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. 2020 Sep 30;18(Suppl 1):18.
doi: 10.1186/s12963-020-00219-y.

The burden of non-communicable diseases attributable to high BMI in Brazil, 1990-2017: findings from the Global Burden of Disease Study

Mariana Santos Felisbino-Mendes  1   2 , Ewerton Cousin  3   4 , Deborah Carvalho Malta  1   2 , Ísis Eloah Machado  2   5 , Antonio Luiz Pinho Ribeiro  6 , Bruce Bartholow Duncan  2 , Maria Inês Schmidt  2 , Diego Augusto Santos Silva  7 , Scott Glenn  4 , Ashkan Afshin  4 , Gustavo Velasquez-Melendez  8   9
Affiliations

The burden of non-communicable diseases attributable to high BMI in Brazil, 1990-2017: findings from the Global Burden of Disease Study

Mariana Santos Felisbino-Mendes et al. Popul Health Metr. .

Abstract

Background: The prevalence and burden of disease resulting from obesity have increased worldwide. In Brazil, more than half of the population is now overweight. However, the impact of this growing risk factor on disease burden remains inexact. Using the 2017 Global Burden of Disease (GBD) results, this study sought to estimate mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) in both sexes and across age categories. This study also aimed to describe the prevalence of overweight and obesity throughout the states of Brazil.

Methods: Age-standardized prevalence of overweight and obesity were estimated between 1990 and 2017. A comparative risk assessment was applied to estimate DALYs and deaths for non-communicable diseases and for all causes linked to high BMI.

Results: The prevalence of overweight and obesity increased during the period of analysis. Overall, age-standardized prevalence of obesity in Brazil was higher in females (29.8%) than in males (24.6%) in 2017; however, since 1990, males have presented greater rise in obesity (244.1%) than females (165.7%). Increases in prevalence burden were greatest in states from the North and Northeast regions of Brazil. Overall, burden due to high BMI also increased from 1990 to 2017. In 2017, high BMI was responsible for 12.3% (8.8-16.1%) of all deaths and 8.4% (6.3-10.7%) of total DALYs lost to non-communicable diseases, up from 7.2% (4.1-10.8%), and 4.6% (2.4-6.0%) in 1990, respectively. Change due to risk exposure is the leading contributor to the growth of BMI burden in Brazil. In 2017, high BMI was responsible for 165,954 deaths and 5,095,125 DALYs. Cardiovascular disease and diabetes have proven to be the most prevalent causes of deaths, along with DALYs caused by high BMI, regardless of sex or state.

Conclusions: This study demonstrates increasing age-standardized prevalence of obesity in all Brazilian states. High BMI plays an important role in disease burdens in terms of cardiovascular diseases, diabetes, and all causes of mortality. Assessing levels and trends in exposures to high BMI and the resulting disease burden highlights the current priority for primary prevention and public health action initiatives focused on obesity.

Keywords: Body mass index; Cardiovascular disease; Comparative risk assessment; Obesity; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Death (a) and DALY (b) rates per 100,000 attributable to High BMI by sex, Brazil, 2017. Legend: Deaths (a) and DALY (b) rates per 100,000 of non-communicable diseases related to high BMI are shown for males and females. Numbers in the x-axis represent the rates. DALYs, disability-adjusted life-years; BMI Body mass index
Fig. 2
Fig. 2
Death (a) and DALY (b) rates per 100,000 of specific causes attributable to high BMI according to age and by sex. Brazil, 2017. Legend: Death (a) and DALY (b) rates per 100,000 related to high BMI are shown for females (dotted line) and males (full line) and across age categories. Each line is a specific cause attributable to high BMI. The y-axis has the death (a) and DALY (b) rates and the x-axis the age categories. DALYs, disability-adjusted life-years; BMI, body mass index
Fig. 3
Fig. 3
Age-standardized Death (a) and DALY (b) rates per 100,000 attributable to high BMI across all states by sex, women on the left and men on the right. Legend: Colored bars are the attributable age-standardized DALY and death rates corresponding to high BMI, each color a specific cause, across all Brazilian states, 2017. Women are on the left and men on the right. DALYs, disability-adjusted life-years; BMI, body mass index
Fig. 4
Fig. 4
Trends of mortality (a) and DALY (b) rates, all ages and age-standardized attributable to high BMI by sex, 1990-2017, Brazil. Legend: Crude and age-standardized deaths and DALY rates attributable to high BMI, by sex, are shown. Y-axis presents the rates and x-axis the years. The line shows the trends in the period of 1990–2017. DALYs, disability-adjusted life-years; BMI, body mass index
Fig. 5
Fig. 5
Decomposition of deaths (a) and DALYs (b) attributable to high BMI, Brazil 1990-2017. Legend: Percent change in risk-attributable deaths and DALYs. Results are shown for all causes combined. The black dot shows total percentage change. The risk-deleted DALY rate is the expected DALY rate if the exposure level for high BMI was reduced to the theoretical minimum risk exposure level. DALYs, disability-adjusted life-years; BMI, body mass index
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