Household food expenditure patterns: a cluster analysis

Jessie X. Fan, Barbara B. Brown, Lori Kowaleski-Jones, Ken R. Smith, and Cathleen D. Zick The 2001 report titled “The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity” identified overweight and obesity as major public health problems, costing U.S. society as much as $117 billion a year and posing as great a threat of death as poverty, smoking, or problem drinking.1 As a first step in screening for overweight and obesity, “Body Mass Index” (BMI) is calculated using a person’s weight and height, and this number is viewed as being a reliable indicator of body fat for most people.2 The percentage of the U.S. population defined as obese (a BMI greater than 30) or overweight (a BMI greater than 25) has been rising in the past decade. Data from the 1999–2002 National Health and Nutrition Examination Survey (NHANES) show that 65 percent of U.S. adults ages 20–74 were overweight or obese. This is a substantial increase from the 56 percent estimated from the 1988–1994 NHANES and the 47 percent estimated from the 1976–1980 NHANES.3 The statistics presented for children are equally grim. The percentage of children defined as overweight (a BMI-for-age at or above the 95th percentile of the CDC Growth Charts) has also been increasing. Among children and teens ages 6–19, 16 percent (more than 9 million) are overweight according to the 1999–2000 NHANES data, triple the percentage reported in 1980.4 While numerous suggestions have been offered as possible solutions to the problem, an energy balance approach to the causes of overweight and obesity recognizes the equiHousehold food expenditure patterns: a cluster analysis