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

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.This study was funded by: - The UK Medical Research Council (grant number MR/V034057/1) - The Wellcome Trust (Pathways to Equitable Healthy Cities grant 209376/Z/17/Z). - The AstraZeneca Young Health Programme and the European Commission (STOP project through EU Horizon 2020 research and innovation programme under Grant Agreement 774548)

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

Anthropometric indices of obesity as predictors of high blood pressure among school children

Background Hypertension is related to increased body fat, which can be evaluated by anthropometric indicators. The aim of this study was to determine the predictive power of anthropometric indicators and to establish their cutoff points as discriminators of high blood pressure. Methods A cross-sectional study was conducted on 793 schoolchildren aged 10–14 years. Six anthropometric indices were used: body mass index-z-score (BMI-z-score), waist circumference (WC), waist-toheight ratio (WHtR), a body shape index (ABSI), body roundness index (BRI) and conicity index (CI). Elevated blood pressure (EBP) and hypertension (HTN) were characterized by values ≥ 90th and <95th percentile and ≥ 95th percentile for systolic and/or diastolic blood pressure, respectively. The predictive power of anthropometric indices was analyzed by sex using the receiver operating characteristic curve (ROC). Results The prevalence of EBP and HTN was 11.0% and 14.8%, respectively. According to the analyses of the ROC curve, WC provided the largest area under the curve (AUC) value, while CI showed the lowest AUC value in predicting elevated blood pressure in the total sample. The BMI z-score provided the largest area under the curve (AUC) value (0.722), followed by WHtR (0.709) and BRI (0.709), in predicting hypertension in boys. Conclusions BMI z-score and WC may be the best predictors of EBP and BMI z-score for HTN among Jordanian schoolchildren

Assessing the Provision of Preconception Care Knowledge, Attitudes, and Practice Among Jordanian Women of Reproductive Age

This study aimed to assess the knowledge, attitudes, and practice of preconception care among women of reproductive age in Jordan. A cross-sectional study that included a random sample of 1,368 women of reproductive age (18–44 years) was conducted using an online self-reported questionnaire. Of the total respondents, 48.6% had good knowledge, 48.1% had a positive attitude, and 47.0% had good practice. Participants with poor knowledge were more prevalent in the 35 to 44 age group (37.3%). Participants with good knowledge had a more positive attitude (57.2%) and good practice (63.5%). Married participants had a higher negative attitude (82.9%). Participants with university education had a good practice (44.5%), knowledge (58.5%), and a positive attitude (52.9%). There were positive correlations between knowledge, attitude, and practice. Good preconception care knowledge was higher among participants in the youngest age, while positive attitude was higher in the age group 25 to 29 years

Habitual food consumption, eating behavior and meal-timing among Jordanian adults with elevated Blood pressure: a cross-sectional population-based study

The prevalence of elevated blood pressure (BP) has been raised worldwide. Food consumption, eating habits, and nutritional lifestyle related to meal timing, skipping meals, and meal contents have recently received more attention in studies on BP and metabolic syndrome. Purpose: This study evaluated the association between habitual food consumption, eating behavior, and meal timing with BP among Jordanian adults. A cross-sectional study included 771 Jordanian adults. A food frequency questionnaire was completed. Data about eating habits, meal timing, and emotional eating were collected. BP was measured. The prevalence of less than recommended intake of vegetables, milk, protein, and fruits was higher in participants with elevated BP (69.2%, 90.2%, 58.9%, and 25.5%, respectively) as compared to the normal BP group (p  Although Jordanian adults with elevated BP appear to have healthy eating habits and meal timing and frequency, their habitual food consumption falls short of the daily recommendations for milk, fruits, vegetables, and protein. Numerous epidemiological studies have revealed a steadily rising prevalence of elevated BP, and one critical independent and modifiable risk factor for this condition is obesity.One global non-communicable diseases (NCD) target adopted by the World Health Assembly in 2013 is to lower the prevalence of raised BP by 25% by 2025 compared with its 2010 level.Lifestyle improvement is a cornerstone of CVD prevention; diet is one of the most effective strategies for attaining BP reduction and control as low-salt diets, dietary approaches to stop hypertension (DASH), a low-salt Mediterranean diet, an energy-restriction diet, vegetarian diet, and alternate-day fasting.Eating habits and nutritional lifestyle related to meal timing, skipping meals, and meal contents have recently received more attention in studies on BP and metabolic syndrome.a relationship between elevated BP and metabolic syndrome, infrequent fruit eating, skipping meals, irregular meal frequency and timing, and obesity has been found among adults.It has been found that earlier meal timing could reduce cardiometabolic disease burden and aid in weight loss; on the other hand, meal frequency was inversely associated with the prevalence of abdominal obesity, elevated BP, and elevated triglycerides. Morning eating was associated with a lower prevalence of metabolic syndrome than no morning eating. Numerous epidemiological studies have revealed a steadily rising prevalence of elevated BP, and one critical independent and modifiable risk factor for this condition is obesity. One global non-communicable diseases (NCD) target adopted by the World Health Assembly in 2013 is to lower the prevalence of raised BP by 25% by 2025 compared with its 2010 level. Lifestyle improvement is a cornerstone of CVD prevention; diet is one of the most effective strategies for attaining BP reduction and control as low-salt diets, dietary approaches to stop hypertension (DASH), a low-salt Mediterranean diet, an energy-restriction diet, vegetarian diet, and alternate-day fasting. Eating habits and nutritional lifestyle related to meal timing, skipping meals, and meal contents have recently received more attention in studies on BP and metabolic syndrome. a relationship between elevated BP and metabolic syndrome, infrequent fruit eating, skipping meals, irregular meal frequency and timing, and obesity has been found among adults. It has been found that earlier meal timing could reduce cardiometabolic disease burden and aid in weight loss; on the other hand, meal frequency was inversely associated with the prevalence of abdominal obesity, elevated BP, and elevated triglycerides. Morning eating was associated with a lower prevalence of metabolic syndrome than no morning eating.</p

Dietary fat types consumption association with obesity and coronary indices

This article aims to study the different dietary fat types associated with obesity and coronary indices. A sample of 491 healthy adults was included in a cross-sectional manner. Dietary fats intake, obesity indices (conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI)), and cardiovascular indices (cardiometabolic index (CMI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP)) were calculated and studied. Participants with an acceptable intake of omega-3 had a higher BRI score (1⋅90 ± 0⋅06 v. 1⋅70 ± 0⋅06). Participants with an unacceptable intake of cholesterol had a higher CI (1⋅31 ± 0⋅11 v. 1⋅28 ± 0⋅12; P = 0⋅011), AVI (20⋅24 ± 5⋅8 v. 18⋅33 ± 6⋅0; P < 0⋅001), BRI (2⋅00 ± 1⋅01 v. 1⋅70 ± 1⋅00; P = 0⋅003), WWI (11⋅00 ± 0⋅91 v. 10⋅80 ± 0⋅97; P = 0⋅032), and lower AIP (0⋅46 ± 0⋅33 v. 0⋅53 ± 0⋅33; P = 0⋅024). Total fat, saturated fat (SFA), and polyunsaturated fat (PUFA) intake had a significant moderate correlation with AVI and BRI. The monounsaturated fat (MUFA) intake had a significantly weak correlation with CI, AVI, BRI, WWI, and AIP. Cholesterol and omega-6 had weak correlations with all indices. Similar correlations were seen among male and female participants. The different types of fat intake significantly affected obesity and coronary indices, especially SFA and PUFA, as well as omega-3 and cholesterol. Gender and the dietary type of fat intake have a relationship to influence the indicators of both obesity and coronary indices

How are university students’ sleep quality affected by different Variables during COVID-19 remote learning?

Background: Severe restrictive measures during the COVID-19 pandemic had negatively affected many health and lifestyle behaviors, including sleep quality, which was correlated to several variables. Aims: To examine the association between sleeping quality, gender, smoking, and body mass index during remote learning periods among university students. Methodology: an online cross-sectional study, that included undergraduate and graduate university students, aged 18-30 years old. A self-reported questionnaire was used. Sleep quality was assessed using a validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI). Results: there was a significant weak correlation between gender and sleep disturbance. While smoking had a significantly weak correlation with subjective sleep quality (r =0.114, p=0.005), and sleep latency (r =0.115, p=0.005). Body mass index had significantly no correlation with sleep latency (r =0.008, p=0.045). However, most of the participants who had low to high sleep disturbance were females (p=0.002), and the participants who had very good subjective sleep quality and no sleep latency were non-smokers (90.0% and 89.2%, respectively). The underweight participants had a higher percentage of very bad subjective sleep quality (20.7%). Conclusion: a weak correlation between sleeping quality component with gender and smoking. no correlation between BMI and the sleeping quality component. Females had higher sleep disturbance and non-smokers had very good subjective sleep quality and no sleep latency. The underweight body mass is associated with very bad subjective sleep quality, and normal weight is associated with fairly good subjective sleep quality

Photographic Jordanian Food Atlas

A photographic manual determining food serving size for Jordanian dishes and food item

Photographic Jordanian Food Atlas

A photographic manual determining food serving size for Jordanian dishes and food item