Age-standardized Prevalence Of Obesity Research Articles

Assessing the relationship between energy-related methane emissions and the burden of cardiovascular diseases: a cross-sectional study of 73 countries

The energy industry significantly contributes to anthropogenic methane emissions, which add to global warming and have been linked to an increased risk of cardiovascular diseases (CVD). This study aims to evaluate the relationship between energy-related methane emissions and the burden of CVD, measured in disability-adjusted life years (DALYs), in 2019. We conducted a cross-sectional analysis of datasets from 73 countries across all continents. The analyzed datasets included information from 2019 on environmental energy-related methane emissions, burden of DALYs due to CVD. The age-standardized prevalence of obesity in adults and life expectancy at birth were retrieved. The relationship between the variables of interest was evaluated using multiple linear regression models. In the multiple model, we observed a positive linear association between methane emissions and the log-transformed count of DALYs related to CVD. Specifically, for each unit increase in energy-related methane emissions, the burden of CVD increased by 0.06% (95% CI 0.03–0.09%, p < 0.001). The study suggests that reducing methane emissions from the energy industry could improve public health for those at risk of CVD. Policymakers can use these findings to develop strategies to reduce methane emissions and protect public health.

Prevalence of Obesity Among Adults in Jordan: National Survey

Background Obesity is a national and global public health problem in terms of morbidity, mortality, and economic burden. In 2014, 5% of deaths worldwide were attributable to obesity, with an estimated economic impact of 2.8% of the global gross domestic product. A survey in 2008 showed a high prevalence of overweight and obesity among adults in Jordan. Objective This study aimed to determine the prevalence of obesity, assess its trends, and identify the factors and comorbidities associated with this condition. Methods A multipurpose national household survey was conducted among Jordanian adults over 4 months in 2017. Data were collected using a structured validated questionnaire. Obesity was defined according to the International Diabetes Federation criteria. Results This study included 4056 adults (1193 men, 29.4%; 2863 women, 70.6%). Their age ranged from 18 to 90 years, with a mean age of 43.8 (SD 14.2) years. According to the International Diabetes Federation criteria, the age-standardized prevalence of obesity was 60.4% in men and 75.6% in women. After adjusting for age, the odds of obesity in 2017 were twice the odds in 2008 in men (odds ratio [OR] 1.98) and women (OR 1.96). In the multivariate analysis, age, place of living, and marital status were significantly associated with obesity in men and women. Obesity was significantly associated with increased odds of diabetes mellitus (OR 2.1 for men; OR 2.9 for women), hypertension (OR 2.4 for men; OR 2.5 for women), elevated triglyceride levels (OR 2.5 for men; OR 4.2 for women), and low high-density lipoprotein levels (OR 2.2 for men; OR 2.1 for women) after adjusting for age. Conclusions The prevalence of obesity is high in Jordan, and this condition is associated with other metabolic abnormalities. Well-defined programs to manage, control, and prevent obesity as well as intersectoral action are urgently required to reverse current trends in Jordan.

Nationwide trends in prevalence of underweight, overweight, and obesity among people with disabilities in South Korea from 2008 to 2017

ObjectivesThis study investigated the 10-year trends of weight and prevalence of underweight, overweight and obesity according to disability grade and types compared with those without disabilities.MethodsThis serial cross-sectional analysis was conducted using national disability registration data with national general health checkup data from 2008 to 2017. Age-standardized prevalence of underweight and obesity were analyzed for each year, according to the presence, type, and severity of disabilities. Odds of underweight, overweight, obesity, and severe obesity were examined by multinomial logistic regression after adjusting for socio-demographic and clinical variables using data in 2017.ResultsOver 10 million subjects in each year were included in the analysis. In 2017, 14,246,785 people with age between 19 and 110 years were included and 53.1% was men. For 10 years, age-standardized prevalence of obesity and severe obesity showed significant increases regardless of sex and presence of disability. However, age-standardized underweight prevalence in people without disability tended to decrease whereas it was an increase in 2012 and the prevalence has remained steady since in people with disability. People with disabilities had higher odds of underweight compared to those without disability (OR 1.41, 95% CI 1.38–1.44 in male and OR 1.31, 95% CI 1.28–1.34 in female), especially in those with severe disabilities (OR 2.00, 95% CI 1.94–2.06 in male and OR 1.83, 95% CI 1.77–1.89 in female). Women with disabilities are more likely to be obese than those without disabilities regardless of disability severity (OR 1.40, 95% CI 1.38–1.41). Participants with mental disorder showed the highest prevalence of obesity, followed by epilepsy and developmental disability.ConclusionsHaving a disability was associated with higher odds/probability of both obesity and underweight. The intersection of female, severe disability, and mental/developmental disabilities was associated with probability of severe obesity. Simultaneous efforts are needed to develop health policy to reduce both the prevalence of obesity and underweight.

