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

An examination of sociocultural factors in the development of body dissatisfaction among Indonesian males and females.

In today’s society, physical appearance is highly valued. From young, children desire to have a perfect body. However, today’s appearance standards are impossible for majority to achieve, giving rise to the development of body dissatisfaction. In turn, body dissatisfaction has been linked to various negative outcomes, such as poor self-esteem, depression, and eating disorders. Hence, this study aims to examine the risk factors associated with body dissatisfaction, particularly the effects of media pressure as well as peer and family pressure, and whether the influences of these sociocultural factors are mediated by appearance comparison and internalization of appearance ideals. The study also seeks to find out if the relationships posited in the tripartite influence model, which is used as the study’s theoretical framework, are applicable in the Asian context, among both male and female young adults.​Master of Mass Communicatio

The role of media exposure, peers, and family on body dissatisfaction amongst boys and girls in Singapore

This study aims to examine how influences of media, peers, and family on body dissatisfaction differ between boys and girls in Singapore through a survey to 277 students aged 10 to 13. The hierarchical regression analyses reveal that two media exposure variables, watching television/VCDs/DVDs/music videos and engagement with online social media, were significantly related to girls’ body dissatisfaction. None of the traditional or new media exposure variables influenced boys’ body dissatisfaction. Instead, boys’ body dissatisfaction was found to be influenced by family member’s criticism of weight. Peers’ perception of weight influenced body dissatisfaction in both gender, although the effect was stronger among girls. Our findings revealed gender differences in the antecedents of body dissatisfaction among children in Singapore, specifically exposure to television/VCDs/DVDs/music videos, family’s criticisms of weight, and peers’ perception of weight. Educators and health authorities should take these differences into account when designing media and school health education programs.Accepted versio

Can exergames impart health messages? game play, framing, and drivers of physical activity among children

This study examines the effectiveness of incorporating exergaming into physical education (PE) lessons as a platform for imparting health education messages and influencing children’s beliefs about and attitudes toward physical activity. We deployed a six-week intervention program using Nintendo Wii games coupled with protection motivation theory-based health messaging among fifth-grade school children in Singapore. The results indicate that when children who were exposed to threat-framed messages played Wii exergames during PE lessons, they reported more positive physical activity attitude, self-efficacy, and perceived behavioral control than those who underwent regular PE lessons and were exposed to the same message. In addition, among children playing Wii, the threat and coping frames had similar effects on the degree of message influence on physical activity attitudes and beliefs. The implications for schools, parents, and health policy are discussed.Accepted versio

Is evoking fear effective? Exploratory findings from a randomized experiment on the impacts of health warning labels on sugar-sweetened beverages

Abstract Objective: Health warning labels (HWLs) have been suggested to be effective in reducing consumption of sugar-sweetened beverages (SSBs). Yet, the efficacy and acceptability of SSB HWLs of different formats (textual/pictorial) and severity remain unclear. This exploratory study aims to examine the extent and mechanism through which HWLs of different formats and severity may affect responses towards the HWLs and SSB consumption. Design: Randomized online experiment. Participants were exposed to images of a hypothetical SSB bearing a HWL of one of three conditions: text-only HWL, moderately severe pictorial HWL, highly severe pictorial HWL. They then responded to theory-based affective, cognitive, and behavioral measures. Setting: Singapore Participants: 127 young adult consumers from a public university Results: Direct effects were found for fear, avoidance, reactance, and acceptability of the HWLs, but not attitude, intention, or motivation to consume less SSBs. Pictorial (moderately severe and highly severe) HWLs were associated with greater fear, avoidance, and reactance, and lower acceptability than text-only HWLs. There was weak evidence that highly severe pictorial HWLs resulted in greater reactance than moderately severe pictorial HWLs. Fear mediated the effect of HWLs of different severity levels on avoidance, reactance, intention, and motivation, but not for attitude or acceptability. Conclusions: Exploratory findings indicate that although pictorial HWLs were less acceptable, they may still be effective in influencing intention and motivation to reduce SSB consumption through the psychological mechanism of fear. Hence, graphic HWLs should not be dismissed too quickly when considering strategies for reducing SSB consumption

The efficacy of exergames-incorporated physical education lessons in influencing drivers of physical activityn : a comparison of children and pre-adolescents

