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

NCD Risk Factor Collaboration (NCD-RisC)

Research output: Contribution to journalArticle

832 Citations (Scopus)

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 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.

Original languageEnglish
Pages (from-to)2627-2642
Number of pages16
JournalThe Lancet
Volume390
Issue number10113
DOIs
Publication statusPublished - Dec 16 2017

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Thinness
Polynesia
Micronesia
Body Mass Index
Obesity
Pediatric Obesity
Population
Palau
Eastern Europe
Latin America
American Samoa
Weights and Measures
Central America
Northern Africa
Eastern Africa
Southeastern Asia
Middle East
Far East
Health
India

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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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. / NCD Risk Factor Collaboration (NCD-RisC).

In: The Lancet, Vol. 390, No. 10113, 16.12.2017, p. 2627-2642.

Research output: Contribution to journalArticle

@article{a16d0e04d8124f9ba8fa217ec9aaabd2,
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",
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 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.",
author = "{NCD Risk Factor Collaboration (NCD-RisC)} and James Bentham and {Di Cesare}, Mariachiara and Ver Bilano and Honor Bixby and Bin Zhou and Stevens, {Gretchen A.} and Riley, {Leanne M.} and Cristina Taddei and Kaveh Hajifathalian and Yuan Lu and Stefan Savin and Cowan, {Melanie J.} and Paciorek, {Christopher J.} and Adela Chirita-Emandi and Hayes, {Alison J.} and Joanne Katz and Roya Kelishadi and Kengne, {Andre Pascal} and Khang, {Young Ho} and Avula Laxmaiah and Yanping Li and Jun Ma and Miranda, {J. Jaime} and Aya Mostafa and Martin Neovius and Cristina Padez and Lekhraj Rampal and Aubrianna Zhu and Bennett, {James E.} and Goodarz Danaei and Bhutta, {Zulfiqar A.} and Majid Ezzati and Leandra Abarca-G{\'o}mez and Abdeen, {Ziad A.} and Hamid, {Zargar Abdul} and Abu-Rmeileh, {Niveen M.} and Benjamin Acosta-Cazares and Cecilia Acuin and Adams, {Robert J.} and Wichai Aekplakorn and Kaosar Afsana and Aguilar-Salinas, {Carlos A.} and Charles Agyemang and Alireza Ahmadvand and Wolfgang Ahrens and Kamel Ajlouni and Nazgul Akhtaeva and Al-Hazzaa, {Hazzaa M.} and Al-Othman, {Amani Rashed} and Rajaa Al-Raddadi",
year = "2017",
month = "12",
day = "16",
doi = "10.1016/S0140-6736(17)32129-3",
language = "English",
volume = "390",
pages = "2627--2642",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "10113",

}

TY - JOUR

T1 - Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016

T2 - a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults

AU - NCD Risk Factor Collaboration (NCD-RisC)

AU - Bentham, James

AU - Di Cesare, Mariachiara

AU - Bilano, Ver

AU - Bixby, Honor

AU - Zhou, Bin

AU - Stevens, Gretchen A.

AU - Riley, Leanne M.

AU - Taddei, Cristina

AU - Hajifathalian, Kaveh

AU - Lu, Yuan

AU - Savin, Stefan

AU - Cowan, Melanie J.

AU - Paciorek, Christopher J.

AU - Chirita-Emandi, Adela

AU - Hayes, Alison J.

AU - Katz, Joanne

AU - Kelishadi, Roya

AU - Kengne, Andre Pascal

AU - Khang, Young Ho

AU - Laxmaiah, Avula

AU - Li, Yanping

AU - Ma, Jun

AU - Miranda, J. Jaime

AU - Mostafa, Aya

AU - Neovius, Martin

AU - Padez, Cristina

AU - Rampal, Lekhraj

AU - Zhu, Aubrianna

AU - Bennett, James E.

AU - Danaei, Goodarz

AU - Bhutta, Zulfiqar A.

AU - Ezzati, Majid

AU - Abarca-Gómez, Leandra

AU - Abdeen, Ziad A.

AU - Hamid, Zargar Abdul

AU - Abu-Rmeileh, Niveen M.

AU - Acosta-Cazares, Benjamin

AU - Acuin, Cecilia

AU - Adams, Robert J.

AU - Aekplakorn, Wichai

AU - Afsana, Kaosar

AU - Aguilar-Salinas, Carlos A.

AU - Agyemang, Charles

AU - Ahmadvand, Alireza

AU - Ahrens, Wolfgang

AU - Ajlouni, Kamel

AU - Akhtaeva, Nazgul

AU - Al-Hazzaa, Hazzaa M.

AU - Al-Othman, Amani Rashed

AU - Al-Raddadi, Rajaa

PY - 2017/12/16

Y1 - 2017/12/16

N2 - 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.

AB - 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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U2 - 10.1016/S0140-6736(17)32129-3

DO - 10.1016/S0140-6736(17)32129-3

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AN - SCOPUS:85030864437

VL - 390

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EP - 2642

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10113

ER -