Obesity continues to increase rapidly in the United States. To alter this trend, strategies and programs for weight maintenance as well as weight reduction must become a higher public health priority.

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Context Binge drinking (consuming Ն5 alcoholic drinks on 1 occasion) generally results in acute impairment and has numerous adverse health consequences. Reports indicate that binge drinking may be increasing in the United States.Objectives To quantify episodes of binge drinking among US adults in 1993-2001, to characterize adults who engage in binge drinking, and to describe state and regional differences in binge drinking. Design, Setting, and ParticipantsThe Behavioral Risk Factor Surveillance System, a random-digit telephone survey of adults aged 18 years or older that is conducted annually in all states. The sample size ranged from 102263 in 1993 to 212510 in 2001.Main Outcome Measures Binge-drinking prevalence, episodes, and episodes per person per year.Results Between 1993 and 2001, the total number of binge-drinking episodes among US adults increased from approximately 1.2 billion to 1.5 billion; during this time, bingedrinking episodes per person per year increased by 17% (from 6.3 to 7.4, P for trend=.03). Between 1995 and 2001, binge-drinking episodes per person per year increased by 35% (P for trend=.005). Men accounted for 81% of binge-drinking episodes in the study years. Although rates of binge-drinking episodes were highest among those aged 18 to 25 years, 69% of binge-drinking episodes during the study period occurred among those aged 26 years or older. Overall, 47% of binge-drinking episodes occurred among otherwise moderate (ie, non-heavy) drinkers, and 73% of all binge drinkers were moderate drinkers. Binge drinkers were 14 times more likely to drive while impaired by alcohol compared with non-binge drinkers. There were substantial state and regional differences in per capita binge-drinking episodes.Conclusions Binge drinking is common among most strata of US adults, including among those aged 26 years or older. Per capita binge-drinking episodes have increased, particularly since 1995. Binge drinking is strongly associated with alcoholimpaired driving. Effective interventions to prevent the mortality and morbidity associated with binge drinking should be widely adopted, including screening patients for alcohol abuse in accordance with national guidelines.

Childhood BMI is associated with adult adiposity, but it is possible that the magnitude of this association depends on the relative fatness of children.

Background: Although body fat patterning has been related to adverse health outcomes in adults, its importance in children and adolescents is less certain. Objective: We examined the relation of circumference (waist and hip) and skinfold-thickness (subscapular and triceps) measurements to lipid and insulin concentrations among 2996 children and adolescents aged 5-17 y. Design: This was a community-based, cross-sectional study conducted in 1992-1994. Results: A central or abdominal distribution of body fat was related to adverse concentrations of triacylglycerol, LDL cholesterol, HDL cholesterol, and insulin; these associations were independent of race, sex, age, weight, and height. These associations were observed whether fat patterning was characterized by using 1) waist circumference alone (after adjustment for weight and height), 2) waist-to-hip ratio, or 3) principal components analysis. Compared with a child at the 10th percentile of waist circumference, a child at the 90th percentile was estimated to have, on average, higher concentrations of LDL cholesterol (0.17 mmol/L), triacylglycerol (0.11 mmol/L), and insulin (6 pmol/L) and lower concentrations of HDL cholesterol (Ϫ0.07 mmol/L). These differences, which were independent of weight and height, were significant at the 0.001 level and were consistent across race-sex groups. Conclusions: These findings emphasize the importance of obtaining information on body fat distribution, waist circumference in particular, in children. Waist circumference, which is relatively easy to measure, may help to identify children likely to have adverse concentrations of lipids and insulin.Am J Clin Nutr 1999;69:308-17. KEY WORDSFat distribution, children, lipids, insulin, waist circumference, hip circumference, skinfold thickness, body weight, Bogalusa Heart Study INTRODUCTIONAfter Vague's (1) observation that android obesity among women is associated with diabetes and atherosclerosis, a preponderance of body fat in the abdomen, upper body, and trunk was found to be predictive of diabetes (2, 3) and cardiovascular disease (4, 5). Several investigators also reported that fat distribution is related to lipid concentrations, insulin concentrations, and hypertension (6-8). These associations, which have frequently been shown to be independent of the general degree of obesity, have been found with the use of various skinfold-thickness and circumference measurements to characterize fat distribution.In contrast with these findings in adults, the importance of fat distribution in early life is less certain. Various fat patterns have been associated with concentrations of lipids and insulin and with blood pressure in some studies (9-14), but equivocal or negative results have also been reported (15)(16)(17)(18)(19); it is also possible that fat patterning is associated with risk factors only after sexual maturation (17). The study of fat distribution among children and adolescents can be difficult because there are marked changes in circumferences (20), skinfold thicknesses ...

Less than half of obese adults report being advised to lose weight by health care professionals. Barriers to counseling need to be identified and addressed.

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Weight loss and weight maintenance are common concerns for US men and women. Most persons trying to lose weight are not using the recommended combination of reducing calorie intake and engaging in leisure-time physical activity 150 minutes or more per week.