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 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 https://researchonline.ljmu.ac.uk/images/research_banner_face_lab_290.jpgunderweight 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

Promoção de saúde em unidades básicas: análise das representações sociais dos usuários sobre a atuação da fisioterapia Health promotion in the basic units: analysis of the users' social representations about the role of the physical therapy

O objetivo deste estudo foi identificar as representações sociais dos usuários de grupos operativos sobre saúde e a atuação da fisioterapia no processo saúde/doença, além de verificar como as representações dos usuários relacionam-se com os propósitos destes grupos. O presente estudo foi desenvolvido numa abordagem qualitativa, utilizando-se a entrevista semi-estruturada. Foram entrevistados os usuários que participam de grupos operativos coordenados por fisioterapeutas em quatro Unidades Básicas de Saúde do município de Divinópolis (MG). As entrevistas foram gravadas e transcritas de forma a recuperar a integralidade dos depoimentos. A análise dos dados foi feita com base em unidades temáticas. Os principais temas que surgiram foram saúde como ausência de doença, dependência do grupo, fisioterapia ligada à reabilitação física e à promoção da saúde, fisioterapia ligada à melhora psicológica e humanização da assistência fisioterapêutica. O conhecimento das representações sociais dos usuários de grupos operativos reforça a necessidade de participação da população no desenvolvimento, realização e avaliação dos programas de saúde, de forma a alcançar uma coerência entre as expectativas do usuário e os propósitos do programa.<br>The aim of this article is to identify the social representations of the users of operative groups about health and the physical therapy role in the health/disease process, as well as to verify how the representations of the users are related to the purposes of these groups. The present study was developed under a qualitative approach using the semi-structured interview. Users of the "Quality of Life" project from four basic health units of the city of Divinópolis, Minas Gerais State, were interviewed. The interviews were recorded and transcribed in order to preserve the totality of the statements. The analysis of the data was performed based on the thematic units. The main themes that emerged were: health as absence of disease, dependency of the group, physical therapy linked to physical rehabilitation and to health promotion, physical therapy linked to the psychological improvement and humanization of the physical therapy assistance. The knowledge of the social representations of the users from the "Quality of Life" project reinforces the need of the participation of the population in the development, accomplishment and evaluation of the health programs in order to reach coherence between the user expectations and the purposes of the program