1417Geographical differentials and trends in obesity burden in Argentina: a socio-demographic approach

Abstract Background In Argentina, there is evidence suggesting the obesity prevalence follows a social gradient. We analyze geographical differentials and trends in obesity burden according to socio-demographic conditions in Argentina (2005-2013). Methods The geographical distribution (n = 24 provinces) of the obesity burden in adult population of Argentina in 2005, 2009, and 2013 was analyzed by using mapping techniques. The National Survey of Chronic Diseases Risk Factors datasets were used to estimate and map the age-standardized prevalence of obesity (ASPO) and group-specific prevalence (% obesity) by province and year. Population groups were defined according to socio-demographic factors: age, sex, income level, education, and poverty level (by unsatisfied basic needs –UBN). Results Most of the provinces had an increasing ASPO between 2005 and 2013. In 2013, 75% of the provinces showed an ASPO above 20% in men, while 50% of the provinces exceed this ASPO value in women. In both sexes, the middle-aged group presented the most unfavorable situation. Overall, all the socio-demographic groups considered showed growing trends in obesity prevalence, although there were geographical disparities. Among the middle-income level population, a marked rising change was observed from 2009 to 2013. The population with incomplete primary education presented higher prevalence for all the years studied compared to the population with university education. Conclusions Since 2005, there was an overall increase in obesity prevalence in Argentina, with persistence of geographical disparities according to socio-demographical conditions. Key messages An overall rising trend in obesity prevalence was observed in Argentina. Geographical disparities by social groups were observed.

Sanitation, Obesity, and Low Body Mass Index as Risk Factors for Bacterial Skin Infections.

Bacterial skin infections can cause significant disability and can lead to mortality with inadequate treatment. To determine whether sanitation and body mass index (BMI) are statistically significant risk factors for the incidence and prognosis of bacterial skin infections. Country-level data regarding the age-standardized rates of incidence, prevalence, and years lived with disability (YLD) from bacterial skin infection per 100 000 persons from the Global Burden of disease dataset, and country-level data on age-standardized prevalence of obesity (BMI ≥30) and low BMI (BMI <18.5) from World Health Organization Global Health Observatory data repository were analyzed. Regression models were created to examine the effects of sanitation, obesity, and low BMI on the burden of bacterial skin infections. The percentage of population using basic sanitation services was positively associated with incidence, prevalence, and YLD from bacterial skin infections (P < .05). After controlling for sanitation, in countries with more than 50% of the population using basic sanitation services, obesity was positively associated with incidence, prevalence, and YLD from bacterial skin infections (P < .05). In countries with less than or equal to 50% of the population using basic sanitation services, low BMI was positively associated with incidence, prevalence, and YLD from bacterial skin infections (P < .05). Improving sanitation access in all countries, reducing the percentage of obese population in countries with good sanitation/hygiene techniques, and addressing malnutrition in countries with poor sanitation/hygiene techniques may help to reduce the burden of bacterial skin infections.

The burden of non-communicable diseases attributable to high BMI in Brazil, 1990\u20132017: findings from the Global Burden of Disease Study

