TY - JOUR
T1 - Worldwide trends in underweight and obesity from 1990 to 2022
T2 - a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults
AU - NCD Risk Factor Collaboration (NCD-RisC)
AU - Phelps, Nowell H.
AU - Singleton, Rosie K.
AU - Zhou, Bin
AU - Heap, Rachel A.
AU - Mishra, Anu
AU - Bennett, James E.
AU - Paciorek, Christopher J.
AU - Lhoste, Victor PF
AU - Carrillo-Larco, Rodrigo M.
AU - Stevens, Gretchen A.
AU - Rodriguez-Martinez, Andrea
AU - Bixby, Honor
AU - Bentham, James
AU - Di Cesare, Mariachiara
AU - Danaei, Goodarz
AU - Rayner, Archie W.
AU - Barradas-Pires, Ana
AU - Cowan, Melanie J.
AU - Savin, Stefan
AU - Riley, Leanne M.
AU - Aguilar-Salinas, Carlos A.
AU - Baker, Jennifer L.
AU - Barkat, Amina
AU - Bhutta, Zulfiqar A.
AU - Branca, Francesco
AU - Caixeta, Roberta B.
AU - Cuschieri, Sarah
AU - Farzadfar, Farshad
AU - Ganapathy, Shubash
AU - Ikeda, Nayu
AU - Iotova, Violeta
AU - Kengne, Andre P.
AU - Khang, Young Ho
AU - Laxmaiah, Avula
AU - Lin, Hsien Ho
AU - Ma, Jun
AU - Mbanya, Jean Claude N.
AU - Miranda, J. Jaime
AU - Pradeepa, Rajendra
AU - Rodríguez-Artalejo, Fernando
AU - Sorić, Maroje
AU - Turley, Maria
AU - Wang, Limin
AU - Webster-Kerr, Karen
AU - Ezzati, Majid
AU - Aarestrup, Julie
AU - Abarca-Gómez, Leandra
AU - Abbasi-Kangevari, Mohsen
AU - Abdeen, Ziad A.
AU - Abdrakhmanova, Shynar
AU - Abdul Ghaffar, Suhaila
AU - Abdul Rahim, Hanan F.
AU - Abdurrahmonova, Zulfiya
AU - Abu-Rmeileh, Niveen M.
AU - Abubakar Garba, Jamila
AU - Acosta-Cazares, Benjamin
AU - Adam, Ishag
AU - Adamczyk, Marzena
AU - Adams, Robert J.
AU - Adu-Afarwuah, Seth
AU - Aekplakorn, Wichai
AU - Afsana, Kaosar
AU - Afzal, Shoaib
AU - Agbor, Valirie N.
AU - Agdeppa, Imelda A.
AU - Aghazadeh-Attari, Javad
AU - Ågren, Åsa
AU - Aguenaou, Hassan
AU - Agyemang, Charles
AU - Ahmad, Mohamad Hasnan
AU - Ahmad, Noor Ani
AU - Ahmadi, Ali
AU - Ahmadi, Naser
AU - Ahmadi, Nastaran
AU - Ahmed, Imran
AU - Ahmed, Soheir H.
AU - Ahrens, Wolfgang
AU - Aitmurzaeva, Gulmira
AU - Ajlouni, Kamel
AU - Al-Hazzaa, Hazzaa M.
AU - Al-Hinai, Halima
AU - Al-Lahou, Badreya
AU - Al-Lawati, Jawad A.
AU - Al-Raddadi, Rajaa
AU - Al Asfoor, Deena
AU - Al Hourani, Huda M.
AU - Al Qaoud, Nawal M.
AU - Alarouj, Monira
AU - AlBuhairan, Fadia
AU - AlDhukair, Shahla
AU - Aldwairji, Maryam A.
AU - Alexius, Sylvia
AU - Ali, Mohamed M.
AU - Alieva, Anna V.
AU - Alkandari, Abdullah
AU - Alkerwi, Ala'a
AU - Alkhatib, Buthaina M.
AU - Allin, Kristine
AU - Alomary, Shaker A.
AU - Alomirah, Husam F.
AU - Alshangiti, Arwa M.
AU - Alvarez-Pedrerol, Mar
AU - Aly, Eman
AU - Amarapurkar, Deepak N.
AU - Amiano Etxezarreta, Pilar
AU - Amoah, John
AU - Amougou, Norbert
AU - Amouyel, Philippe
AU - Andersen, Lars Bo
AU - Anderssen, Sigmund A.
AU - Androutsos, Odysseas
AU - Ängquist, Lars
AU - Anjana, Ranjit Mohan
AU - Ansari-Moghaddam, Alireza
AU - Anufrieva, Elena
AU - Aounallah-Skhiri, Hajer
AU - Araújo, Joana
AU - Ariansen, Inger
AU - Aris, Tahir
AU - Arku, Raphael E.
AU - Arlappa, Nimmathota
AU - Aryal, Krishna K.
AU - Assefa, Nega
AU - Aspelund, Thor
AU - Assah, Felix K.
AU - Assembekov, Batyrbek
AU - Assunção, Maria Cecília F.
AU - Aung, May Soe
AU - Aurélio de Valois, Correia Júnior Marco
AU - Auvinen, Juha
AU - Avdičová, Mária
AU - Avi, Shina
AU - Azad, Kishwar
AU - Azevedo, Ana
AU - Azimi-Nezhad, Mohsen
AU - Azizi, Fereidoun
AU - Babu, Bontha V.
AU - Bacopoulou, Flora
AU - Bæksgaard Jørgensen, Maja
AU - Baharudin, Azli
AU - Bahijri, Suhad
AU - Bajramovic, Izet
AU - Bakacs, Marta
AU - Balakrishna, Nagalla
AU - Balanova, Yulia
AU - Bamoshmoosh, Mohamed
AU - Banach, Maciej
AU - Banegas, José R.
AU - Baran, Joanna
AU - Baran, Rafał
AU - Barbagallo, Carlo M.
AU - Barbosa Filho, Valter
AU - Barceló, Alberto
AU - Baretić, Maja
AU - Barnoya, Joaquin
AU - Barrera, Lena
AU - Barreto, Marta
AU - Barros, Aluisio JD
AU - Barros, Mauro Virgílio Gomes
AU - Bartosiewicz, Anna
AU - Basit, Abdul
AU - Bastos, Joao Luiz
AU - Bata, Iqbal
AU - Batieha, Anwar M.
AU - Batista, Aline P.
AU - Batista, Rosangela L.
AU - Battakova, Zhamilya
AU - Baur, Louise A.
AU - Bayauli, Pascal M.
AU - Beaglehole, Robert
AU - Bel-Serrat, Silvia
AU - Belavendra, Antonisamy
AU - Ben Romdhane, Habiba
AU - Benedek, Theodora
AU - Benedics, Judith
AU - Benet, Mikhail
AU - Benitez Rolandi, Gilda Estela
AU - Benzeval, Michaela
AU - Bere, Elling
AU - Berger, Nicolas
AU - Bergh, Ingunn Holden
AU - Berhane, Yemane
AU - Berkinbayev, Salim
AU - Bernabe-Ortiz, Antonio
AU - Bernotiene, Gailute
AU - Berrios Carrasola, Ximena
AU - Bettiol, Heloísa
AU - Beutel, Manfred E.
AU - Beybey, Augustin F.
AU - Bezerra, Jorge
AU - Bhagyalaxmi, Aroor
AU - Bharadwaj, Sumit
AU - Bhargava, Santosh K.
AU - Bi, Hongsheng
AU - Bi, Yufang
AU - Bia, Daniel
AU - Biasch, Katia
AU - Bika Lele, Elysée Claude
AU - Bikbov, Mukharram M.
AU - Bista, Bihungum
AU - Bjelica, Dusko J.
AU - Bjerregaard, Anne A.
AU - Bjerregaard, Peter
AU - Bjertness, Espen
AU - Bjertness, Marius B.
AU - Björkelund, Cecilia
AU - Bloch, Katia V.
AU - Blokstra, Anneke
AU - Blychfeld Magnazu, Moran
AU - Bo, Simona
AU - Bobak, Martin
AU - Boddy, Lynne M.
AU - Boehm, Bernhard O.
AU - Boer, Jolanda MA
AU - Boggia, Jose G.
AU - Bogova, Elena
AU - Boissonnet, Carlos P.
AU - Bojesen, Stig E.
AU - Bonaccio, Marialaura
AU - Bongard, Vanina
AU - Bonilla-Vargas, Alice
AU - Bopp, Matthias
AU - Borghs, Herman
AU - Botomba, Steve
AU - Bourne, Rupert RA
AU - Bovet, Pascal
AU - Boymatova, Khadichamo
AU - Braeckevelt, Lien
AU - Braeckman, Lutgart
AU - Bragt, Marjolijn CE
AU - Braithwaite, Tasanee
AU - Brajkovich, Imperia
AU - Breckenkamp, Juergen
AU - Breda, João
AU - Brenner, Hermann
AU - Brewster, Lizzy M.
AU - Brian, Garry R.
AU - Briceño, Yajaira
AU - Brinduse, Lacramioara
AU - Bringolf-Isler, Bettina
AU - Brito, Miguel
AU - Brophy, Sinead
AU - Brug, Johannes
AU - Clarke, Janine
AU - Islam, Muhammad
AU - Janus, Edward
AU - Laatikainen, Tiina
AU - Taylor, Julie
AU - Tran, Thi Tuyet Hanh
AU - Wong, Emily B.
AU - Yang, Yang
PY - 2024/3/16
Y1 - 2024/3/16
N2 - Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.
AB - Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.
KW - Overweight
KW - Underweight
KW - Obesity
KW - Nutrition
KW - Diet
UR - http://www.scopus.com/inward/record.url?scp=85186605044&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(23)02750-2
DO - 10.1016/S0140-6736(23)02750-2
M3 - Article
C2 - 38432237
AN - SCOPUS:85186605044
SN - 0140-6736
VL - 403
SP - 1027
EP - 1050
JO - The Lancet
JF - The Lancet
IS - 10431
ER -