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Documentation, Codebook, and Frequencies Body Measurements Examination Survey Years: 2005 to 2006 SAS Transport File: BMX_D.XPT November 2007

NHANES 2005 2006 Data Documentation Exam Component: Body Measurements (BMX_D) First Published: November 2007 Last Revised: NA Component Description NHANES body measurement data are used to monitor trends in infant and child growth, to estimate the prevalence of overweight and obesity in the U.S. population, and to examine the associations between body weight and the health and nutritional status of the U.S. population. The target age groups for the NHANES 2005-2006 body measurement component are as follows: Head circumference: birth through 6 months of age Maximal calf circumference: 8 years of age and older Mid-thigh circumference: 8 years of age and older Mid-upper arm circumference: 2 months of age and older Recumbent length: birth through 47 months Standing height: 2 years and older Subscapular skin fold: 2 months of age and older Triceps skin fold: 2 months of age and older Upper arm length: 2 months of age and older Upper leg length: 8 years and older Waist circumference: 2 years of age and older Weight: All ages Eligible Sample All survey participants were eligible for the body measurement component. There were no medical, safety, or other exclusions for the body measurements protocol. The health technicians used their discretion to obtain as many measures as practical for persons who used a wheelchair. No changes have been made to the NHANES body measurement protocol since the continuous NHANES began in1999. Protocol and Procedure The body measurement data were collected by trained health technicians. The health technician was accompanied by a recorder during each body measurement examination. The respondent s age, at the time of the screening interview, determined the body measurement examination protocol for survey participants. In some instances, several weeks elapsed between the initial screening interview and the health examination. The Demographics data file includes variables for age at screening (RIDAGEYR and RIDAGEMN) and age at examination (RIDAGEEX). Body Measurements (BMX_D) Page 1 of 5

Arm and leg measurements were made on the right side of the body. If an examinee had an amputation, medical condition, or medical appliance such as a cast that prevented measurements from being taken on the right side of the body, the examiner took measurements on the left side. The body measurements file does not identify persons who had amputations because the information might be considered identifiable and pose a disclosure concern. Therefore, body weight data for individuals who had limb amputations were set to missing. This data file includes body measurements for women who were pregnant at the time of their health examination. Pregnancy status at the time of the health examination is indicated by the Demographic file variable, RIDEXPRG - pregnancy status at the time of the health examination. For general guidelines on the body measurement procedures, please refer to the Anthropometric Standardization Reference Manual (1). The NHANES body measurement techniques are illustrated in the NHANES III Anthropometric Procedures Video (2). The NHANES III body measurement protocol included more measurements than the protocol that was used in NHANES 2005-2006. The maximal calf circumference measurement was added to NHANES in 1999 and is not shown in the NHANES III video. The NHANES 2005-2006 Body Measurement Procedures Manual is posted on the NHANES 2005-2006 website. The manual provides descriptions of the NHANES protocol, survey equipment, and quality control procedures. Quality Assurance & Quality Control The NHANES health technicians completed a 2-day training program with survey staff and an expert anthropometrist. The training included an overview of the component using the NHANES III anthropometry video and demonstrations conducted by the expert examiner with volunteer subjects. The expert examiner reviewed and demonstrated the proper technique to use for each measurement. Supervised practice exercises followed with several volunteer subjects, including infants, children, and adults. New technicians were monitored closely by the chief health technician when they started working in the field. Health technician performance in the field was monitored continuously using direct observation, data reviews, and periodic expert examiner (gold standard comparison) evaluations. All of the body measurement Body Measurements (BMX_D) Page 2 of 5