BackgroundThe prevalence and burden of disease resulting from obesity have increased worldwide. In Brazil, more than half of the population is now overweight. However, the impact of this growing risk factor on disease burden remains inexact. Using the 2017 Global Burden of Disease (GBD) results, this study sought to estimate mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) in both sexes and across age categories. This study also aimed to describe the prevalence of overweight and obesity throughout the states of Brazil.MethodsAge-standardized prevalence of overweight and obesity were estimated between 1990 and 2017. A comparative risk assessment was applied to estimate DALYs and deaths for non-communicable diseases and for all causes linked to high BMI.ResultsThe prevalence of overweight and obesity increased during the period of analysis. Overall, age-standardized prevalence of obesity in Brazil was higher in females (29.8%) than in males (24.6%) in 2017; however, since 1990, males have presented greater rise in obesity (244.1%) than females (165.7%). Increases in prevalence burden were greatest in states from the North and Northeast regions of Brazil. Overall, burden due to high BMI also increased from 1990 to 2017. In 2017, high BMI was responsible for 12.3% (8.8–16.1%) of all deaths and 8.4% (6.3–10.7%) of total DALYs lost to non-communicable diseases, up from 7.2% (4.1–10.8%), and 4.6% (2.4-6.0%) in 1990, respectively. Change due to risk exposure is the leading contributor to the growth of BMI burden in Brazil. In 2017, high BMI was responsible for 165,954 deaths and 5,095,125 DALYs. Cardiovascular disease and diabetes have proven to be the most prevalent causes of deaths, along with DALYs caused by high BMI, regardless of sex or state.ConclusionsThis study demonstrates increasing age-standardized prevalence of obesity in all Brazilian states. High BMI plays an important role in disease burdens in terms of cardiovascular diseases, diabetes, and all causes of mortality. Assessing levels and trends in exposures to high BMI and the resulting disease burden highlights the current priority for primary prevention and public health action initiatives focused on obesity.

An alarmingly high and increasing prevalence of obesity in Jordan.

OBJECTIVESThe aim of this study was to determine the prevalence of obesity in Jordan, to assess related trends, and to determine associated factors and comorbidities.METHODSA multipurpose national household survey of Jordanian adults was conducted over a 4-month period in 2017. Data were collected using a structured validated questionnaire. Anthropometric measurements including waist circumference (WC; measured midway between the iliac crest and the lower rib margin), body mass index (BMI), hip circumference, waist-to-hip ratio, and waist-to-height ratio were obtained to categorize participants with regard to overweight and obesity.RESULTSThis study included 4,056 persons (1,193 men and 2,863 women) aged 18 years to 90 years (mean±standard deviation, 43.8±14.2 years). According to the International Diabetes Federation WC criteria, the age-standardized prevalence of obesity was 60.4% among men and 75.6% among women, while approximately three-quarters of men and women were overweight or obese as defined by BMI. The age-adjusted odds of obesity in 2017 were approximately twice those in 2009 in men (odds ratio [OR], 1.98) and women (OR, 1.96). In the multivariate analysis, age, region of residence, and marital status were significantly associated with obesity in both genders. Obesity was significantly associated with increased odds of diabetes mellitus, hypertension, elevated triglycerides, and low high-density lipoprotein cholesterol after adjusting for age.CONCLUSIONSThe rate of obesity in Jordan is high and increasing, and obesity is associated with other metabolic abnormalities. Well-defined programs to control and prevent obesity, as well as intersectoral action, are urgently required to reverse current trends.

Trends in total fat and fatty acid intakes and chronic health conditions in Korean adults over 2007-2015.

To investigate trends in total fat and fatty acid intakes and chronic health conditions among Korean adults over nine years between 2007 and 2015. Cross-sectional, observational study using a stratified, multistage probability sampling design at a national level. Intakes of total fat and fatty acids were estimated from 24 h dietary recalls by sex and age groups. Trends of total fat and fatty acid intakes were determined by multiple linear regression after adjusting for covariates. Trends in age-standardized prevalence of obesity, hypercholesterolaemia and hypertriacylglycerolaemia were examined by sex. Korea.ParticipantsPopulation data of 47749 healthy adults (aged ≥19 years) derived from the Korea National Health and Nutrition Examination Survey between 2007 and 2015. Over the survey period, daily intakes of energy and total, saturated, monounsaturated, polyunsaturated, n-3 and n-6 fats (grams and percentage of energy (%E)) increased steadily. In all sex and age groups, significant increases were seen in SFA intake from 9·9 g (4·7 %E) to 12·0 g (5·3 %E) and in MUFA intake from 9·9 g (4·6 %E) to 13·3 g (5·8 %E). The prevalence of hypercholesterolaemia increased from 10·7 to 17·9 % over the same period. In Korean adults, total fat, SFA and other fatty acids have been increasing along with the prevalence of hypercholesterolaemia. This information can help set adequate macronutrient and fatty acid distribution ranges in developing population-specific preventive strategies against diet-related illness.

