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
Authors: Leandra Abarca-Gómez, Ziad A Abdeen, Zargar Abdul Hamid, Niveen M Abu-Rmeileh, Benjamin Acosta-Cazares, Cecilia Acuin, Robert J Adams, Wichai Aekplakorn, Kaosar Afsana, Carlos A Aguilar-Salinas, Charles Agyemang, Alireza Ahmadvand, Wolfgang Ahrens, Kamel Ajlouni, Nazgul Akhtaeva, Hazzaa M Al-Hazzaa, Amani Rashed Al-Othman, Rajaa Al-Raddadi, Fadia Al Buhairan, Shahla Al Dhukair, Mohamed M Ali, Osman Ali, Ala'a Alkerwi, Mar Alvarez-Pedrerol, Eman Aly, Deepak N Amarapurkar, Philippe Amouyel, Antoinette Amuzu, Lars Bo Andersen, Sigmund A Anderssen, Dolores S Andrade, Lars H Ängquist, Ranjit Mohan Anjana, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Nimmathota Arlappa, Dominique Arveiler, Krishna K Aryal, Thor Aspelund, Felix K Assah, Maria Cecília F Assunção, May Soe Aung, Mária Avdicová, Ana Azevedo, Fereidoun Azizi, Bontha V Babu, Suhad Bahijri, Jennifer L Baker, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R Banegas, Carlo M Barbagallo, Alberto Barceló, Amina Barkat, Aluisio JD Barros, Mauro VG Barros, Iqbal Bata, Anwar M Batieha, Rosangela L Batista, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Habiba Ben Romdhane, Judith Benedics, Mikhail Benet, James E Bennett, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloisa Bettiol, Aroor Bhagyalaxmi, Sumit Bharadwaj, Santosh K Bhargava, Zaid Bhatti, Zulfiqar A Bhutta, Hongsheng Bi, Yufang Bi, Anna Biehl, Mukharram Bikbov, Bihungum Bista, Dusko J Bjelica, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Anneke Blokstra, Simona Bo, Martin Bobak, Lynne M Boddy, Bernhard O Boehm, Heiner Boeing, Jose G Boggia, Carlos P Boissonnet, Marialaura Bonaccio, Vanina Bongard, Pascal Bovet, Lien Braeckevelt, Lutgart Braeckman, Marjolijn CE Bragt, Imperia Brajkovich, Francesco Branca, Juergen Breckenkamp, João Breda, Hermann Brenner, Lizzy M Brewster, Garry R Brian, Lacramioara Brinduse, Graziella Bruno, H B(as) Bueno-de-Mesquita, Anna Bugge, Marta Buoncristiano, Genc Burazeri, Con Burns, Antonio Cabrera de León, Joseph Cacciottolo, Hui Cai, Tilema Cama, Christine Cameron, José Camolas, Günay Can, Ana Paula C Cândido, Mario Capanzana, Vincenzo Capuano, Viviane C Cardoso, Axel C Carlsson, Maria J Carvalho, Felipe F Casanueva, Juan-Pablo Casas, Carmelo A Caserta, Snehalatha Chamukuttan, Angelique W Chan, Queenie Chan, Himanshu K Chaturvedi, Nishi Chaturvedi, Chien-Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Zhengming Chen, Ching-Yu Cheng, Angela Chetrit, Ekaterina Chikova-Iscener, Arnaud Chiolero, Shu-Ti Chiou, Adela Chirita-Emandi, María-Dolores Chirlaque, Belong Cho, Yumi Cho, Kaare Christensen, Diego G Christofaro, Jerzy Chudek, Renata Cifkova, Eliza Cinteza, Frank Claessens, Els Clays, Hans Concin, Susana C Confortin, Cyrus Cooper, Rachel Cooper, Tara C Coppinger, Simona Costanzo, Dominique Cottel, Chris Cowell, Cora L Craig, Ana B Crujeiras, Alexandra Cucu, Graziella D'Arrigo, Eleonora