Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight (original) (raw)
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eLife, 2016
Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3-19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increas...
Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Nature, 2019
Rising rural body-mass index is the main driver of the global obesity epidemic in adults NCD risk Factor Collaboration (NCD-risC)* Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3-6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low-and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low-and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low-and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. Being underweight or overweight can lead to adverse health outcomes. BMI-a measure of underweight and overweight-is rising in most countries 2. It is commonly stated that urbanization is one of the most important drivers of the worldwide rise in BMI because diet and lifestyle in cities lead to adiposity 3-6. However, such statements are typically based on cross-sectional comparisons in one or a small number of countries. Only a few studies have analysed how BMI is changing over time in rural and urban areas. The majority have been in one country, over short durations, and/or in one sex and narrow age groups. The few studies that covered more than one country 7-12 used at most a few dozen data sources and hence could not systematically estimate trends, and focused primarily on women of child-bearing age. Data on how BMI in rural and urban populations is changing are needed to plan interventions that address underweight and overweight. Here, we report on mean BMI in rural and urban areas of 200 countries and territories from 1985 to 2017. We used 2,009 population-based studies of human anthropometry conducted in 190 countries (Extended Data Fig. 1), with measurements of height and weight in more than 112 million adults aged 18 years and older. We excluded data based on self-reported height and weight because they are subject to bias. For each sex, we used a Bayesian hierarchical model to estimate mean BMI by year, country and rural or urban place of residence. As described in the Methods, the estimated trends in population mean BMI represent a combination of (1) the change in the health of individuals due to change in their economic status and environment, and (2) the change in the composition of individuals that make up the population (and their economic status and environment). From 1985 to 2017, the proportion of the world's population who lived in urban areas 1 increased from 41% to 55%. Over the same period, global age-standardized mean BMI increased from 22.6 kg m −2 (95% credible interval 22.4-22.9) to 24.7 kg m −2 (24.5-24.9) in women, and from 22.2 kg m −2 (22.0-22.4) to 24.4 kg m −2 (24.2-24.5) in men. The increase in mean BMI was 2.09 kg m −2 (1.73-2.44) and 2.10 kg m −2 (1.79-2.41) among rural women and men, respectively, compared to 1.35 kg m −2 (1.05-1.65) and 1.59 kg m −2 (1.33-1.84) in urban women and men. Nationally, change in mean BMI ranged from small decreases among women in 12 countries in Europe and Asia Pacific, to a rise of >5 kg m −2 among women in Egypt and Honduras. The lowest Hong Kong, Bermuda and Nauru) or rural (Tokelau)-shown in grey. See Extended Data Fig. 3 for mean BMI at the national level and in rural and urban populations in 1985 and 2017. See Extended Data Fig. 6 for comparison of results between women and men.
Lancet (London, England), 2017
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. 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 (...
2018
Background Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between...
Lancet (London, England), 2016
Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to…
Obesity, Physical Activity and Sedentary Time during Covid-19 Confinement: Moroccan Adult Study
Universal Journal of Public Health, 2022
Introduction: The objective of this study is to study the correlation between obesity, physical activity and sedentary behavior in a sample of the population in Kénitra, Morocco. Materials and methods: The obesity assessment was based on Body Mass Index (BMI), which pertains to sedentary time and physical activity. A questionnaire was completed by participants with respect to covid-19 precautions. The level of physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ) short version. Results: Our study included 100 subjects (50 women and 50 men), the average age was 33.83±14.72 years. Our sample showed that 32 percent of individuals who are pre-obese and 9 percent who are obese. The IPAQ score showed that 41% of individuals had high physical activity and 37% low physical activity and 22% moderate physical activity with an insignificant relationship between physical activity and BMI (p=0.664). Our study showed that 50% of individuals had sedentary activity times below 20 hours/week, and 28% had sedentary activity times between 20 and 30 hours/week, and 18% had sedentary activity times between 30 and 40 hours/week, and 4% had a significant relationship between sedentary time and BMI (p=0.017). Conclusion: Our results have shown that there are inconveniences of containment on the health of individuals, requiring the intervention of specialists to find suitable solutions.
Incident type 2 diabetes attributable to suboptimal diet in 184 countries
Nature Medicine
The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generall...
eLife, 2021
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Review of the nutrition situation in the Eastern Mediterranean Region
Eastern Mediterranean Health Journal, 2018
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