Weight or metabolism: which deserve more attention in obesity?

Obesity has become an important public health issue worldwide. A previous study has indicated that age-standardized average body mass index (BMI) increased from 21.7 kg/m 2 in 1975 to 24.2 kg/m 2 in 2014 in men, and from 22.1 to 24.4 kg/m 2 in women worldwide (1). With regard to children, it has been demonstrated that the global age-standardized prevalence of obesity increased from 0.7% in 1975 to 5.6% in 2016 in girls (5–19 years old), and from 0.9% to 7.8% in boys (5–19 years old) (2).

World Bank Income Group, Health Expenditure or Cardiometabolic Risk Factors? A Further Explanation of the Wide Gap in Cardiometabolic Mortality Between Worldwide Countries: An Ecological Study.

BackgroundFor addressing the burden of non-communicable diseases and policymaking, the world health organization uses World Bank income group to classify countries. This calcification method might not be optimal. This study aimed to investigate the role of World Bank income group, health expenditure, and cardiometabolic risk factors of countries in explaining the gap between their cardiometabolic mortality.MethodsIn total, 190 countries were categorized into four income groups according to the World Bank definition. The energy consumption, health expenditure, and data of sex-specified age-standardized prevalence of obesity, hypercholesterolemia, hypertension, diabetes, smoking, and physical inactivity in 2008 and cardiometabolic mortality in 2012 were used. Multivariable-adjusted mixed-effect linear regression models were applied to relate country-level predictors to their mortality outcomes.ResultsWhile the lowest cardiometabolic mortality was recorded in high-income countries in both genders, the highest rates were recorded in the low-income category for women and in low and middle-income for men. Countries had lower cardiometabolic mortality for women compared to men; however, such a difference was not shown in low-income countries. World Bank income group of countries, per se, explained one-third of the variation in their mortality outcomes while adding health expenditure, energy consumption, and cardiometabolic risk factors increased the explanatory power of the model considerably. Moreover, the more the health expenditure, the weaker the association of prevalence of hypertension with cardiometabolic mortality.ConclusionsAdding countries’ health expenditure and/or the prevalence of risk factors to their World Bank income group may contribute to the better explanation of the gap between them in cardiometabolic mortality.

Prevalence of general and abdominal obesity in Portugal: comprehensive results from the National Food, nutrition and physical activity survey 2015\u20132016

BackgroundThis study includes, for the first time, estimates of general and abdominal obesity prevalence for all ages of the Portuguese population, using common standardized methodologies. Results are compared by sex, age groups, educational level and geographical regions.MethodsParticipants were a representative sample of the Portuguese population aged between 3 months and 84 years of age (n = 6553), enrolled in the National Food, Nutrition and Physical Activity Survey, 2015–2016. Objective anthropometric measurements included length/height, weight and body circumferences, performed according to standard procedures. Body mass index (BMI) was classified according to the World Health Organization (WHO) growth charts for children and adolescents, and WHO criteria for adults. Abdominal obesity was defined in adults as waist-hip ratio ≥ 0.85 in women or ≥ 0.90 in men. Prevalence estimates and 95% confidence intervals (95%CI) were weighted according to a complex sampling design, considering stratification by seven geographical regions and cluster effect for the selected Primary Health Care Unit.ResultsThe national prevalence of obesity is 22.3% (95%CI: 20.5–24.0), significantly higher in women. Obesity prevalence is much higher in the elderly (39.2%, 95%CI. 34.2–44.2), while children and adolescents have the lowest prevalence around 8–9%. In a regression model, three knot points denoting an inflection of obesity prevalence across the life span were observed around 5, 15 and 75 years.The prevalence of pre-obesity at national level is 34.8% (95%CI: 32.9–36.7), higher in men, and almost 18% of children and 24% of adolescents have pre-obesity.The sex- and age-standardized prevalence of obesity ranged from 38.3% (95%CI: 34.6–42.1) to 13.1% (95%CI: 10.3–15.9) for the less and the most educated individuals, respectively. Although some geographical region disparities, obesity prevalence did not significantly differed across regions (p = 0.094).The national prevalence of abdominal obesity in adults is 50.5% (95%CI: 47.9–53.1), particularly high in the elderly (80.2%).ConclusionAlmost 60% of the general Portuguese population is obese or pre-obese. Women, elderly and less educated individuals present the highest obesity prevalence. Abdominal obesity, in particular, seems to be a relevant public health problem among the elderly men.