d'Orsi, Jean Dallongeville, Albertino Damasceno, Camilla T Damsgaard, Goodarz Danaei, Rachel Dankner, Thomas M Dantoft, Saeed Dastgiri, Luc Dauchet, Kairat Davletov, Guy De Backer, Dirk De Bacquer, Amalia De Curtis, Giovanni de Gaetano, Stefaan De Henauw, Paula Duarte de Oliveira, Karin De Ridder, Delphine De Smedt, Mohan Deepa, Alexander D Deev, Abbas Dehghan, Hélène Delisle, Francis Delpeuch, Valérie Deschamps, Klodian Dhana, Augusto F Di Castelnuovo, Juvenal Soares Dias-da-Costa, Alejandro Diaz, Zivka Dika, Shirin Djalalinia, Ha TP Do, Annette J Dobson, Maria Benedetta Donati, Chiara Donfrancesco, Silvana P Donoso, Angela Döring, Maria Dorobantu, Ahmad Reza Dorosty, Kouamelan Doua, Wojciech Drygas, Jia Li Duan, Charmaine Duante, Vesselka Duleva, Virginija Dulskiene, Vilnis Dzerve, Elzbieta Dziankowska-Zaborszczyk, Eruke E Egbagbe, Robert Eggertsen, Gabriele Eiben, Ulf Ekelund, Jalila El Ati, Paul Elliott, Reina Engle-Stone, Rajiv T Erasmus, Cihangir Erem, Louise Eriksen, Johan G Eriksson, Jorge Escobedo-de la Peña, Alun Evans, David Faeh, Caroline H Fall, Victoria Farrugia Sant'Angelo, Farshad Farzadfar, Francisco J Felix-Redondo, Trevor S Ferguson, Romulo A Fernandes, Daniel Fernández-Bergés, Daniel Ferrante, Marika Ferrari, Catterina Ferreccio, Jean Ferrieres, Joseph D Finn, Krista Fischer, Eric Monterubio Flores, Bernhard Föger, Leng Huat Foo, Ann-Sofie Forslund, Maria Forsner, Heba M Fouad, Damian K Francis, Maria do Carmo Franco, Oscar H Franco, Guillermo Frontera, Flavio D Fuchs, Sandra C Fuchs, Yuki Fujita, Takuro Furusawa, Zbigniew Gaciong, Mihai Gafencu, Daniela Galeone, Fabio Galvano, Manoli Garcia-de-la-Hera, Dickman Gareta, Sarah P Garnett, Jean-Michel Gaspoz, Magda Gasull, Louise Gates, Harald Geiger, Johanna M Geleijnse, Anoosheh Ghasemian, Simona Giampaoli, Francesco Gianfagna, Tiffany K Gill, Jonathan Giovannelli, Aleksander Giwercman, Justyna Godos, Sibel Gogen, Rebecca A Goldsmith, David Goltzman, Helen Gonçalves, Margot González-Leon, Juan P González-Rivas, Marcela Gonzalez-Gross, Frederic Gottrand, Antonio Pedro Graça, Sidsel Graff-Iversen, Dušan Grafnetter, Aneta Grajda, Maria G Grammatikopoulou, Ronald D Gregor, Tomasz Grodzicki, Anders Grøntved, Giuseppe Grosso, Gabriella Gruden, Vera Grujic, Dongfeng Gu, Emanuela Gualdi-Russo, Pilar Guallar-Castillón, Ong Peng Guan, Elias F Gudmundsson, Vilmundur Gudnason, Ramiro Guerrero, Idris Guessous, Andre L Guimaraes, Martin C Gulliford, Johanna Gunnlaugsdottir, Marc Gunter, Xiuhua Guo, Yin Guo, Prakash C Gupta, Rajeev Gupta, Oye Gureje, Beata Gurzkowska, Laura Gutierrez, Felix Gutzwiller, Farzad Hadaegh, Charalambos A Hadjigeorgiou, Khairil Si-Ramlee, Jytte Halkjær, Ian R Hambleton, Rebecca Hardy, Rachakulla Hari Kumar, Maria Hassapidou, Jun Hata, Alison J Hayes, Jiang He, Regina Heidinger-Felso, Mirjam Heinen, Marleen Elisabeth Hendriks, Ana Henriques, Leticia Hernandez Cadena, Sauli Herrala, Victor M Herrera, Isabelle Herter-Aeberli, Ramin