Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults
- PMID: 29029897
- PMCID: PMC5735219
- DOI: 10.1016/S0140-6736(17)32129-3
Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults
Abstract
Background: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.
Methods: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).
Findings: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.
Interpretation: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.
Funding: Wellcome Trust, AstraZeneca Young Health Programme.
Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Figures
Comment in
-
Obesity: Trends in underweight and obesity - scale of the problem.Nat Rev Endocrinol. 2018 Jan;14(1):5-6. doi: 10.1038/nrendo.2017.157. Epub 2017 Nov 24. Nat Rev Endocrinol. 2018. PMID: 29170540 Free PMC article.
-
Determining the worldwide prevalence of obesity.Lancet. 2018 May 5;391(10132):1773-1774. doi: 10.1016/S0140-6736(18)30794-3. Lancet. 2018. PMID: 29739565 No abstract available.
Similar articles
-
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.Lancet. 2024 Mar 16;403(10431):1027-1050. doi: 10.1016/S0140-6736(23)02750-2. Epub 2024 Feb 29. Lancet. 2024. PMID: 38432237 Free PMC article.
-
Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants.Lancet. 2020 Nov 7;396(10261):1511-1524. doi: 10.1016/S0140-6736(20)31859-6. Lancet. 2020. PMID: 33160572 Free PMC article.
-
[Body mass index among children and adolescents: prevalences and distribution considering underweight and extreme obesity : Results of KiGGS Wave 2 and trends].Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Oct;62(10):1225-1234. doi: 10.1007/s00103-019-03015-8. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019. PMID: 31529189 Review. German.
-
Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants.Lancet. 2016 Apr 2;387(10026):1377-1396. doi: 10.1016/S0140-6736(16)30054-X. Lancet. 2016. PMID: 27115820 Free PMC article. Review.
-
Underweight and overweight among children and adolescents in Tuscany (Italy). Prevalence and short-term trends.J Prev Med Hyg. 2008 Mar;49(1):13-21. J Prev Med Hyg. 2008. PMID: 18792529
Cited by
-
An immersive virtual reality communication skills training for dietitians: A feasibility study.PEC Innov. 2024 May 21;4:100292. doi: 10.1016/j.pecinn.2024.100292. eCollection 2024 Dec. PEC Innov. 2024. PMID: 38827246 Free PMC article.
-
Impact of a nationwide school policy on body mass index in Danish school children: An interrupted time series analysis.Public Health Pract (Oxf). 2024 May 17;7:100510. doi: 10.1016/j.puhip.2024.100510. eCollection 2024 Jun. Public Health Pract (Oxf). 2024. PMID: 38826636 Free PMC article.
-
Changes in patient profiles in the cardiology department of the University Hospital Gabriel Touré (UH-GT) : results of two cross-sectional studies of 2010 and 2022.BMC Cardiovasc Disord. 2024 Jun 1;24(1):290. doi: 10.1186/s12872-024-03890-3. BMC Cardiovasc Disord. 2024. PMID: 38822250 Free PMC article.
-
The association between caesarean section delivery and obesity at age 17 years. Evidence from a longitudinal cohort study in the United Kingdom.PLoS One. 2024 May 31;19(5):e0301684. doi: 10.1371/journal.pone.0301684. eCollection 2024. PLoS One. 2024. PMID: 38820521 Free PMC article.
-
The association between maximal muscle strength, disease severity and psychopharmacotherapy among young to middle-aged inpatients with affective disorders - a prospective pilot study.BMC Psychiatry. 2024 May 29;24(1):401. doi: 10.1186/s12888-024-05849-2. BMC Psychiatry. 2024. PMID: 38811916 Free PMC article.
References
-
- Han Z, Mulla S, Beyene J, Liao G, McDonald SD. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. Int J Epidemiol. 2011;40:65–101. - PubMed
-
- Black RE, Victora CG, Walker SP. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427–451. - PubMed
-
- WHO . Consideration of the evidence on childhood obesity for the Commission on Ending Childhood Obesity: report of the Ad hoc Working Group on Science and Evidence for Ending Childhood Obesity. World Health Organization; Geneva: 2016.
-
- Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obes Rev. 2004;5:4–85. - PubMed
MeSH terms
Grants and funding
- MC_UP_A620_1015/MRC_/Medical Research Council/United Kingdom
- MC_U147574218/MRC_/Medical Research Council/United Kingdom
- MC_UU_12026/2/MRC_/Medical Research Council/United Kingdom
- MC_UU_12011/1/MRC_/Medical Research Council/United Kingdom
- MC_UP_A620_1014/MRC_/Medical Research Council/United Kingdom
- P2C HD041020/HD/NICHD NIH HHS/United States
- MC_UU_12019/1/MRC_/Medical Research Council/United Kingdom
- G0401527/MRC_/Medical Research Council/United Kingdom
- MC_U137686851/MRC_/Medical Research Council/United Kingdom
- G1000143/MRC_/Medical Research Council/United Kingdom
- PG/13/66/30442/BHF_/British Heart Foundation/United Kingdom
- MC_U147585824/MRC_/Medical Research Council/United Kingdom
- MC_UU_12011/3/MRC_/Medical Research Council/United Kingdom
- MC_U147574242/MRC_/Medical Research Council/United Kingdom
- G0400519/MRC_/Medical Research Council/United Kingdom
- MC_UU_12015/1/MRC_/Medical Research Council/United Kingdom
- G0400491/MRC_/Medical Research Council/United Kingdom
- MC_U147585819/MRC_/Medical Research Council/United Kingdom
- MR/N003284/1/MRC_/Medical Research Council/United Kingdom
- MC_UU_12011/2/MRC_/Medical Research Council/United Kingdom
- MC_U147585827/MRC_/Medical Research Council/United Kingdom
- 14136/CRUK_/Cancer Research UK/United Kingdom
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous