diagnosis of cardiovascular disease, diabetes, or hyperlipidemia that include counseling or education related to diet and nutrition.

Target: 22.9 percent.

Baseline: 20.8 percent of physician office visits of adult patients with a diagnosis of cardiovascular disease, diabetes, or hyperlipidemia included counseling or education related to diet and nutrition in 2007 (age adjusted to the year 2000 standard population).

Target setting method: 10 percent improvement.

Data source: National Ambulatory Medical Care Survey, CDC, NCHS.

NWS–6.2 Increase the proportion of physician office visits made by adult patients who are obese that include counseling or education related to weight reduction, nutrition, or physical activity.

Target: 31.8 percent.

Baseline: 28.9 percent of physician office visits of adult patients who are obese included counseling or education related to weight reduction, nutrition, or physical activity in 2007 (age adjusted to the year 2000 standard population).

Target setting method: 10 percent improvement.

Data source: National Ambulatory Medical Care Survey, CDC, NCHS.

NWS–6.3 Increase the proportion of physician visits made by all child or adult patients that include counseling about nutrition or diet.

Target: 15.2 percent.

Baseline: 12.2 percent of physician office visits of all child or adults patients included counseling about nutrition or diet in 2007 (age adjusted to the year 2000 standard population).

Target setting method: 3 percentage point improvement.

Data source: National Ambulatory Medical Care Survey, CDC, NCHS.

NWS–7: (Developmental) Increase the proportion of worksites that offer nutrition or weight management classes or counseling.

Potential data source: A followup survey to the 2004 National Worksite Health Promotion Survey.

 

Weight Status

NWS–8: Increase the proportion of adults who are at a healthy weight.

Target: 33.9 percent.

Baseline: 30.8 percent of persons aged 20 years and over were at a healthy weight in 2005–08 (age adjusted to the year 2000 standard population).

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–9: Reduce the proportion of adults who are obese.

Target: 30.6 percent.

Baseline: 34.0 percent of persons aged 20 years and over were obese in 2005–08 (age adjusted to the year 2000 standard population).

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–10 Reduce the proportion of children and adolescents who are considered obese.

NWS–10.1 Children aged 2 to 5 years.

Target: 9.6 percent.

Baseline: 10.7 percent of children aged 2 to 5 years were considered obese in 2005–08.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–10.2 Children aged 6 to 11 years.

Target: 15.7 percent.

Baseline: 17.4 percent of children aged 6 to 11 years were considered obese in 2005–08.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–10.3 Adolescents aged 12 to 19 years.

Target: 16.1 percent.

Baseline: 17.9 percent of adolescents aged 12 to 19 years were considered obese in 2005–08.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–10.4 Children and adolescents aged 2 to 19 years.

Target: 14.6 percent.

Baseline: 16.2 percent of children and adolescents aged 2 to 19 years were considered obese in 2005–08.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–11: (Developmental) Prevent inappropriate weight gain in youth and adults.

NWS–11.1 Children aged 2 to 5 years.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–11.2 Children aged 6 to 11 years.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–11.3 Adolescents aged 12 to 19 years.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–11.4 Children and adolescents aged 2 to 19 years.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–11.5 Adults aged 20 years and older.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

 

Food Insecurity

NWS–12: Eliminate very low food security among children.

Target: 0.2 percent.

Baseline: 1.3 percent of households with children had very low food security among children in 2008.

Target setting method: Consistent with the Department of Agriculture’s policy to eliminate childhood hunger by 2015.

Data source: Food Security Supplement to the Current Population Survey, U.S. Department of Commerce, Bureau of the Census.

NWS–13: Reduce household food insecurity and in so doing reduce hunger.

Target: 6.0 percent.

Baseline: 14.6 percent of households were food insecure in 2008.

Target setting method: Retain 2010 target.

Data source: Food Security Supplement to the Current Population Survey, U.S. Department of Commerce, Bureau of the Census.

 

Food and Nutrient Consumption

NWS–14: Increase the contribution of fruits to the diets of the population aged 2 years and older.

Target: 0.9 cup equivalents per 1,000 calories.

