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. 2023 Feb 16:57:101850.
doi: 10.1016/j.eclinm.2023.101850. eCollection 2023 Mar.

Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019

Bryan Chong  1 , Jayanth Jayabaskaran  1 , Gwyneth Kong  1 , Yiong Huak Chan  2 , Yip Han Chin  1 , Rachel Goh  1 , Shankar Kannan  1 , Cheng Han Ng  1 , Shaun Loong  1 , Martin Tze Wah Kueh  3 , Chaoxing Lin  1 , Vickram Vijay Anand  1 , Ethan Cheng Zhe Lee  1 , H S Jocelyn Chew  4 , Darren Jun Hao Tan  1 , Kai En Chan  1 , Jiong-Wei Wang  5   6   7 , Mark Muthiah  8   9 , Georgios K Dimitriadis  10   11 , Derek J Hausenloy  1   12   13   14 , Anurag J Mehta  15 , Roger Foo  1   4 , Gregory Lip  16   17 , Mark Y Chan  1   4 , Mamas A Mamas  18   19 , Carel W le Roux  20 , Nicholas W S Chew  1   4
Affiliations

Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019

Bryan Chong et al. EClinicalMedicine. .

Abstract

Background: Malnutrition and obesity are interdependent pathologies along the same spectrum. We examined global trends and projections of disability-adjusted life years (DALYs) and deaths from malnutrition and obesity until 2030.

Methods: Using data from the 2019 Global Burden of Disease study involving 204 countries and territories, trends in DALYs and deaths were described for obesity and malnutrition from 2000 to 2019, stratified by geographical regions (as defined by WHO) and Socio-Demographic Index (SDI). Malnutrition was defined according to the 10th revision of International Classification of Diseases codes for nutritional deficiencies, stratified by malnutrition type. Obesity was measured via body mass index (BMI) using metrics related to national and subnational estimates, defined as BMI ≥25 kg/m2. Countries were stratified into low, low-middle, middle, high-middle, and high SDI bands. Regression models were constructed to predict DALYs and mortality up to 2030. Association between age-standardised prevalence of the diseases and mortality was also assessed.

Findings: In 2019, age-standardised malnutrition-related DALYs was 680 (95% UI: 507-895) per 100,000 population. DALY rates decreased from 2000 to 2019 (-2.86% annually), projected to fall 8.4% from 2020 to 2030. Africa and low SDI countries observed highest malnutrition-related DALYs. Age-standardised obesity-related DALY estimates were 1933 (95% UI: 1277-2640). Obesity-related DALYs rose 0.48% annually from 2000 to 2019, predicted to increase by 39.8% from 2020 to 2030. Highest obesity-related DALYs were in Eastern Mediterranean and middle SDI countries.

Interpretation: The ever-increasing obesity burden, on the backdrop of curbing the malnutrition burden, is predicted to rise further.

Funding: None.

Keywords: Disability-adjusted life years; Global burden; Malnutrition; Mortality; Obesity.

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Conflict of interest statement

GYHL is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, Anthem; no fees are received personally. GYHL is also co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union's Horizon 2020 research and innovation programme (under grant agreement no. 899871). MYC receives speaker's fees and research grants from Astra Zeneca, Abbott Technologies and Boston Scientific. CWlR reports grants from the Irish Research Council, Science Foundation Ireland, Anabio, and the Health Research Board; serves on advisory boards of Novo Nordisk, Herbalife, GI Dynamics, Eli Lilly, Johnson & Johnson, Glia, and Boehringer Ingelheim; is a member of the Irish Society for Nutrition and Metabolism outside the area of work commented on here; and was the chief medical officer and director of the Medical Device Division of Keyron in 2011 (both are unremunerated positions). CWlR was a previous investor in Keyron, which develops endoscopically implantable medical devices intended to mimic the surgical procedures of sleeve gastrectomy and gastric bypass. The product has only been tested in rodents and none of Keyron's products are currently licensed. They do not have any contracts with other companies to put their products into clinical practice. No patients have been included in any of Keyron's studies and they are not listed on the stock market. CWlR was also gifted stock holdings in September 2021 and divested all stock holdings in Keyron in September, 2021; CWlR continues to provide scientific advice to Keyron for no remuneration. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A) Disability-adjusted life year (DALYs) and age-standardised DALYs and B) number of deaths and age-standardised death rates at the global level by obesity and malnutrition, 2000–2019. Bar charts depict the age-standardised DALYs/deaths and line graphs depict the total DALYs/deaths.
Fig. 2
Fig. 2
A) Proportion of deaths and, B) Proportion of disability-adjusted life years (DALYs) due to obesity and malnutrition, at global and regional levels by sex, 2019. SDI, Socio-Demographic Index.
Fig. 3
Fig. 3
The global trends of A) obesity related age-standardised mortality and B) annual percentage change in malnutrition-related age-standardised death rate.
Fig. 4
Fig. 4
The global trends of A) obesity related age-standardised mortality and B) annual percentage change in obesity-related age-standardised death rate.
Fig. 5
Fig. 5
Bar graphs of Annual Percentage Change of Disability-adjusted Life Years (DALYs) by disease from 2000 to 2030.
Fig. 6
Fig. 6
Projection of Disability-adjusted Life Years (DALYs) by disease from 2000 to 2030. Bar charts depict total DALYs and line graphs depict male/female DALYs.
Central illustration
Central illustration
Global trends and predictions of the burden of malnutrition and obesity.
See this image and copyright information in PMC

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