Objective: This study examines the efficacy of incorporating exergaming into physical education (PE) lessons among children and pre-adolescents in influencing the social cognitive factors and behaviors of physical activity (PA), based on the theory of planned behavior (TPB). Design: We conducted a six-week study centered on a 2 (exergaming: PE lesson with Wii vs. PE lesson without Wii) × 2 (age group: 10 years-old children vs. 12 years-old pre-adolescents) between-subject factorial design. Method: 1112 participants were randomly assigned to the study conditions. At the end of the six-week program, participants completed a survey consisting of measures from the TPB variables. Results: Exergaming significantly influenced PA attitude, subjective norm, intention, and strenuous exercise behavior, with participants in the Wii-incorporated PE lesson more likely to emerge with more positive beliefs and behaviors. Age significantly influenced outcome variables, with the effect of exergaming more pronounced among children than pre-adolescents in attitude, moderate and mild exercise behaviors. Conclusions: Incorporating exergaming into PE lessons can be more effective than regular PE in enhancing PA beliefs and behaviors, particularly among younger children

Comparative study on lifestyle between Chinese Singaporeans and Chinese Indonesians

This study seeks to investigate the opinions and attitudes of Chinese students in Singapore and Indonesia on various aspects of their life

Association between food availability and young people's fruits and vegetables consumption: understanding the mediation role of the theory of planned behaviour

Objective: To evaluate the relationship between fruits and vegetables (F&V) availability at home and young people's F&V consumption behaviour, and how the theory of planned behaviour (TPB) constructs could potentially mediate the relationship. Design: Cross-sectional face-to-face survey questionnaire to assess the TPB constructs and home food availability assessed using open inventories method. F&V availability was categorised into low and high levels based on median split. Setting: Singapore. Participants: Two hundred and ten households (each consisting one parent-child pair) recruited via stratified cluster sampling with child participants ranging from 9 to 16 years of age. Results: Mediation analyses were conducted using structural equation modelling. The relationship between home F&V availability and F&V consumption behaviour did not have a significant direct association, but there were significant indirect effects through the routes of perceived behavioural control (PBC) and intention as well as attitude and intention. Specifically, higher level of F&V availability at home was related to more positive PBC and attitude towards F&V, and subsequently greater intention to consume F&V and higher consumption of F&V. Conclusions: Parents should make F&V more readily available at home as increased exposure to F&V could be related to enhanced liking, sense of control and intention to consume F&V and facilitate children's healthy diet.National Medical Research Council (NMRC)Published versionThis study was supported by the National Medical Research Council, Singapore (grant no. NMRC/HSRG/0046/2013)

Migrant mothering and mobile phones : negotiations of transnational identity

Transnational mothers working in foreign countries face the challenges of providing “intensive” mothering to their children from a distance, and risk being subject to the “deviancy” discourse of mothering. This paper investigates the role of mobile phone usage, via voice, text messages, and social networking sites, in dealing with the tensions and ambivalence arising from transnational mothering as a dialectical process. We surveyed 42 Filipina and Indonesian foreign domestic workers (FDWs) in Singapore using a mixture of quantitative and qualitative methods. FDWs addressed tensions arising out of societal expectations of motherhood and their own anxieties about children’s well-being. The reluctant obsessive struggled to maintain a balance between an intensive nurturing style and a deviant mode of mothering that respected the growing independence of the children. The diverted professional had to balance the financial empowerment of being the primary breadwinner with the risk of surrogate motherhood for the employer’s children subsuming the care provided to her own. The remote-control parent shared mothering responsibilities with caregivers, usually relatives, who acted as a contradictory proxy presence for intensive mothering. The incomplete union of stressed marital parenting put further pressure on the romantic and sexual identities of migrant women. Transnational mothers utilized mobile phones actively as a tool to negotiate and redefine identities and relationships that created fissures in their sense of self. These included the management of third-party relationships, withholding of emotions or information, and engaging in counterintuitive phenomenon such as restricting, or actively dis-engaging from, mobile phone usage as a communication strategy. The paper calls for future research into the multiple, and interacting, social identities assumed and managed by transnational mothers, and the complex role played by mobile phones in the constant process of negotiation by agentic, self-relective and multifaceted women.Accepted versio