Changes in waist circumference independent of weight: Implications for population level monitoring of obesity

Population monitoring of obesity is most commonly conducted using body mass index (BMI). We test the hypothesis that because of increases in waist circumference (WC) independent of increases in weight, BMI alone detects an increasingly smaller proportion of the population with obesity. MethodsAustralian adults with measured height, weight, and WC were selected from three nationally representative cross-sectional surveys (1989, 1999–2000, 2011–12; n=8313, 5903 & 3904). Participants were defined as having obesity using classifications for an obese BMI (≥30kg·m−2) and substantially-increased-risk WC (≥88cm [women], ≥102cm [men]). Age-standardised prevalence of obesity according to BMI and/or WC, and the proportion of these detected by BMI and by WC were compared across surveys. FindingsBetween 1989 and 2011–12, weight and WC increased by 5.4kg and 10.7cm (women), and by 7.0kg and 7.3cm (men). For women and men, 63% and 38% of increases in WC were independent of increases in weight. Over this period, the prevalence of obesity according to BMI and/or WC increased by 25.3 percentage-points for women (18.9% to 44.3%) and 21.1 percentage-points for men (17.1% to 38.2%). The proportion of these detected by BMI decreased for women by 20 percentage-points (77% to 57%) with no change for men. The proportion of these detected by WC increased for women and men by 10 percentage-points (87% to 97%) and 6 percentage-points (85% to 91%) respectively. ConclusionBMI alone is detecting a decreasing proportion of those considered obese by BMI and/or WC. Renewed discussion regarding how we monitor obesity at the population level is required.

Six-year changes in the prevalence of obesity and obesity-related diseases in Northeastern China from 2007 to 2013

Obesity and obesity-related diseases are important public health challenges. In this study, we aimed to provide updated trends in the prevalence of these conditions. We conducted two independent cross-sectional surveys of the general population aged 20–75 years in 2007 and 2013 in Jilin, China. A total of 3636 (1719 males) and 1359 (602 males) participants were enrolled in the 2007 and 2013 surveys, respectively. Obesity-related diseases were defined as type 2 diabetes, hypertension, dyslipidemia and non-alcoholic fatty liver disease (NAFLD). The age-standardized prevalence of obesity, overweight, diabetes, pre-diabetes, dyslipidemia and NAFLD increased from 2007 to 2013 from 15.82% to 19.41%, 35.85% to 41.80%, 6.37% to 9.23%, 16.77% to 23.49%., 53.46% to 65.50%, and 23.48% to 44.31% in males, respectively, and from 13.18% to 18.77%, 31.11% to 37.54%, 4.41% to 8.48%, 8.10% to 16.49%, 41.96% to 54.70%, and 17.56% to 43.06% in females, respectively. However, the prevalence of hypertension remained stable (males: 38.10% vs. 38.63% and females: 33.04% vs. 33.01% in 2007 and 2013, respectively). The prevalence of obesity and obesity-related diseases, except for hypertension, increased significantly in the general population in Northeastern China. More targeted measures should be implemented to address the serious challenges presented by these diseases.

Trends in adult overweight and obesity prevalence in Mongolia, 2005-2013.

To analyze trends in the prevalence of overweight and obesity among Mongolian adults during the past decade as measured by body mass index (BMI) and waist circumference (WC). Data from the repeated cross-sectional surveys on the prevalence of noncommunicable disease risk factors conducted in 2005, 2009, and 2013 in Mongolia were used. Linear regression was used to quantify trends in mean BMI and WC, adjusted for age group, sex, and survey year. The age-standardized prevalence of obesity, denoted by the international BMI cutoff values, in men and women between 2005 and 2013 increased from 10.8% to 17.6% and from 18.9% to 26.4%, respectively. Using Asian-specific BMI cutoff values for men and women, the age-standardized prevalence of obesity between 2005 and 2013 increased from 20.0% to 32.8% and 33.4% to 43.7%, respectively. The prevalence of overweight and obesity has increased markedly between 2005 and 2013 similarly across all age groups and sexes. It is important to consider the use of Asian-specific cut-offs as the burden of obesity is twice as high as when using international BMI cutoffs. These data demonstrate the urgent need for obesity treatment, prevention, and monitoring in Mongolia.

Prevalence of general and abdominal obesity and overweight among adults in Poland. Results of the WOBASZ II study (2013-2014) and comparison with the WOBASZ study (2003-2005).

INTRODUCTION There are limited data on the current prevalence of overweight and obesity as well asits changes with time in Poland. OBJECTIVES The aim of the study was to assess the prevalence of general and abdominal obesity andoverweight in Polish adults in the years 2013-2014, and to compare it with the prevalence in the years2003-2005. PATIENTS AND METHODS The study was conducted in 2 independent, representative samples of thePolish population, comprising 14 537 persons (aged 20-74 years) examined in the years 2003-2005and 6164 persons (aged ≥20 years) examined in the years 2013-2014. Anthropometric measurementswere done by trained nurses. RESULTS In the years 2013-2014, the age-standardized prevalence of obesity (body mass index [BMI]≥30 kg/m2) was 24.4% in men and 25.0% in women. The prevalence of overweight (BMI, 25.0-29.9kg/m2) was 43.2% in men and 30.5% in women. Abdominal obesity (waist circumference ≥102 cm inmen or ≥88 cm in women) was noted in 32.2% of men and 45.7% of women. Abdominal overweight(waist circumference, 94-101.9 cm in men or 80-87.9 cm in women) was present in 27.2% of menand 21.7% of women. Since the years 2003-2005, the distribution of body mass according to the BMIcategory had shifted to higher values, and an increase in the prevalence of obesity was observed inmen. The percentage of adults with normal waist circumference decreased significantly in both sexes. CONCLUSIONS Every fourth inhabitant of Poland is obese, and during the last decade, the prevalence ofobesity has increased, particularly in men. Abdominal obesity is observed in every third man and nearlyevery second woman, and an excess of abdominal fat has increased in both sexes.

The Muscle Race After Bariatric Surgery: Ribosomal Proteins Come First.

Obesity and its associated cardiometabolic comorbidities, which include type 2 diabetes, have emerged as a global pandemic condition. The global age-standardized prevalence of obesity was 12.0% in 2008, indicating that roughly 500 million adults were obese (1). More recent estimates indicate that, worldwide, the proportion of adults who were overweight or obese in 2013 was 36.9% for men and 38.0% for women (2) and that the number of overweight and obese individuals was 2.1 billion in 2013. As for obesity in children, global estimates also indicate that levels have been rising in recent decades (2,3). If nothing is done to reverse the epidemic, more than 1 billion adults are projected to be obese by 2030 (4). The use of bariatric surgery to treat obesity has rapidly gained widespread acceptance owing, in part, to greater weight loss and effective treatment of diabetes and other cardiometabolic risk factors. Different types of bariatric surgery such as laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion are linked to distinct rates of hyperglycemia remission in patients with type 2 diabetes (5,6). RYGB has emerged as an efficient tool for treating obesity, and it leads to remission in 75% of patients with type 2 diabetes (5,7). The RYGB procedure involves the creation of a stomach pouch out of a small portion of the stomach and attaching it directly to the small intestine, bypassing a large part of the stomach and duodenum. Not only is the stomach pouch …

Reduced Prevalence of Obesity in 14 Disadvantaged Black Communities in the United States: A Successful 4-Year Place-Based Participatory Intervention.

To assess the impact of a large-scale place-based intervention on obesity prevalence in Black communities. The Racial and Ethnic Approaches to Community Health across the United States (REACH US) project was conducted in 14 predominantly Black communities in California, Illinois, Massachusetts, New York, Ohio, Pennsylvania, South Carolina, Virginia, Washington, and West Virginia. We measured trends from 2009 to 2012 in the prevalence of obesity. We used Behavioral Risk Factor Surveillance System data to compare these trends with trends among non-Hispanic Whites and non-Hispanic Blacks in the United States and in the 10 states where REACH communities were located, and with a propensity score-matched national sample of non-Hispanic Blacks. The age-standardized prevalence of obesity decreased in REACH US communities (P = .045), but not in the comparison populations (P = .435 to P = .996). The relative change was -5.3% in REACH US communities versus +2.4% in propensity score-matched controls (P value for the difference = .031). The net effect on the reduction of obesity prevalence was about 1 percentage point per year for REACH. Obesity prevalence was reduced in 14 disadvantaged Black communities that participated in the REACH project.

