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Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults

, ; Bentham, James; Di Cesare, Mariachiara; Bilano, Ver; Bixby, Honor; Zhou, Bin; Stevens, Gretchen A.; Riley, Leanne M.; Taddei, Cristina and Hajifathalian, Kaveh, et al. (2017) In The Lancet 390(10113). p.2627-2642
Abstract

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged... (More)

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (−0·01 kg/m2 per decade; 95% credible interval −0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69–1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64–1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. Funding Wellcome Trust, AstraZeneca Young Health Programme.

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The Lancet
volume
390
issue
10113
pages
16 pages
publisher
Elsevier Limited
external identifiers
  • scopus:85030864437
ISSN
0140-6736
DOI
10.1016/S0140-6736(17)32129-3
language
English
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yes
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dbe6e408-3ec8-4c9e-9b95-2f6076880157
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2019-02-08 15:08:37
date last changed
2019-03-24 04:52:45
@article{dbe6e408-3ec8-4c9e-9b95-2f6076880157,
  abstract     = {<p>Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (−0·01 kg/m<sup>2</sup> per decade; 95% credible interval −0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m<sup>2</sup> per decade (0·69–1·35, PP&gt;0·9999) in central Latin America and an increase of 0·95 kg/m<sup>2</sup> per decade (0·64–1·25, PP&gt;0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m<sup>2</sup> per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m<sup>2</sup> per decade (0·50–1·06, PP&gt;0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. Funding Wellcome Trust, AstraZeneca Young Health Programme.</p>},
  author       = {,  and Bentham, James and Di Cesare, Mariachiara and Bilano, Ver and Bixby, Honor and Zhou, Bin and Stevens, Gretchen A. and Riley, Leanne M. and Taddei, Cristina and Hajifathalian, Kaveh and Lu, Yuan and Savin, Stefan and Cowan, Melanie J. and Paciorek, Christopher J. and Chirita-Emandi, Adela and Hayes, Alison J. and Katz, Joanne and Kelishadi, Roya and Kengne, Andre Pascal and Khang, Young Ho and Laxmaiah, Avula and Li, Yanping and Ma, Jun and Miranda, J. Jaime and Mostafa, Aya and Neovius, Martin and Padez, Cristina and Rampal, Lekhraj and Zhu, Aubrianna and Bennett, James E. and Danaei, Goodarz and Bhutta, Zulfiqar A. and Ezzati, Majid and Abarca-Gómez, Leandra and Abdeen, Ziad A. and Hamid, Zargar Abdul and Abu-Rmeileh, Niveen M. and Acosta-Cazares, Benjamin and Acuin, Cecilia and Adams, Robert J. and Aekplakorn, Wichai and Afsana, Kaosar and Aguilar-Salinas, Carlos A. and Agyemang, Charles and Ahmadvand, Alireza and Ahrens, Wolfgang and Ajlouni, Kamel and Akhtaeva, Nazgul and Giwercman, Aleksander and Sonestedt, Emily and Stocks, Tanja},
  issn         = {0140-6736},
  language     = {eng},
  month        = {12},
  number       = {10113},
  pages        = {2627--2642},
  publisher    = {Elsevier Limited},
  series       = {The Lancet},
  title        = {Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults},
  url          = {http://dx.doi.org/10.1016/S0140-6736(17)32129-3},
  volume       = {390},
  year         = {2017},
}