Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

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 schoolaged 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 obesit

Worldwide trends in underweight and obesity from 1990 to 2022 : a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

A list of authors and their affiliations appears online. A supplementary appendix is herewith attached.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 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.peer-reviewe

Transición nutricional ¿ruta segura a la obesidad?

Durante el siglo XX, Venezuela recorrió la ruta de la malnutrición. Si bien la desnutrición existía desde antes de 1900, el Dr. Juan de Dios Villegas en 1908 funda en Caracas “La Gota de Leche”, que es una de las primeras instituciones para atender a los niños desnutridos y educar a las madres. En el periodo 1900 a 1980, el Ministerio de Sanidad y Asistencia Social y el Instituto Nacional de Nutrición, unen esfuerzos para reducir la alta mortalidad infantil y la desnutrición. En sólo dos décadas la mortalidad infantil se redujo a la mitad de 121,2 a 60,6 /1000nv (1941-1961) y continúo descendiendo hasta 14/1000nv en 2008, al mismo tiempo, que las enfermedades infecciosas, fueron desplazadas por las enfermedades crónico no trasmisibles, como primeras causas de muerte. Este fenómeno se produjo a la par de un cambio en los hábitos de vida y de alimentación, en un país con más del ochenta por ciento de la población urbana y cada vez más sedentaria. Este fenómeno, que se conoce con el nombre de transición nutricional, no es más que la secuencia de características y cambios del estado nutricional, como consecuencia de la sustitución de la alimentación tradicional por una alimentación hipercalórica con exceso de grasas y azúcares en medio de cambios económicos, demográficos, sociales y de salud, considerados por algunos estudiosos como parte del riesgo cuando se transita el camino al desarrollo. En el modelo europeo, se describen cuatro etapas: una de pre transición nutricional, caracterizada por una dieta escasa en grasas y azúcares, donde predomina la desnutrición; una de transición donde dichos alimentos aumentan, generando la coexistencia de desnutridos y obesos, una tercera etapa en que las grasas y azúcares se mantienen, predominando la obesidad; y una última etapa donde se produce una combinación y equilibrio de las dos primeras, que se manifiesta por una reducción de la malnutrición por exceso

Challenges in Food Security, Nutritional, and Social Public Policies for Venezuela: Rethinking the Future

Food security in Venezuela presents signs of individual, family, community and national deterioration. The food and nutrition system has been weakened by the decrease in the production and the installation of parallel, irregular and insufficient distribution networks. Economic turmoil, political instability, hyperinflation, and poverty, the highest in recent history, limit the population's income and the access to quality food. The transition from capitalism to state-centered socialism has not been successful in ensuring enough foods for Venezuelans and the effect on the well-being of the population has been detrimental. This study proposes to design a public policy model based on the analysis of food security indicators, to generate an integrated framework of actions. The proposed model considers Dunn's classic public policy approach (2017) and the criteria of the Public Health Tools/Community Nutrition Program-Nutritional Care Process: Nutrition Care Process (NCP) of the Academy of Nutrition and Dietetics, 2012. The World Food Program survey on food security in Venezuela 2019, and the HumVenezuela.com 2020 platform were used. The integrated model includes two levels, one for bringing assistance to the most vulnerable and the other for strategic planning of structural, legal and institutional problems, and health and food safety gaps, in an ethical and moral framework that challenges corruption and promotes education and culture of peace. It is necessary for public policies to have parallel levels of actions to assist those most in need and to face long-term structural changes, which should begin as soon as possible, to ensure the correct path toward development.</jats:p

Alcohol drinking, smoking and food insecurity in Venezuelan parents as potential determinants of their children’s growth

Abstract Life conditions are key factors for defining growth and development of future generations. Exposure of parents to alcohol, tobacco, food insecurity conditions and adverse socioeconomic environment as part of their lifestyle and quality of life, have been reported to affect their children’s health and wellbeing. Prenatal exposures have been extensively documented, but less is known about influences from parental harmful habits and disadvantaged environment during children‘s school years. The aim of this study is to examine potential associations between parental habits and environmental socioeconomic conditions, including food security status, and anthropometric characteristics of their children. Parental smoking, alcohol intake, food security, and socioeconomic status (SES) were explored in parents of 1730 children recruited at private and public schools in eight Venezuelan cities. These qualitative variables were collected through a semi-structured questionnaire. Weight, height and body mass index were measured using standardized methods in children. Height and BMI were converted to z-scores according to WHO international growth reference. Low BMI z-scores in children were significantly associated with mothers consuming alcohol. The frequency of children with short height was higher in households with impaired access to quality foods and where mothers reported low and very low food security status. In brief, our study indicates that social environment could have detrimental effects on child anthropometry thus, affecting their wellbeing.</jats:p

Energy imbalance gap was associated with body mass index and sex in Latin American adolescents—results from the ELANS study

