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

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

Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil

O estudo consiste em avaliar os níveis de mercúrio no pescado consumido pela comunidade indígena de Sai Cinza (Reserva Munduruku) no Estado do Pará, e associá-los com os hábitos de consumo da população. Um total de oitenta espécimes de peixes foram capturados. As determinações de Hg foram realizadas por absorção atômica. A concentração média de Hg nas espécies carnívoras foi de 0,293 µg/g (DP = 0,104) enquanto nas não carnívoras foi de 0,112 µg/g (DP = 0,036). As espécies referidas como de maior consumo ente os 330 indivíduos entrevistados foram: tucunaré, pacu, jaraqui, traíra, aracu, matrinchã e caratinga. As espécies com concentrações mais elevadas de Hg foram tucunaré e traíra, que estão entre os peixes mais consumidos. A freqüência de consumo constitui-se num fator importante na avaliação de risco de contaminação por mercúrio em comunidades que não têm outras alternativas de alimentação

Mercury contamination of fish and exposures of an indigenous community in Pará state, Brazil

MS/FNS/Instituto Evandro Chagas and the European Union.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Coordenação de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Coordenação de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Coordenação de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Secretaria Executiva de Indústria, Comércio e Mineração do Estado do Pará. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Coordenação de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Fish consumption is an important source of protein among indigenous communities in Amazonian Brazil. Exposures to mercury via fish were studied in an indigenous community of the Munduruku reserve, located in the Tapajós River basin in the state of Pará, one of the oldest and most productive gold mining areas in the Amazon region. This study summarizes the results of mercury (Hg) analyses of fish consumed by inhabitants of the Munduruku settlement of Sai Cinza. The most frequently consumed fish, reported by 330 persons interviewed for this study, were tucunaré, pacu, jaraqui, traíra, aracu, matrinchã, and caratinga. The mean mercury concentration in carnivorous fish was 0.297 microg.g(-1) while in noncarnivorous fish mean mercury concentration was 0.095 microg.g(-1). Only in caratinga was there a significant relationship between fish size, weight, and mercury levels. Levels of methylmercury in the tucunaré averaged 0.170 microg.g(-1), while in traíra the mean level of methylmercury was 0.212 microg.g(-1). Although the levels of Hg in fish consumed by the Sai Cinza community are below the Brazilian limit value for consumption, the high rates and amounts of fish consumed by this population are relevant to evaluating risks of mercury contamination for communities with limited food resources

Mercury exposures in riverside amazon communities in Para, Brazil

MS/FNS/Instituto Evandro Chagas and European UnionMinistério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Serviço de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Serviço de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Serviço de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Serviço de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Secretaria Executiva de Indústria, Comércio e Mineração do Pará. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Serviço de Ecologia Humana e Meio Ambiente. Belém, PA, Brasil.Universidade Federal do Rio de Janeiro. Núcleo de Estudos de Saúde Coletiva. Rio de Janeiro, RJ, Brasil.European UnionCross-sectional studies were conducted in three riverside communities in the state of Para in the Amazon Region of Brazil. Two of these communities, Brasilia Legal and Sao Luis do Tapajos, are located in a watershed exposed to mercury pollution from artisanal gold mining, and the third, Santana do Ituqui, is outside this area. The studies were based upon a community census and included all persons volunteering for participation in each community. All participants were surveyed by questionnaire for health history, occupation, residence, and diet. Clinical evaluations were also done on each subject, along with collection of blood, urine, feces, and hair. Fish samples were collected to represent the most frequently consumed species. Mercury was measured in hair and fish. Although no signs or symptoms of overt mercury intoxication were observed, persons in Brasilia Legal and Sao Luis do Tapajos had higher levels of mercury in hair than residents of Santana de Ituqui, located out of the risk area. Levels of mercury in fish were below Brazilian health guidance limits, but the high rates of fish consumption among these populations raise concerns for the possible effects of chronic exposure, especially among young children and women of childbearing age

Mercury exposure in Munduruku Indians from the community of Sai Cinza, State of Pará, Brazil

Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Executive Secretariat of Industry, Commerce and Minning, Brazil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Federal University of Rio de Janeiro. Center for Studies in Public Health. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Executive Secretariat of Industry. Commerce and Minning. Brazil.European Union. Brazil.The objective of this cross-sectional study was to evaluate mercury exposure and health status among Munduruku Indians from the community of Sai Cinza, State of ParaH, Brazil. The population studied included 330 indians, who submitted to a questionnaire, clinical exams, and collection of hair, blood, urine, and feces. Mercury was measured in hair and Ash. Although no person was found to have overt mercury intoxication, the mean levels of mercury in hair were elevated (14.45 g/g for children from 7 to 12 years old, 15.70 g/g for women between 14 and 44 years old, and 14.1 g/g for the remaining population). Mercury levels in Ash were below levels recommended by the World Health Organization, but rates of Ash consumption were high. These results place this indigenous populations as a group under risk of mercury toxicity from the gold production