Obesity continues to increase in the majority of the population in mid-Sweden-a 12-year follow-up.

The aim was to investigate trends in the prevalence of obesity by age and level of education in the general population in mid-Sweden from year 2000 to 2012. A postal questionnaire was sent to a random population sample aged 25-74 years in years 2000, 2004, 2008 and 2012. The overall response rates were 67%, 65%, 60% and 53%, respectively, and the study included 29 017, 27 385, 25 910 and 24 152 respondents, respectively. Obesity (BMI ≥ 30 kg/m(2)) was based on self-reported weight and height. The age-standardized prevalence of obesity increased from 13% to 17% in women and from 12% to 17% in men between 2000 and 2012. Obesity increased in all age groups from 2000 to 2008 and continued to increase among the middle aged (45-64 years) between 2008 and 2012. The socioeconomic gradient in obesity changed during the study period since the absolute increase in obesity was steepest at the middle educational level. In 2012, the prevalence of obesity was almost twice as high at both middle and low educational levels compared with high educational level. The 'true' prevalence of adult obesity, corrected for self-reported weight and height, was around 20% in 2012 for both men and women. In the majority, among the middle-aged and those with secondary education, the prevalence of obesity continued to increase even between 2008 and 2012.

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

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/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), ≥40 kg/m(2) [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/m(2) (95% credible interval 21·3-22·1) in 1975 to 24·2 kg/m(2) (24·0-24·4) in 2014 in men, and from 22·1 kg/m(2) (21·7-22·5) in 1975 to 24·4 kg/m(2) (24·2-24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m(2) in central Africa and south Asia to 29·2 kg/m(2) (28·6-29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m(2) (21·4-22·3) in south Asia to 32·2 kg/m(2) (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/m(2)). 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. Wellcome Trust, Grand Challenges Canada.

Prevalence of obesity using the body mass index and equivalent age- and sex-specific thresholds for percentage body fat mass

The body mass index (BMI, kg/m2) of at least 30 kg/m2 is used to identify obesity. However, the BMI indicates weight adjusted for height without considering differences in body composition and the contribution of body fat mass to an individual’s weight. Consequently, the BMI as an indicator of adiposity tends to over-estimate adiposity in muscular body builds and under-estimate adiposity in the elderly. The aim of this study was to identify ageand sex-specific values for percentage body fat mass (%BFM), measured using whole body dual energy Xray absorptiometry (DXA), that correspond to BMI 30 kg/m2 [1], and to compare the prevalence of obesity in the adult Australian population using BMI≥ 30 kg/m2 and the equivalent cut-points for %BFM. This analysis utilises data from randomlyselected men (n = 1467) and women (n = 1076), age 20—96 years, who had BMI and DXAmeasures as part of the Geelong Osteoporosis Study, 2001—2008. Age-specific %BFM cut-points for obesity in men and women, respectively, were calculated as: 20—29 years 27.5%, 43.4%; 30—39 years 28.1%, 43.6%; 40—49 years 28.7%, 43.8%; 50—59 years 29.3%, 44.0%; 60—69 years 29.9%, 44.2%; 70—79 years 30.5%, 44.4%; 80+ years 31.1%, 44.6%. Using these cut-points, the age-standardised prevalence of obesity for men is 25.0% (95% CI 22.6—27.4) and for women is 29.8% (95% CI 27.0—32.6). Prevalence using BMI≥ 30 kg/m2 is 20.2% (95% CI 18.0—22.4) for men and 28.6% (95% CI 25.8—31.3) for women. Estimating the prevalence of obesity using one BMI threshold may under-estimate the true extent of obesity in the population, particularly among men. We recognise that optimal thresholds for defining obesity will depend on risk assessment for morbidity and mortality.