Background. Few studies have examined racial and educational disparities in recent population-based trends. Methods. We analyzed data of a nationally representative sample of 174,228 US-born adults in the National Health Interview Survey from 1997 to 2008. We determined mean BMI trends by educational attainment and race and black-white prevalence ratios (PRs) for overweight/obesity (BMI > 25？kg/m2) using adjusted Poisson regression with robust variance. Results. From 1997 to 2008, BMI increased by ≥1？kg/m2 in all race-sex groups, and appeared to increase faster among whites. Blacks with greater than a high school education (GHSE) had a consistently higher BMI over time than whites in both women (28.3 ± 0.14 to 29.7 ± 0.18？kg/m2 versus 25.8 ± 0.58 to 26.5 ± 0.08？kg/m2) and men (28.1 ± 0.17？kg/m2 to 29.0 ± 0.20 versus 27.1 ± 0.04？kg/m2 to 28.1 ± 0.06？kg/m2). For participants of all educational attainment levels, age-adjusted overweight/obesity was greater by 44% (95% CI: 1.42–1.46) in black versus white women and 2% (1.01–1.04) in men. Among those with GHSE, overweight/obesity prevalence was greater (PR: 1.52; 1.49–1.55) in black versus white women, but greater (1.07; 1.05–1.09) in men. Conclusions. BMI increased steadily in all race-sex and education groups from 1997 to 2008, and blacks (particularly women) had a consistently higher BMI than their white counterparts. Overweight/obesity trends and racial disparities were more prominent among individuals with higher education levels, compared to their counterparts with lower education levels. 1. Introduction The prevalence of overweight and obesity in the United States has increased at an alarming rate over the past several decades [1, 2], and large disparities between racial and socioeconomic groups have been documented [3]. Different levels of education, suggested as the single most important social influence on health [4], likely contribute to these obesity disparities [5–7], and explanations for the positive association between educational attainment and health are well established [8]. For instance, gradients in health by educational attainment have been long recognized with greater years of education generally associated with healthier behaviors (e.g., no smoking, physical activity, drinking in moderation) as well as access to resources that lead to greater perceived health and physical functioning in addition to lower levels of morbidity and mortality compared to individuals with less years of education [8, 9]. Years of education also appears to be monotonically and linearly associated with
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