rooms in the mobile examination centers (MECs) were identical with respect to the arrangement and type of equipment. Scheduled equipment calibration was performed by the health technicians and verified by supervisory staff. Please refer to the Body Measures Procedures Manual for a detailed description of the quality assurance and control measures used in NHANES. Data Processing and Editing Data were reviewed for unusual and erroneous values. The initial checks used range criteria that were based on the NHANES III and NHANES 1999 2004 body measures data. Range checks for infants under 2 months of age and maximal calf circumference were based on NHANES 1999 2004 data. During the data review, values that were above the 99th percentile or below the 1st percentile for a particular age or age-gender group were flagged for review. When records were flagged, the entire body measurements record was reviewed for reasonableness. Subject characteristics such as height, weight, age and gender were taken into consideration. Values that were unrealistic were deleted from the file. None of the original body measures data were changed and there are no imputed values in this file. Analytic Notes Component status code: A final body measures component status code (BMDSTAT) provides analysts with a quick method of determining complete and partial body measures examination records. Unusual values: Unusual body measurement values were noted during the review of the data. Typically, unusual values occurred when a subject was extremely short, tall, overweight or underweight. Analysts should examine the distributions of the body measurements carefully. In particular, the upper arm length (BMXARML) and upper leg length (BMXLEG) values are affected by extreme amounts of adipose tissue. Skinfold measurements were not obtained for many obese subjects because the amount of adipose tissue exceeded the limits of the caliper, or the technician was not able to grasp a double thickness of tissue. Comment Codes: Comment codes were noted by the health technicians during data collection to document problems or situations that arose during the body measurement examination. For example, the variable BMIWT is a comment code for the body weight measurement. If a subject did not change into the NHANES exam gown, a code of BMIWT of 3 denoting clothing worn was made in the record. Analysts should review the comment code information prior to analyzing the data and selecting the subjects to include in their analytic samples. Sample Weights: The examination sample weights should be used to Body Measurements (BMX_D) Page 3 of 5

analyze the body measurement data. Please refer to the Analytic Guidelines for further details on the use of sample weights and other analytic issues. The Analytic Guidelines are available on the NHANES website. References 1. Lohman TG, Roche AF, Martorell R, editors. Anthropometric Standardization Reference Manual. Abridged ed. Champaign, IL: Human Kinetics Books; 1988. 2. Centers for Disease Control and Prevention, National Center for Health Statistics. NHANES III Anthropometric Procedures Video. Available from: http://www.cdc.gov/nchs/products/elec_prods/subject/video.htm [Accessed 6/5/07] Body Measurements (BMX_D) Page 4 of 5

Locator Record Title: Body Measurements (BMX_D) Contact Number: 1-866-441-NCHS Years of Content: 2005 2006 First Published: November 2007 Revised: NA Access Constraints: None Use Constraints: None Geographic Coverage: National Subject: Body measurement component of the NHANES health examination Record Source: NHANES 2005 2006 Survey Methodology: NHANES 2005 2006 is a stratified multistage probability sample of the civilian non-institutionalized population of the U.S. Medium: NHANES Web site; SAS transport files Body Measurements (BMX_D) Page 5 of 5

National Health and Nutrition Examination Survey Codebook for Data Production (2005-2006) Exam Component: Body Measurements (BMX_D) November 2007

SEQN SEQN English Text: Respondent sequence number. B(0 Yrs. to 150 Yrs.) Respondent sequence number BMDSTATS BMDSTATS English Text: Body Measures Component status Code B(0 Yrs. to 150 Yrs.) Body Measures Component Status Code 1 Complete data for age group 7910 7910 2 Partial: Height and weight obtained 196 8106 3 Other partial exam 1766 9872 4 No body measures exam data 78 9950. Missing 0 9950

BMXWT BMXWT B(0 Yrs. to 150 Yrs.) 0.0000 to 440.0000 Weight (kg) English Text: Weight (kg) 2.6 to 371 Range of Values 9847 9847. Missing 103 9950 BMIWT BMIWT English Text: Weight Comment B(0 Yrs. to 150 Yrs.) Weight Comment 1 Could not obtain 29 29 2 Exceeds capacity 0 29 3 Clothing 282 311 4 Medical appliance 15 326. Missing 9624 9950

BMXRECUM BMXRECUM B(0 Mos. to 47 Mos.) 16.0000 to 119.3000 Recumbent Length (cm) English Text: Recumbent Length (cm) 46.8 to 113.3 Range of Values 1356 1356. Missing 8594 9950 BMIRECUM BMIRECUM English Text: Recumbent Length Comment B(0 Mos. to 47 Mos.) Recumbent Length Comment 1 Could not obtain 38 38 2 Exceeds capacity 0 38 3 Not straight 1 39. Missing 9911 9950

BMXHEAD BMXHEAD B(0 Mos. to 6 Mos.) 00.0000 to 99.9999 Head Circumference (cm) English Text: Head Circumference (cm) 32.6 to 48 Range of Values 292 292. Missing 9658 9950 BMIHEAD BMIHEAD English Text: Head Circumference Comment B(0 Mos. to 6 Mos.) Head Circumference Comment 1 Could not obtain 0 0 2 Exceeds capacity 0 0 3 Not straight 0 0. Missing 9950 9950

