Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

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

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity . Here we use 2,009\ua0population-based studies, with measurements of height and weight in more than 112\ua0million adults, to report national, regional and global trends in mean\ua0BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in\ua0some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities\ua0in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Inherent resonance of carbon and graphene-based nanocomposite coupled single-span arch beams

In recent decades, there has been a significant rise in the utilization of composite materials for various engineering applications. These advanced materials offer the potential to improve the mechanical properties and vibration characteristics of structural components. This particular study is dedicated to enhancing the vibration performance of coupled curved-curved beams that feature a linear elastic mid-layer, achieved through the incorporation of carbon nanotubes (CNTs), graphene nanoplates (GNPs), and graphene oxide powder (GOPs). The governing equations of the system are solved using the generalized differential quadrature (GDQ) method. While previous research primarily focused on the use of CNTs to enhance the vibration behavior of coupled-curved beams, this study delves into the utilization of multiple nanofillers for this purpose. An essential aspect of modeling composite materials lies in determining their equivalent mechanical properties. This research undertakes a comparison between the rule of mixture (RoM) and Halpin-Tsai methods for calculating these properties, revealing that frequencies derived from the RoM method are higher than those obtained through the Halpin-Tsai approach. Additionally, the study highlights that systems incorporating GNPs demonstrate higher frequencies at lower nanofiller volumes, with CNTs and GOPs following in ranking. However, this hierarchy shifts at higher nanofiller volumes. The arrangement of nanofillers within the system is influenced by its boundary conditions, with the curvature of the bottom beam playing a significant role in affecting vibration behavior. Increasing the radius of the bottom beam (R2) leads to higher system frequencies, which subsequently decrease with higher R2 values

Improving composite cable performance: Nonlinear thermo-elastic analysis with temperature-dependent pretension and 3D cable elements

Composite cables are widely used in various engineering applications due to their high strength-to-weight ratio and versatility. However, their performance is highly influenced by temperature changes and the application of pretension, which must be considered to perform accurate analysis. Fibrous materials, characterized by their high strength and flexibility, are incorporated into the cable structure to enhance its performance. This research paper presents a comprehensive study on the nonlinear analysis of cable structures made of fibrous materials considering temperature-dependent effects and pretension. A three-dimensional cable element model is employed to accurately capture the complex behavior of composite cables. The proposed approach allows for a more realistic representation of the cable's response, accounting for both mechanical and thermal effects. In order to effectively solve nonlinear equations, the Newton-Raphson (NR) method, a powerful iterative technique for solving nonlinear equations, is employed. This technique is employed to analyze the behavior of composite cables under various loading conditions, accounting for factors such as temperature dependence and pretension. Through extensive numerical simulations, the effects of temperature variation and pretension on the structural performance of composite cables are evaluated. The results provide valuable insights into the behavior of composite cables and offer guidelines for optimizing their performance in real-world applications. This research contributes to advancing composite cable design and engineering practices by considering the intricate interplay between temperature-dependent behavior, pretension, and nonlinear thermo-elastic analysis

Unveiling the potential of an evolutionary approach for accurate compressive strength prediction of engineered cementitious composites

The different human activities in numerous fields of civil engineering have become possible due to recent development in soft computing. As many researchers have widely extended the use of evolutionary numerical methods to predict the mechanical properties of construction materials, it has become necessary to investigate the performance, accuracy, and robustness of these approaches. Gene Expression Programming (GEP) is a method that stands out among these methods as it can generate highly accurate formulas. In this study, two models of GEP are used to anticipate the compressive strength of engineered cementitious composite (ECC) containing fly ash (FA) and polyvinyl alcohol (PVA) fiber at 28 days. The experimental results for 76 specimens, which are made with ten different mixture properties, are taken from the literature to build the models. Considering the experimental results, four different input variables in the GEP approach are used to arrange the models in two modes: sorted data distribution (SDD) and random data distribution (RDD). Prognosticating the compressive strength values based on the mechanical properties of ECC containing FA and PVA will be possible for the models of the GEP method by using these input variables. The comparison between the experimental results and the results of training, testing, and validation sets of two models (GEP-I and GEP-II), each of which has two distinct distribution modes, is done. It is observed that both modes of RDD and SDD lead to responses with the same accuracy (R-square more than 0.9). Nevertheless, the GEP-I (SDD) model was chosen as the best model in this study based on its performance with the validation data set

Nonlinear Regression Prediction of Mechanical Properties for SMA-Confined Concrete Cylindrical Specimens

In order to achieve active confinement in concrete elements, researchers have recently employed smart materials called shape memory alloys (SMA). Several empirical relationships have been widely used to predict the behavior of confined concrete. To develop more accurate relations for predicting the behavior of concrete actively confined with SMA spirals, it is necessary to obtain new relations for determining the peak compressive stress and the corresponding strain in addition to the ultimate stress and strain. For this purpose, existing data from 42 specimens of plain concrete cylindrical specimens confined with SMA spirals and subjected to uniaxial compression were collected. Then, by using MATLAB and SigmaPlot software, nonlinear regression analyses were conducted to obtain the optimum relations. The best equations were selected using multiple error criteria of root mean square error (RMSE) and R-squared (R2). Finally, the accuracy of the proposed relations was compared to the existing relations for active concrete confinement which showed better accuracy

Enhancing Mechanical Behavior and Energy Dissipation in Fiber-Reinforced Polymers through Shape Memory Alloy Integration: A Numerical Study on SMA-FRP Composites under Cyclic Tensile Loading

Conventional fiber-reinforced polymers (FRPs) have a relatively linear stress–strain behavior up to the failure point. Therefore, they show brittle behavior until the failure point. Shape memory alloys, in addition to having high ductility and good energy dissipation capability, are highly resistant to corrosion and show good performance against fatigue. Therefore, using the SMA fibers in the production of FRPs can be a suitable solution to solve the problem of the brittle behavior of conventional FRPs. SMA fibers can be integrated with a polymeric matrix with or without conventional fibers and create a new material called SMA-FRP. This study investigates the effect of using different volume fractions of conventional fibers (carbon, glass, and aramid) and SMA fibers (NiTi) in the super-elastic phase and the effect of the initial strain of SMA fibers on the behavior of SMA-FRP composites under cyclic tensile loading. Specimens are designed to reach a target elastic modulus and are modeled using OpenSees (v. 3.5.0) finite element software. Analyzing the results shows that in the SMA-FRP composites that are designed to reach a target elastic modulus, with an increase in the volume fraction of SMA fibers, the maximum stress, residual strain, and strain hardening ratio are reduced, and the ability to energy dissipation capability and residual stress increases. It was also observed that increasing the percentage of the initial strain of SMA fibers increases the maximum stress and energy dissipation capability and reduces the residual strain and yield stress. In the investigation of the effect of the type of conventional fibers used in the construction of composites, it was found that the use of fibers that have a larger failure strain increases the maximum stress and energy dissipation capability of the composite and reduces the strain hardening ratio. In addition, increasing the elastic modulus of conventional fibers increases the residual strain and residual stress of the composites