Abstract
ObjectiveObesity is one of the most important public health issues worldwide. Moreover, an extreme phenotype, morbid obesity (MO) has insidiously become a global problem. Therefore, we aimed to document the prevalence trend and to unveil the epidemiological characteristics of MO in Taiwan.MethodsNationally representative samples aged 19 years and above from three consecutive waves of Nutrition and Health survey in Taiwan: 1993–1996, 2005–2008, and 2013–2014 (n = 3,071; 1,673; and 1,440; respectively) were analyzed for prevalence trend. And 39 MO (BMI ≥35 kg/m2) cases from the two recent surveys compared with 156 age, gender, and survey-matched normal weight controls (BMI: 18.5–24 kg/m2) for epidemiological characteristics study. The reduced rank regression analysis was used to find dietary pattern associated with MO.ResultsThe prevalence of overweight and obesity together (BMI ≥24 kg/m2) was stabilized in the recent two surveys, but that of MO (0.4%, 0.6%, to 1.4%) and obesity (BMI ≥27 kg/m2) (11.8%, 17.9%, to 22.0%) increased sharply. MO cases tended to have lower levels of education, personal income, and physical activity. Furthermore, their dietary pattern featured with a higher consumption frequency of red meat, processed animal products, and sweets/sweetened beverage, but lower frequencies of fresh fruits, nuts, breakfast cereal, and dairy products.ConclusionThis study documents a polarization phenomenon with smaller proportion of overweight people at the center and higher proportions of normal weight and obesity subjects at two extremes. MO was associated with low socioeconomic status and poor dietary pattern. The obesogenic dietary pattern became more prevalent in later time.
Highlights
Obesity is a major public health issue in the world
morbid obesity (MO) cases tended to have lower levels of education, personal income, and physical activity. Their dietary pattern featured with a higher consumption frequency of red meat, processed animal products, and sweets/ sweetened beverage, but lower frequencies of fresh fruits, nuts, breakfast cereal, and dairy products
MO was associated with low socioeconomic status and poor dietary pattern
Summary
Obesity is a major public health issue in the world. It has been estimated that there are approximately 1.9 billion adults who are either overweight or obese (body mass index, BMI !25 kg/ m2). The current worldwide prevalence of obesity in adults has been more than doubled in the world since 1980[1].At the same time, the trend of obesity rates seems to be levelling off in some developed countries since 2006[4].On the other hand, the prevalence of an extreme phenotype, morbid obesity (MO) (BMI !40 kg/m2), is persistently rising, and expected to increase in an accelerating speed in the coming decades [5, 6].Compared to those whom were overweight and obesity, MO population suffer from even a shorter life expectancy, greater severity of many comorbidity, and higher all-cause mortality rate[7, 8],so that associated medical cost and social economic burden are tremendous[9, 10]. Weight control measures are less efficient for MO except an extreme measure, bariatric surgery[11]
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