BMXHT BMXHT B(2 Yrs. to 150 Yrs.) 70.0000 to 208.4000 Standing Height (cm) English Text: Standing Height (cm) 79.8 to 204.1 Range of Values 8962 8962. Missing 988 9950 BMIHT BMIHT English Text: Standing Height Comment B(2 Yrs. to 150 Yrs.) Standing Height Comment 1 Could not obtain 62 62 2 Exceeds capacity 0 62 3 Not straight 258 320. Missing 9630 9950

BMXBMI BMXBMI English Text: Body Mass Index (kg/m**2) B(2 Yrs. to 150 Yrs.) Body Mass Index (kg/m**2) 11.74 to 130.21 Range of Values 8949 8949. Missing 1001 9950 BMXLEG BMXLEG B(8 Yrs. to 150 Yrs.) 0.0000 to 200.0000 Upper Leg Length (cm) English Text: Upper Leg Length (cm) 21.5 to 53.7 Range of Values 7314 7314. Missing 2636 9950

BMILEG BMILEG English Text: Upper Leg Length Comment B(8 Yrs. to 150 Yrs.) Upper Leg Length Comment 1 Could not obtain 325 325. Missing 9625 9950 BMXCALF BMXCALF B(8 Yrs. to 150 Yrs.) 0.0000 to 200.0000 Maximal Calf Circumference (cm) English Text: Maximal Calf Circumference (cm) 20.2 to 75.6 Range of Values 7386 7386. Missing 2564 9950

BMICALF BMICALF English Text: Maximal Calf Comment B(8 Yrs. to 150 Yrs.) Maximal Calf Comment 1 Could not obtain 258 258. Missing 9692 9950 BMXARML BMXARML B(2 Mos. to 150 Yrs.) 0.0000 to 200.0000 Upper Arm Length (cm) English Text: Upper Arm Length (cm) 9.5 to 48.6 Range of Values 9498 9498. Missing 452 9950

BMIARML BMIARML English Text: Upper Arm Length Comment B(2 Mos. to 150 Yrs.) Upper Arm Length Comment 1 Could not obtain 291 291. Missing 9659 9950 BMXARMC BMXARMC B(2 Mos. to 150 Yrs.) 0.0000 to 200.0000 Arm Circumference (cm) English Text: Arm Circumference (cm) 11 to 62.4 Range of Values 9494 9494. Missing 456 9950

BMIARMC BMIARMC English Text: Arm Circumference Comment B(2 Mos. to 150 Yrs.) Arm Circumference Comment 1 Could not obtain 297 297. Missing 9653 9950 BMXWAIST BMXWAIST B(2 Yrs. to 150 Yrs.) 0.0000 to 200.0000 Waist Circumference (cm) English Text: Waist Circumference (cm) 40.2 to 175 Range of Values 8672 8672. Missing 1278 9950

BMIWAIST BMIWAIST English Text: Waist Circumference Comment B(2 Yrs. to 150 Yrs.) Waist Circumference Comment 1 Could not obtain 346 346. Missing 9604 9950 BMXTHICR BMXTHICR B(8 Yrs. to 150 Yrs.) 0.0000 to 200.0000 Thigh Circumference (cm) English Text: Thigh Circumference (cm) 28.3 to 93.9 Range of Values 7295 7295. Missing 2655 9950

BMITHICR BMITHICR English Text: Thigh Circumference Comment B(8 Yrs. to 150 Yrs.) Thigh Circumference Comment 1 Could not obtain 350 350. Missing 9600 9950 BMXTRI BMXTRI B(2 Mos. to 150 Yrs.) 0.0000 to 45.0000 Triceps Skinfold (mm) English Text: Triceps Skinfold (mm) 3 to 45 Range of Values 8897 8897. Missing 1053 9950

BMITRI BMITRI English Text: Triceps Skinfold Comment B(2 Mos. to 150 Yrs.) Triceps Skinfold Comment 1 Could not obtain 712 712 2 Exceeds capacity 183 895 3 Hard to obtain 0 895. Missing 9055 9950 BMXSUB BMXSUB B(2 Mos. to 150 Yrs.) 0.0000 to 45.0000 Subscapular Skinfold (mm) English Text: Subscapular Skinfold (mm) 2.8 to 44 Range of Values 8110 8110. Missing 1840 9950

BMISUB BMISUB English Text: Subscapular Skinfold Comment B(2 Mos. to 150 Yrs.) Subscapular Skinfold Comment 1 Could not obtain 1575 1575 2 Exceeds capacity 108 1683 3 Hard to obtain 0 1683. Missing 8267 9950