National, regional, and global trends in body mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants

By M. Finucane, Gretchen A. Stevens, Melanie J. Cowan, G. Danaei, J. Lin, Christopher J. Paciorek, G. Singh, Hialy R. Gutierrez, Yuan Lu, A. Bahalim and 3 more. The Lancet, 2011

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Summary Background Rising body weight is a major public health concern. However there have been few worldwide comparative analyses of long-term trends of body mass index (BMI), and none that have used recent national health examination surveys. Methods We estimated trends in mean in BMI and their uncertainties for adults 20 years of age and older in 199 countries and territories. Data were from published and unpublished health examination surveys and epidemiologic studies. For each sex, we used a Bayesian hierarchical model to estimate BMI by age, country, and year, accounting for whether a given study was nationally representative. Findings Between 1980 and 2008, global mean BMI increased at an annualized rate of 0.4 (95% uncertainty interval 0.2, 0.6, posterior probability (PP) of being a true increase > 0.999) kg/m2/decade for men and 0.5 (0.3–0.7, PP > 0.999) for women. National BMI change for women ranged from non-significant declines in 19 countries to rising over 2.5 (PP > 0.999) kg/m2/decade in Tonga and Cook Islands. There was an increase in male BMI in all but a few countries, reaching over 2 kg/m2/decade in Nauru and Cook Islands, PP > 0.999. Male and female BMIs in 2008 were highest in some Oceania countries, reaching 33.9 (32.8, 35.0) kg/m2 (men) and 35.0 (33.6, 36.3) (women) in Nauru. Female BMI was lowest in Bangladesh (20.5; 19.8, 21.3) kg/m2 and male BMI in Democratic Republic of the Congo 19.9 (18.2, 21.5), with BMI also below 21.5 kg/m2 for both sexes in a few countries in sub-Saharan Africa, and East, South, and Southeast Asia. USA had the highest BMI among high-income countries, followed by New Zealand. In 2008, an estimated 1.47 billion adults worldwide had BMI ≥ 25 kg/m2; of these 205 (193, 217) million men and 297 (280, 315) million women were obese. Interpretation Globally, mean BMI increased since 1980. The trends since 1980, and mean population BMI in 2008, varied substantially across nations. Interventions and policies that can curb or reverse the increase, and mitigate the health effects of high BMI by targeting its metabolic mediators, are needed in most countries.

Subfields: Endocrinology, Diabetes and Metabolism, Physiology, Public Health, Environmental and Occupational Health

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Citations in the corpus

Global gender disparities in obesity: a review. (2012, background): “Global survey data indicate that the prevalence of both male and female overweight and obesity varies by region and has rapidly increased between 1980 and 2008 (19).”
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 (2017, neutral): “We made a similar request to the authors of an earlier pooled analysis of cardiometabolic risk factors, 18–21 and invited them to reanalyse data from their studies and join NCD-RisC.”
National, regional, and global trends in adult overweight and obesity prevalences (2012, methodology): “The uncertainty of the estimated prevalences included those of mean BMI from the Bayesian model, described elsewhere [6,7] and summarized above, and the uncertainty associated with converting mean to prevalence.”