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Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants

Di Cesare, M and Bentham, J and Stevens, GA and Zhou, B and Danaei, G and Lu, Y and Bixby, H and Cowan, MJ and Riley, LM and Hajifathalian, K and Fortunato, L and Taddei, C and Bennett, JE and Ikeda, N and Khang, Y-H and Kyobutungi, C and Laxmaiah, A and Li, Y and Lin, H-H and Miranda, JJ and Mostafa, A and Turley, ML and Paciorek, CJ and Gunter, M and Ezzati, M and Abdeen, ZA and Hamid, ZA and Abu-Rmeileh, NM and Acosta-Cazares, B and Adams, R and Aekplakorn, W and Aguilar-Salinas, CA and Ahmadvand, A and Ahrens, W and Ali, MM and Alkerwi, A and Alvarez-Pedrerol, M and Aly, E and Amouyel, P and Amuzu, A and Andersen, LB and Anderssen, SA and Andrade, DS and Anjana, RM and Aounallah-Skhiri, H and Ariansen, I and Aris, T and Arlappa, N and Arveiler, D and Assah, FK and Avdicova, M and Azizi, F and Babu, BV and Balakrishna, N and Bandosz, P and Banegas, JR and Barbagallo, CM and Barcelo, A and Barkat, A and Barros, MV and Bata, I and Batieha, AM and Batista, RL and Baur, LA and Beaglehole, R and Ben Romdhane, H and Benet, M and Bernabe-Ortiz, A and Bernotiene, G and Bettiol, H and Bhagyalaxmi, A and Bharadwaj, S and Bhargava, SK and Bhatti, Z and Bhutta, ZA and Bi, H and Bi, Y and Bjerregaard, P and Bjertness, E and Bjertness, MB and Bjorkelund, C and Blake, M and Blokstra, A and Bo, S and Bobak, M and Boddy, LM and Boehm, BO and Boeing, H and Boissonnet, CP and Bongard, V and Bovet, P and Braeckman, L and Bragt, MCE and Brajkovich, I and Branca, F and Breckenkamp, J and Brenner, H and Brewster, LM and Brian, GR and Bruno, G and Bueno-de-Mesquita, HBA and Bugge, A and Burns, C and Cabrera de Leon, A and Cacciottolo, J and Cama, T and Cameron, C and Camolas, J and Can, G and Candido, APC and Capuano, V and Cardoso, VC and Carvalho, MJ and Casanueva, FF and Casas, J-P and Caserta, CA and Castetbon, K and Chamukuttan, S and Chan, AW and Chan, Q and Chaturvedi, HK and Chaturvedi, N and Chen, C-J and Chen, F and Chen, H and Chen, S and Chen, Z and Cheng, C-Y and Chetrit, A and Chiolero, A and Chiou, S-T and Chirita-Emandi, A and Cho, Y and Christensen, K and Chudek, J and Cifkova, R and Claessens, F and Clays, E and Concin, H and Cooper, C and Cooper, R and Coppinger, TC and Costanzo, S and Cottel, D and Cowell, C and Craig, CL and Crujeiras, AB and D'Arrigo, G and d'Orsi, E and Dallongeville, J and Damasceno, A and Damsgaard, CT and Danaei, G and Dankner, R and Dauchet, L and De Backer, G and De Bacquer, D and de Gaetano, G and De Henauw, S and De Smedt, D and Deepa, M and Deev, AD and Dehghan, A and Delisle, H and Delpeuch, F and Dhana, K and Di Castelnuovo, AF and Dias-da-Costa, JS and Diaz, A and Djalalinia, S and Do, HTP and Dobson, AJ and Donfrancesco, C and Doering, A and Doua, K and Drygas, W and Egbagbe, EE and Eggertsen, R and Ekelund, U and El Ati, J and Elliott, P and Engle-Stone, R and Erasmus, RT and Erem, C and Eriksen, L and Escobedo-de la Pena, J and Evans, A and Faeh, D and Fall, CH and Farzadfar, F and Felix-Redondo, FJ and 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Plans-Rubio, P and Poh, BK and Porta, M and Portegies, MLP and Poulimeneas, D and Pradeepa, R and Prashant, M and Price, JF and Puiu, M and Punab, M and Qasrawi, RF and Qorbani, M and Tran, QB and Radic, I and Radisauskas, R and Rahman, M and Raitakari, O and Raj, M and Rao, SR and Ramachandran, A and Ramke, J and Ramos, R and Rampal, S and Rasmussen, F and Redon, J and Reganit, PFM and Ribeiro, R and Riboli, E and Rigo, F and de Wit, TFR and Ritti-Dias, RM and Rivera, JA and Robinson, SM and Robitaille, C and Rodriguez-Artalejo, F and del Cristo Rodriguez-Perez, M and Rodriguez-Villamizar, LA and Rojas-Martinez, R and Rojroongwasinkul, N and Romaguera, D and Ronkainen, K and Rosengren, A and Rouse, I and Rubinstein, A and Ruehli, FJ and Rui, O and Sandra Ruiz-Betancourt, B and Russo Horimoto, ARV and Rutkowski, M and Sabanayagam, C and Sachdev, HS and Saidi, O and Salanave, B and Salazar Martinez, E and Salomaa, V and Salonen, JT and Salvetti, M and Sanchez-Abanto, J and Sandjaja, and Sans, S and Santos, DA and Santos, O and dos Santos, RN and Santos, R and Sardinha, LB and Sarrafzadegan, N and Saum, K-U and Savva, SC and Scazufca, M and Rosario, AS and Schargrodsky, H and Schienkiewitz, A and Schmidt, IM and Schneider, IJ and Schultsz, C and Schutte, AE and Sein, AA and Senbanjo, IO and Sepanlou, SG and Shalnova, SA and Shaw, JE and Shibuya, K and Shin, Y and Shiri, R and Siantar, R and Sibai, AM and Silva, AM and Santos Silva, DA and Simon, M and Simons, J and Simons, LA and Sjostrom, M and Slowikowska-Hilczer, J and Slusarczyk, P and Smeeth, L and Smith, MC and Snijder, MB and So, H-K and Sobngwi, E and Soderberg, S and Soekatri, MYE and Solfrizzi, V and Sonestedt, E and Sorensen, TIA and Soric, M and Jerome, CS and Soumare, A and Staessen, JA and Starc, G and Stathopoulou, MG and Staub, K and Stavreski, B and Steene-Johannessen, J and Stehle, P and Stein, AD and Stergiou, GS and Stessman, J and Stieber, J and Stoeckl, D and Stocks, T and Stokwiszewski, J and Stratton, G and Strufaldi, MW and Sun, C-A and Sundstrom, J and Sung, Y-T and Sunyer, J and Suriyawongpaisal, P and Swinburn, BA and Sy, RG and Szponar, L and Tai, ES and Tammesoo, M-L and Tamosiunas, A and Tang, L and Tang, X and Tanser, F and Tao, Y and Tarp, J and Tarqui-Mamani, CB and Taylor, A and Tchibindat, F and Thijs, L and Thuesen, BH and Tjonneland, A and Tolonen, HK and Tolstrup, JS and Topbas, M and Topor-Madry, R and Torrent, M and Traissac, P and Trichopoulou, A and Trichopoulos, D and Trinh, OTH and Trivedi, A and Tshepo, L and Tulloch-Reid, MK and Tuomainen, T-P and Tuomilehto, J and Turley, ML and Tynelius, P and Tzotzas, T and Tzourio, C and Ueda, P and Ukoli, FAM and Ulmer, H and Unal, B and Valdivia, G and Vale, S and Valvi, D and van der Schouw, YT and Van Herck, K and Hoang, VM and van Valkengoed, IGM and Vanderschueren, D and Vanuzzo, D and Vatten, L and Vega, T and Velasquez-Melendez, G and Veronesi, G and Verschuren, WMM and Viegi, G and Viet, L and Viikari-Juntura, E and Vineis, P and Vioque, J and Virtanen, JK and Visvikis-Siest, S and Viswanathan, B and Vollenweider, P and Voutilainen, S and Vrijheid, M and Wade, AN and Wagner, A and Walton, J and Mohamud, WNW and Wang, M-D and Wang, Q and Wang, YX and Wannamethee, SG and Wareham, N and Weerasekera, D and Whincup, PH and Widhalm, K and Widyahening, IS and Wiecek, A and Wilks, RJ and Willeit, J and Wojtyniak, B and Wong, JE and Wong, TY and Woo, J and Woodward, M and Wu, FC and Wu, J and Wu, SL and Xu, H and Xu, L and Yamborisut, U and Yan, W and Yang, X and Yardim, N and Ye, X and Yiallouros, PK and Yoshihara, A and You, QS and Younger-Coleman, NO and Yusoff, AF and Zainuddin, AA and Zambon, S and Zdrojewski, T and Zeng, Y and Zhao, D and Zhao, W and Zheng, Y and Zhou, M and Zhu, D and Zimmermann, E and Zuniga Cisneros, J (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. LANCET, 387 (10026). pp. 1377-1396. ISSN 0140-6736

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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/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.


We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women.


If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

Item Type: Article
Uncontrolled Keywords: 11 Medical And Health Sciences
Subjects: Q Science > QP Physiology
R Medicine > RA Public aspects of medicine
Divisions: Sport & Exercise Sciences
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Date Deposited: 24 May 2016 08:50
Last Modified: 24 May 2016 08:50
URI: http://researchonline.ljmu.ac.uk/id/eprint/3661

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