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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 Ferguson, TS and Fernandez-Berges, D and Ferrante, D and Ferrari, M and Ferreccio, C and Ferrieres, J and Finn, JD and Fischer, K and Monterubio Flores, E and Foeger, B and Foo, LH and Forslund, A-S and Fortmann, SP and Fouad, HM and Francis, DK and Franco, MDC and Franco, OH and Frontera, G and Fuchs, FD and Fuchs, SC and Fujita, Y and Furusawa, T and Gaciong, Z and Gafencu, M and Gareta, D and Garnett, SP and Gaspoz, J-M and Gasull, M and Gates, L and Geleijnse, JM and Ghasemian, A and Giampaoli, S and Gianfagna, F and Giovannelli, J and Giwercman, A and Goldsmith, RA and Gonzalez Gross, M and Gonzalez Rivas, JP and Bonet Gorbea, M and Gottrand, F and -Iversen, SG and Grafnetter, D and Grajda, A and Grammatikopoulou, MG and Gregor, RD and Grodzicki, T and Grontved, A and Gruden, G and Grujic, V and Gu, D and Guan, OP and Gudnason, V and Guerrero, R and Guessous, I and Guimaraes, AL and Gulliford, MC and Gunnlaugsdottir, J and Gunter, M and Guo, XH and Guo, Y and Gupta, PC and Gureje, O and Gurzkowska, B and Gutierrez, L and Gutzwiller, F and Halkjaer, J and Hardy, R and Kumar, RH and Hayes, AJ and He, J and Hendriks, ME and Hernandez Cadena, L and Heshmat, R and Hihtaniemi, IT and Ho, SY and Ho, SC and Hobbs, M and Hofman, A and Hormiga, CM and Horta, BL and Houti, L and Htay, TT and Htet, AS and Htike, MMT and Hu, Y and Hussieni, AS and Chinh, NH and Huybrechts, I and Hwalla, N and Iacoviello, L and Iannone, AG and Ibrahim, MM and Ikeda, N and Ikram, MA and Irazola, VE and Islam, M and Iwasaki, M and Jackson, RT and Jacobs, JM and Jafar, T and Jamil, KM and Jamrozik, K and Jasienska, G and Jiang, CQ and Joffres, M and Johansson, M and Jonas, JB and Jorgensen, T and Joshi, P and Juolevi, A and Jurak, G and Juresa, V and Kaaks, R and Kafatos, A and Kalter-Leibovici, O and Kapantais, E and Kasaeian, A and Katz, J and Kaur, P and Kavousi, M and Keil, U and Boker, LK and Kelishadi, R and Kemper, HHCG and Kengne, AP and Kersting, M and Key, T and Khader, YS and Khalili, 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Mann, JI and Manzato, E and Margozzini, P and Markey, O and Marques-Vidal, P and Marrugat, J and Martin-Prevel, Y and Martorell, R and Masoodi, SR and Matsha, TE and Mazur, A and Mbanya, JCN and McFarlane, SR and McGarvey, ST and McKee, M and McLachlan, S and McLean, RM and McNulty, BA and Yusof, SM and Mediene-Benchekor, S and Meirhaeghe, A and Meisinger, C and Mendes, LL and Menezes, AMB and Mensink, GBM and Meshram, II and Metspalu, A and Mi, J and Michaelsen, KF and Mikkel, K and Miller, JC and Francisco Miquel, J and Jaime Miranda, J and Misigoj-Durakovic, M and Mohamed, MK and Mohammad, K and Mohammadifard, N and Mohan, V and Yusoff, MFM and Molbo, D and Moller, NC and Molnar, D and Mondo, CK and Monterrubio, EA and Monyeki, KDK and Moreira, LB and Morejon, A and Moreno, LA and Morgan, K and Mortensen, EL and Moschonis, G and Mossakowska, M and Mostafa, A and Mota, J and Motlagh, ME and Motta, J and Mu, TT and Muiesan, ML and Mueller-Nurasyid, M and Murphy, N and Mursu, J and Murtagh, EM and Musa, KI and Musil, V and Nagel, G and Nakamura, H and Namesna, J and Nang, EEK and Nangia, VB and Nankap, M and Narake, S and Maria Navarrete-Munoz, E and Nenko, I and Neovius, M and Nervi, F and Neuhauser, HK and Nguyen, ND and Quang, NN and Nieto-Martinez, RE and Ning, G and Ninomiya, T and Nishtar, S and Noale, M and Norat, T and Noto, D and Al Nsour, M and O'Reilly, D and Ochoa-Aviles, AM and Oh, K and Olayan, IH and Anselmo Olinto, MT and Oltarzewski, M and Omar, MA and Ordunez, P and Ortiz, AP and Osler, M and Osmond, C and Ostojic, SM and Otero, JA and Overvad, K and Paccaud, FM and Padez, C and Pajak, A and Palli, D and Palloni, A and Palmieri, L and Panda-Jonas, S and Panza, F and Parnell, WR and Parsaeian, M and Pednekar, MS and Peeters, PH and Peixoto, SV and Pereira, AC and Perez, CM and Peters, A and Peykari, N and Son, TP and Pigeot, I and Pikhart, H and Pilav, A and Pilotto, L and Pistelli, F and Pitakaka, F and Piwonska, A and Piwonski, J and 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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Abstract

Background

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.

Methods

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.

Findings

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.

Interpretation

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
Publisher: ELSEVIER SCIENCE INC
Related URLs:
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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