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

Nursing education: contradictions and challenges of pedagogical practice La formacion del enfermero: contradicciones y desafíos de la práctica pedagógica A formação do enfermeiro: contradições e desafios à prática pedagógica

This study deals with the nursing curriculum, pedagogical practice and education. Nowadays, this theme has taken up considerable space in academic debates. Thus, this study aimed to get empirical knowledge and provide an analytical description of the academic reality of nursing education at Santa Cruz State University in the undergraduate nursing course. This is a descriptive study, which may provide a new view of the problem, with careful observation, description, and exploration of the situation aspects, interpreting the reality, without interfering in it and, consequently, being open to new studies. Descriptive statistics with simple frequency and percentage calculation was applied. In summary, results indicate that professors and students have difficulties to evaluate the curriculum. In addition, the curriculum under study is characterized as a collection curriculum, with a pedagogical practice predominantly directed at the traditional model. Hence, nursing education still shows features of the biomedical-technical model.<br>Este estudio trata de la temática currículo, práctica pedagógica y formación del enfermero, que en la actualidad viene tomando espacio relevante en el debate académico. Así, buscamos conocer empíricamente y describir analíticamente la realidad académica de la formación del enfermero en la carrera de Enfermería de la UESC. Se trata de un estudio descriptivo que puede proporcionar una nueva visión del problema, teniendo cuidado de observar, describir y explotar aspectos de la situación, interpretando la realidad, sin interferir en ella para modificarla y, consecuentemente, abierto a nuevos estudios. Para el análisis de los datos, utilizamos la estadística descriptiva con cálculo de frecuencia simple y porcentual. Sintéticamente, los resultados señalaron que los profesores y los alumnos tienen dificultades para conceptualizar currículo. Y el currículo estudiado se caracteriza dentro del tipo colección, con una práctica pedagógica volcada, predominantemente hacia el modelo tradicional y, en consecuencia, la formación del enfermero sigue teniendo características del modelo biomédico-tecnicista.<br>Este estudo aborda a temática currículo, prática pedagógica e formação do enfermeiro que, na atualidade, tem tomado espaço relevante no debate acadêmico. Assim, buscou-se conhecer empiricamente e descrever analiticamente a realidade acadêmica da formação do enfermeiro no Curso de Graduação em Enfermagem da Universidade Estadual de Santa Cruz. Trata-se de estudo descritivo, que pode proporcionar nova visão do problema, tendo tido o cuidado de observar, descrever e explorar aspectos da situação, interpretando a realidade, sem nela interferir para modificá-la, estando, conseqüentemente, aberto a novos estudos. Para análise dos dados, utilizou-se estatística descritiva com cálculo de freqüência simples e percentual. Sinteticamente, os resultados apontaram que os professores e alunos têm dificuldade em conceituar currículo. E o currículo estudado se caracteriza como do tipo coleção, com uma prática pedagógica voltada, predominantemente, para o modelo tradicional e, em conseqüência, a formação do enfermeiro continua tendo características do modelo biomédico-tecnicista