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

Source of Publication

The Lancet

Abstract

© 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 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.

Document Type

Article

First Page

2627

Last Page

2642

Publication Date

12-16-2017

DOI

10.1016/S0140-6736(17)32129-3

Author First name, Last name, Institution

James Bentham, University of Kent
Mariachiara Di Cesare, Middlesex University
Ver Bilano, Imperial College London
Honor Bixby, Imperial College London
Bin Zhou, Imperial College London
Gretchen A. Stevens, Organisation Mondiale de la Santé
Leanne M. Riley, Organisation Mondiale de la Santé
Cristina Taddei, Imperial College London
Kaveh Hajifathalian, Cleveland Clinic Foundation
Yuan Lu, Yale University
Stefan Savin, Organisation Mondiale de la Santé
Melanie J. Cowan, Organisation Mondiale de la Santé
Christopher J. Paciorek, University of California, Berkeley
Adela Chirita-Emandi, Universitatea de Medicina si Farmacie Victor Babes din Timisoara
Alison J. Hayes, The University of Sydney
Joanne Katz, Johns Hopkins University
Roya Kelishadi, Isfahan University of Medical Sciences
Andre Pascal Kengne, South African Medical Research Council
Young Ho Khang, Seoul National University
Avula Laxmaiah, National Institute of Nutrition India
Yanping Li, Harvard T.H. Chan School of Public Health
Jun Ma, Peking University
J. Jaime Miranda, Universidad Peruana Cayetano Heredia
Aya Mostafa, Ain Shams University
Martin Neovius, Karolinska Institutet
Cristina Padez, Universidade de Coimbra
Lekhraj Rampal, Universiti Putra Malaysia
Aubrianna Zhu, Imperial College London
James E. Bennett, Imperial College London
Goodarz Danaei, Harvard T.H. Chan School of Public Health
Zulfiqar A. Bhutta, Hospital for Sick Children University of Toronto
Majid Ezzati, Imperial College London

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