Baseline: 0.5 cup equivalents of fruits per 1,000 calories was the mean daily intake by persons aged 2 years and older in 2001–04.

Target setting method: Evidence-based approach (Considered the baseline in relation to 2005 Dietary Guidelines for Americans [DGA] recommendations, past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–15: Increase the variety and contribution of vegetables to the diets of the population aged 2 years and older.

NWS–15.1 Increase the contribution of total vegetables to the diets of the population aged 2 years and older.

Target: 1.1 cup equivalents per 1,000 calories.

Baseline: 0.8 cup equivalents of total vegetables per 1,000 calories was the mean daily intake by persons aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to 2005 DGA recommendations, past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–15.2 Increase the contribution of dark green vegetables, orange vegetables, and legumes to the diets of the population aged 2 years and older.

Target: 0.3 cup equivalents per 1,000 calories.

Baseline: 0.1 cup equivalents of dark green or orange vegetables or legumes per 1,000 calories was the mean daily intake by persons aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to USDA Food Guide recommendations, past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–16 Increase the contribution of whole grains to the diets of the population aged 2 years and older.

Target: 0.6 ounce equivalents per 1,000 calories.

Baseline: 0.3 ounce equivalents of whole grains per 1,000 calories was the mean daily intake by persons aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to 2005 DGA recommendation, past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–17: Reduce consumption of calories from solid fats and added sugars in the population aged 2 years and older.

NWS–17.1 Reduce consumption of calories from solid fats.

Target: 16.7 percent.

Baseline: 18.9 percent was the mean percentage of total daily calorie intake provided by solid fats for the population aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to USDA Food Guide recommendations, potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–17.2 Reduce consumption of calories from added sugars.

Target: 10.8 percent.

Baseline: 15.7 percent was the mean percentage of total daily calorie intake provided by added sugars for the population aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard population).

Target setting method: Evidence- based approach (Considered the baseline in relation to USDA Food Guide recommendations, potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–17.3 Reduce consumption of calories from solid fats and added sugars.

Target: 29.8 percent.

Baseline: 34.6 percent was the mean percentage of total daily calorie intake provided by solid fats and added sugars for the population aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to USDA Food Guide recommendations, potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–18: Reduce consumption of saturated fat in the population aged 2 years and older.

Target: 9.5 percent.

Baseline: 11.3 percent was the mean percentage of total daily calorie intake provided by saturated fat for the population aged 2 years and older in 2003–06 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to 2005 DGA recommendation, past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–19: Reduce consumption of sodium in the population aged 2 years and older.

Target: 2,300 milligrams.

Baseline: 3,641 milligrams of sodium from foods, dietary supplements and antacids, drinking water, and salt use at the table was the mean total daily intake by persons aged 2 years and older in 2003–06 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to the 2005 DGA recommendations and Institute of Medicine [IOM] Dietary Reference Intakes [DRIs], past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

NWS–20: Increase consumption of calcium in the population aged 2 years and older.

Target: 1,300 milligrams.

Baseline: 1,118 milligrams of calcium from foods, dietary supplements and antacids, and drinking water was the mean total daily intake by persons aged 2 years and older in 2003–06 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to IOM DRIs, past trends and potentially achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and USDA, ARS.

 

Iron Deficiency

NWS–21: Reduce iron deficiency among young children and females of childbearing age.

NWS–21.1 Children aged 1 to 2 years.

Target: 14.3 percent.

Baseline: 15.9 percent of children aged 1 to 2 years were iron deficient in 2005–08.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–21.2 Children aged 3 to 4 years.

Target: 4.3 percent.

Baseline: 5.3 percent of children aged 3 to 4 years were iron deficient in 2005–08.

Target setting method: 1 percentage point improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–21.3 Females aged 12 to 49 years.

Target: 9.4 percent.

Baseline: 10.4 percent of females aged 12 to 49 years old were iron deficient in 2005–08.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NWS–22: Reduce iron deficiency among pregnant females.

Target: 14.5 percent.

Baseline: 16.1 percent of pregnant females were iron deficient in 2003–06.

Target setting method: 10 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

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