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Meta-Analysis
. 2021 Mar 9:10:e60060.
doi: 10.7554/eLife.60060.

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

NCD Risk Factor Collaboration (NCD-RisC)
Collaborators, Affiliations
Meta-Analysis

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

NCD Risk Factor Collaboration (NCD-RisC). Elife. .

Abstract

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

Keywords: BMI; epidemiology; global health; none; obesity; underweight.

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Conflict of interest statement

No competing interests declared

Figures

Figure 1.
Figure 1.. Schematic diagram of contribution of change in mean body mass index (BMI) to change in total prevalence of underweight or obesity.
(A) Change in the prevalence of underweight and obesity if the distribution shifts, represented by a change in its mean and its shape. In this example, the change (shown as the difference between blue and gray) results in a small decrease of underweight and a large increase in obesity. (B) Change in the prevalence of underweight and obesity when only mean BMI changes (shown as the difference between orange and gray), without a change in the shape of the distribution.
Figure 2.
Figure 2.. Number of data sources with participants aged 20-79 years.
Figure 3.
Figure 3.. Change in mean body mass index (BMI) from 1985 to 2016 by region, sex, and age group.
Figure 4.
Figure 4.. Change in prevalence of underweight, obesity, and severe obesity from 1985 to 2016 by region, sex, and age group.
Figure 5.
Figure 5.. Contribution of change in mean body mass index (BMI) to total change from 1985 to 2016 in prevalence of underweight, obesity, or severe obesity by region, sex, and age group.
Blue arrows show the total change in prevalence of underweight, obesity, or severe obesity. Orange arrows show the contribution of change in mean BMI to the change in prevalence. The difference between these two arrows is shown with a line, whose colour follows the shorter arrow.
Author response image 1.
Author response image 1.. Standard deviation of BMI from 1985 to 2019 by sex and age group.
Each point shows one age-sex group in one study. The size of each point is proportional to its sample size. Colour for each point indicates the region it is from.
Author response image 2.
Author response image 2.. Skewness of BMI from 1985 to 2019 by sex and age group.
Each point shows one age-sex group in one study. The size of each point is proportional to its sample size. Colour for each point indicates the region it is from.
Author response image 3.
Author response image 3.. Distributions of BMI in NCD-RisC studies for 50-59-year old by sex and region.
Each curve is a single study and the colour indicates its year from 1985 to 2019.
Author response image 4.
Author response image 4.. Comparison of mean and median BMI by sex and age group.
Each point represents a sex-age group in a study conducted between 1985 and 2019.
See this image and copyright information in PMC

References

    1. Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJ, Lozano R, Inoue M. Age Standardization of Rates: A New WHO Standard. Geneva: World Health Organization; 2001. https://www.who.int/healthinfo/paper31.pdf
    1. Bleich SN, Rimm EB, Brownell KD. U.S. nutrition assistance, 2018 - Modifying SNAP to promote population health. New England Journal of Medicine. 2017;376:1205–1207. doi: 10.1056/NEJMp1613222. - DOI - PubMed
    1. Bovet P, Chiolero A, Shamlaye C, Paccaud F. Prevalence of overweight in the Seychelles: 15 year trends and association with socio-economic status. Obesity Reviews. 2008;9:511–517. doi: 10.1111/j.1467-789X.2008.00513.x. - DOI - PubMed
    1. Brandkvist M, Bjørngaard JH, Ødegård RA, Åsvold BO, Sund ER, Vie GÅ. Quantifying the impact of genes on body mass index during the obesity epidemic: longitudinal findings from the HUNT study. BMJ. 2019;366:l4067. doi: 10.1136/bmj.l4067. - DOI - PMC - PubMed
    1. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang YH, Stevens GA, Rao M, Ali MK, Riley LM, Robinson CA, Ezzati M, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose) National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. The Lancet. 2011a;378:31–40. doi: 10.1016/S0140-6736(11)60679-X. - DOI - PubMed

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