Introduction: Energy imbalance gap (EIG) is defined as the average daily difference between energy intake (EI) and energy expenditure (EE). This study aimed to examine the associations between EIG and sociodemographic and anthropometric variables in the adolescent population of eight Latin America countries. Methods: A total of 680 adolescents aged 15 to 18 were included in this study. The estimation of EI was based on two non-consecutive 24-h dietary recalls. EE was predicted from Schofield equations using physical activity level obtained through the long version of the International Physical Activity Questionnaire. Sociodemographic data and anthropometric measurements were also obtained. A descriptive analysis and multilevel linear regression models were used to examine associations between variables. Results: The mean EI, EE, and EIG were 2091.3 kcal, 2067.8 kcal, and 23.5 kcal, respectively. Argentina had the highest EI and EIG, whereas Chile had the lowest EI and EIG. Males had a higher EI (2262.4 kcal) and EE (2172.2 kcal) than females (1930.1 kcal and 2084.5 kcal), respectively (p < 0.05). Overweight subjects had a lower EIG than did underweight and normal-weight subjects (p < 0.05). Subjects with low socioeconomic status (SES) had a lower EE (2047.0 kcal) than those with a high SES (2164.2 kcal) (p < 0.05). Conclusion: Sex and BMI were associated with EIG in adolescents from Latin America. Copyright © 2024 Hernandez, Herrera-Cuenca, Ferrari, Yépez Almeida, Yépez García, Villar Cáceres, Cortés Sanabria, Sifontes, Landaeta-Jimenez, Gómez, Monge-Rojas, Pareja, Rigotti, Kovalskys and Fisberg.Fundación Bengoa; Universidad San Francisco de Quito, USFQ; Instituto Pensi; Universidad Central de Venezuela, UCV; Pontificia Universidad Católica de Chile, UC; Instituto de Investigación Nutricional; Coca Cola Company; Universidad de Costa Rica, UCR; International Life Sciences Institute, ILSI; Pontificia Universidad Javeriana; Hospital Infantil SabaraUniversidad Autónoma de Chil

Childbearing Age Women Characteristics in Latin America. Building Evidence Bases for Early Prevention. Results from the ELANS Study

Latin American (LA) women have been exposed to demographic and epidemiologic changes that have transformed their lifestyle, with increasing sedentary and unhealthy eating behaviors. We aimed to identify characteristics of LA women to inform public policies that would benefit these women and their future children. The Latin American Study of Nutrition and Health (ELANS) is a multicenter cross-sectional study of representative samples in eight Latin American countries (n = 9218) with a standardized protocol to investigate dietary intake, anthropometric variables, physical activity, and socioeconomic characteristics. Here we included the subsample of all 3254 women of childbearing age (15 to &lt;45 years). The majority of ELANS women had a low socioeconomic status (53.5%), had a basic education level (56.4%), had a mostly sedentary lifestyle (61.1%), and were overweight or obese (58.7%). According to the logistic multiple regression model, living in Peru and Ecuador predicts twice the risk of being obese, and an increased neck circumference is associated with a 12-fold increased obesity risk. An increased obesity risk was also predicted by age &lt;19 years (Relative Risk (RR) 19.8) and adequate consumption of vitamin D (RR 2.12) and iron (RR 1.3). In conclusion, the identification of these risk predictors of obesity among Latin American women may facilitate targeted prevention strategies focusing on high-risk groups to promote the long-term health of women and their children.</jats:p

Contribution of Proteins to the Latin American Diet: Results of the ELANS Study

Dietary protein intake is vital to life. Here we sought to characterize dietary sources of protein in eight Latin American countries. Survey data were collected for Estudio Latinoamericano de Nutrici&oacute;n y Salud (ELANS); participants were from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (n = 9218, 15&ndash;65 years old). The primary aim of this analysis was to quantify per-person daily protein consumption by country and sociodemographic factors. Secondary aims: to quantify proportional intake of proteins by source, amount and processing, and to determine the adequacy of protein/essential amino acid intake. Younger groups (adolescents 15&ndash;19 years, adults 20&ndash;33 years) had the highest intake of proteins; middle-aged adults (34&ndash;49 years) had a lower intake, and older adults (50&ndash;65 years) had a strikingly lower intake. Protein consumption was higher in men than women. Animal proteins comprised nearly 70% of total daily protein intake in Argentina and Venezuela, contrasting with &lt;60% in Peru, Chile, and Costa Rica. Brazil and Venezuela showed the highest protein intake within the highest education level. The higher the socioeconomic level, the higher the protein intake, except for Argentina, Chile, and Peru. Proportional intake of animal- and plant-based protein generally reflected the food availability by country. This study presents a pre-pandemic regional baseline and offers a perspective for future studies of changes related to government policies, climate, and dietary practices

Anthropometric Profile of Latin American Population: Results From the ELANS Study

Background: Latin America has experienced changes in lifestyle since 1960.Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity.Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status.Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%).Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.</jats:p

Anthropometric Profile of Latin American Population: Results from the ELANS Study

Background: Latin America has experienced changes in lifestyle since 1960. Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity. Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status. Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%). Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.Coca Cola Company///Estados UnidosFerrero///ItaliaHospital Infantil Sabará///BrazilInternational Life Science Institute//ILSI/ArgentinaUniversidad de Costa Rica//UCR/Costa RicaPontificia Universidad Católica de Chile///ChilePontificia Universidad Javeriana///ColombiaUniversidad Central de Venezuela//UCV/VenezuelaUniversidad San Francisco de Quito///EcuadorInstituto de Investigación Nutricional de Perú///PerúUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin