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

Proceso de Enfermería en un paciente adulto mayor con infarto agudo de miocardio (IAM)

The professional practice of nursing has achieved a philosophy of responsibility and ethical behavior for the care of human life, sustenance that gives meaning to their practice, which contributes to the man obtaining well-being in all aspects during its life cycle . Nursing practice is aimed at providing care to the user according to their human needs, in any area where they are taking into account the biological, psychological, social and spiritual aspects. In addition, it is an important part of the health team, acting in collaboration with other disciplines. Its essence is the care of man in a holistic way, in all its dimensions, so it is necessary to apply a systematic method to assess, diagnose, plan, execute and evaluate their interventions in users in order to preserve and recover health . Nursing professionals require their own scientific foundations, crystallized in the nursing process, to guide their actions in a planned, systematized and organized way1. In particular, the nursing process performed in a patient with acute myocardial infarction (AMI), aims to identify real and potential health problems that allow decision making based on existing knowledge and evidence of nursing care to be applied In a systematic and organized way.El ejercicio profesional de la enfermería ha alcanzado una filosofía de responsabilidad y comportamiento ético para el cuidado de la vida humana, sustento que le da significado a su práctica, misma que contribuye para que el hombre obtenga bienestar en todos los aspectos durante su ciclo de vida. La práctica de enfermería esta dirigida a proporcionar cuidados al usuario de acuerdo a sus necesidades humanas, en cualquier ámbito donde se encuentre tomando en cuenta los aspectos biológico, psicológico, social y espiritual. Además, forma parte importante del equipo de salud, al actuar en colaboración con otras disciplinas. Su esencia es el cuidado del hombre de forma holística, en todas sus dimensiones, por lo que se requiere aplicar un método sistemático que permita valorar, diagnosticar, planear, ejecutar y evaluar sus intervenciones en los usuarios con el fin de conservar y recuperar la salud. Los profesionales de enfermería requieren de fundamentos científicos propios, cristalizados en el proceso de enfermería, que guíe en forma planeada, sistematizada y organizada sus acciones1. En particular, el proceso de enfermería realizado a un paciente con infarto agudo al miocardio (IAM), pretende identificar los problemas de salud reales y potenciales que permitan la toma de decisiones con base en el conocimiento y evidencia existente del cuidado de enfermería para ser aplicado en forma sistemática y organizada

LA OBESIDAD, UN PROBLEMA DE SALUD Y SU INFLUENCIA EN LAS RELACIONES DE PAREJA.

The objective of the study was to search for relationships of the influence of the perception of obesity on the relationship of partners, social interaction and fears, both in the family and work environment, in women from Tepic, Nayarit; Mexico. The research was based on the theory of Callista Roy. This theory had the meaning of identifying how the perception of its obesity in the relationship of pair, social interaction and fears influences, taking as reference the focal, contextual and residual stimuli. The method of work was structured with a qualitative perspective, with a qualitative and interpretative approach. Women were selected from that locality and a semi-structured interview was carried out in depth, later the recorded speeches were transcribed, an inductive analysis of the interpretative type was carried out to generate categories and to search for relations that had influence in the previously described objectives. The findings suggest that women who are obese have a perception of their altered body image that negatively influences their relationship, social interaction and fears. Apparently the obesity that each of the interviewed women has has repercussions of disapproval on their body image, a situation that makes them have conflicting relationships in the relationship.El estudio realizado, tuvo por objeto buscar relaciones de la influencia de la percepción de la obesidad en la relación de pareja, interacción social y temores, tanto en el ambiente familiar como laboral, en mujeres de Tepic, Nayarit; México. La investigación se fundamentó en la teoría de Callista Roy. Dicha teoría tuvo el significado de identificar cómo influye la percepción de su obesidad en la relación de pareja, interacción social y temores, tomando como referencia los estímulos focales, contextuales y residuales. El método de trabajo se estructuró con una perspectiva cualitativa, con enfoque cualitativo e interpretativo. Se seleccionaron mujeres de esa localidad y se realizaron entrevista semiestructuradas a profundidad, posteriormente se transcribieron los discursos grabados, se procedió a un análisis inductivo de tipo interpretativo para generar categorías y buscar relaciones que tuvieran influencia en los objetivos antes descritos. Los hallazgos sugieren que las mujeres que tienen obesidad, tienen una percepción de su imagen corporal alterada que influye de manera negativa en su relación de pareja, interacción social y temores. Aparentemente la obesidad que tiene cada una de las mujeres entrevistadas tiene repercusiones de desaprobación sobre su imagen corporal, situación que logra que estas tengan relaciones conflictivas en la relación de pareja

Envejecimiento y capacidad funcional en adultos mayores institucionalizados del occidente de México

Objectives. To identify, in older adults living in care centers in 3 western Mexican states, the functional capacity to perform 10 basic daily activities. Material and methods. A multicenter, cross-sectional descriptive study was conducted on 373 older adults from the states of Colima (n=151), Nayarit (n=111), and Jalisco (n=111). Through non-probability sampling (convenience sampling) and after obtaining informed consent, the Barthel scale was applied in order to identify functional capacity level. The demographic variables and the dominance level of each daily activity were analyzed using descriptive statistics. The chi-square test was employed to compare the physical functionality proportions based on sex.Statistically significant difference was set at a p≤ 0.05. Results. For Colima, the unctional capacity in the categories of total independence and mild, moderate, and severe dependence were (%): 10.6, 52.3, 15.9, 7.3, and 13.9, respectively; for Nayarit (%): 13.5, 41.4, 19.8, 9.90, and 15.3, respectively; and for Jalisco (%): 27.9, 28.8, 14.4, 18.0, and 10.8, respectively. The differences based on sex were only significant for the state of Nayarit (p= de 0.000). The daily life activity with the highest proportion of totally independent subjects was “eating”, and the activities with the most totally dependent subjects were “going up and down stairs” and “bathing”. Conclusions. Functional limitation is a natural part of the aging process and it is important to systematically apply the Barthel scale to older adults living in care centers because it is a relevant tool for identifying motor function deficit in these persons.Objetivo. Identificar la capacidad funcional para realizar 10 actividades básicas de la vida diaria en adultos mayores institucionalizados de 3 diferentes Estados del Occidente de México. Material y métodos. Estudio trasversal descriptivo, multicéntrico realizado en 373 adultos mayores de los Estados de Colima (n=151), Nayarit (n=111) y Jalisco n=111) en los que mediante un muestreo no probabilístico por conveniencia y previo consentimiento informado, se aplicó la escala de Barthel para identificar su nivel de apacidad funcional. Estadística descriptiva fue utilizada para analizar variables demográficas y nivel de dominio de cada actividad de la vida diaria. Chi cuadrado para comparar proporciones de funcionalidad física con base a géneros. Se consideraron significativas las diferencias cuando p≤ 0.05. Resultados. La capacidad funcional para las categorías: independencia total, dependencia leve, moderada, severa y total, fueron para Colima (%): 10.6, 52.3, 15.9, 7.3 y 13.9 respectivamente. Para Nayarit (%): 13.5, 41.4, 19.8, 9.90 y 15.3. Para Jalisco (%): 27.9,28.8, 14.4, 18.0 y 10.8 respectivamente. Las diferencias con base a género, fue significativa únicamente para el estado de Nayarit (p= de 0.000). La actividad de la vida diaria que presentó mayor proporción de sujetos independientes totales fue “comer”, en tanto que “subir-bajar escaleras y lavarse” fueron las que registraron más sujetos dependientes totales. Conclusión. La limitación funcional es un proceso natural del envejecimiento y es importante que de manera sistemáticase aplique la escala de Barthel al adulto mayor institucionalizado, ya que ha demostrado ser relevante para identificar déficit funcional motor en estas persona

Influencia de los hábitos alimenticios en la obesidad/sobrepeso de escolares, en Bellavista, Nayarit

Currently eating disorders are a very important issue, as they bring serious complications and health problems such as obesity and overweight, which according to the World Health Organization (WHO), 2012) are the fifth major risk factor of deaths in the world. Every year at least 2.8 million adults die as a result of these pathologies; 44% of the diabetes burden, 23% of ischemic heart disease and 7% to 41% of some cancers are attributable to overweight and obesity (WHO, 2012).Actualmente los trastornos alimenticios son un tema de suma importancia, ya que éstos traen graves complicaciones y problemas de salud como la obesidad y el sobrepeso, que según la (Organización Mundial de la Salud (OMS), 2012) son el quinto factor principal de riesgo de defunciones en el mundo. Cada año fallecen por lo menos, 2.8 millones de personas adultas a consecuencia de estas patologías; un 44% de la carga de diabetes, el 23% de las cardiopatías isquémicas y entre el 7% y el 41% de algunos cánceres son atribuibles al sobrepeso y la obesidad (OMS, 2012)

Capacidad funcional en adultos mayores residentes en asilos y casas de cuidado del estado de Nayarit

The physiological aging of a person is conditioned by multiple diseases, mainly chronic degenerative diseases, which generates a situation of dependence on the elderly (AM) that affects their quality of life. It is due to this series of changes that the AM experiences progressive alterations in its coping mechanisms, which often results in problems of physical, psychological and social adaptation at this stage of its life.El envejecimiento fisiológico de una persona se ve condicionado por múltiples enfermedades, principalmente crónico degenerativas, lo cual genera una situación de dependencia en el adulto mayor (AM) que repercute en su calidad de vida. Es debido a esta serie de cambios, que el AM experimenta de manera progresiva alteraciones en sus mecanismos de afrontamiento, lo que da como resultado frecuentemente problemas de adaptación física, psicológica y social en esta etapa de su vida

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

International audienceSummaryBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.MethodsWe used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson’s correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).FindingsThe correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.InterpretationBMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions

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