Heshmat, Ilpo Tapani Hihtaniemi, Sai Yin Ho, Suzanne C Ho, Michael Hobbs, Albert Hofman, Wilma M Hopman, Andrea RVR Horimoto, Claudia M Hormiga, Bernardo L Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, Yonghua Hu, José María Huerta, Constanta Huidumac Petrescu, Martijn Huisman, Abdullatif Husseini, Chinh Nguyen Huu, Inge Huybrechts, Nahla Hwalla, Jolanda Hyska, Licia Iacoviello, Anna G Iannone, Jesús M Ibarluzea, Mohsen M Ibrahim, Nayu Ikeda, M Arfan Ikram, Vilma E Irazola, Muhammad Islam, Aziz al-Safi Ismail, Vanja Ivkovic, Masanori Iwasaki, Rod T Jackson, Jeremy M Jacobs, Hashem Jaddou, Tazeen Jafar, Kazi M Jamil, Konrad Jamrozik, Imre Janszky, Juel Jarani, Grazyna Jasienska, Ana Jelakovic, Bojan Jelakovic, Garry Jennings, Seung-Lyeal Jeong, Chao Qiang Jiang, Santa Magaly Jiménez-Acosta, Michel Joffres, Mattias Johansson, Jost B Jonas, Torben Jørgensen, Pradeep Joshi, Dragana P Jovic, Jacek Józwiak, Anne Juolevi, Gregor Jurak, Vesna Jureša, Rudolf Kaaks, Anthony Kafatos, Eero O Kajantie, Ofra Kalter-Leibovici, Nor Azmi Kamaruddin, Efthymios Kapantais, Khem B Karki, Amir Kasaeian, Joanne Katz, Jussi Kauhanen, Prabhdeep Kaur, Maryam Kavousi, Gyulli Kazakbaeva, Ulrich Keil, Lital Keinan Boker, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Cecily Kelleher, Han CG Kemper, Andre P Kengne, Alina Kerimkulova, Mathilde Kersting, Timothy Key, Yousef Saleh Khader, Davood Khalili, Young-Ho Khang, Mohammad Khateeb, Kay-Tee Khaw, Ilse MSL Khouw, Ursula Kiechl-Kohlendorfer, Stefan Kiechl, Japhet Killewo, Jeongseon Kim, Yeon-Yong Kim, Jeannette Klimont, Jurate Klumbiene, Michael Knoflach, Bhawesh Koirala, Elin Kolle, Patrick Kolsteren, Paul Korrovits, Jelena Kos, Seppo Koskinen, Katsuyasu Kouda, Viktoria A Kovacs, Sudhir Kowlessur, Slawomir Koziel, Wolfgang Kratzer, Susi Kriemler, Peter Lund Kristensen, Steinar Krokstad, Daan Kromhout, Herculina S Kruger, Ruzena Kubinova, Renata Kuciene, Diana Kuh, Urho M Kujala, Zbigniew Kulaga, R Krishna Kumar, Marie Kunešová, Pawel Kurjata, Yadlapalli S Kusuma, Kari Kuulasmaa, Catherine Kyobutungi, Quang Ngoc La, Fatima Zahra Laamiri, Tiina Laatikainen, Carl Lachat, Youcef Laid, Tai Hing Lam, Orlando Landrove, Vera Lanska, Georg Lappas, Bagher Larijani, Lars E Laugsand, Laura Lauria, Avula Laxmaiah, Khanh Le Nguyen Bao, Tuyen D Le, May Antonnette O Lebanan, Catherine Leclercq, Jeannette Lee, Jeonghee Lee, Terho Lehtimäki, Luz M León-Muñoz, Naomi S Levitt, Yanping Li, Christa L Lilly, Wei-Yen Lim, M Fernanda Lima-Costa, Hsien-Ho Lin, Xu Lin, Lars Lind, Allan Linneberg, Lauren Lissner, Mieczyslaw Litwin, Jing Liu, Helle-Mai Loit, Luis Lopes, Roberto Lorbeer, Paulo A Lotufo, José Eugenio Lozano, Dalia Luksiene, Annamari Lundqvist, Nuno Lunet, Per Lytsy, Guansheng Ma, Jun Ma, George LL Machado-Coelho, Aristides M Machado-Rodrigues, Suka Machi, Stefania Maggi, Dianna J Magliano, Emmanuella Magriplis, Alagappan Mahaletchumy, Bernard Maire, Marjeta Majer, Marcia Makdisse, Reza Malekzadeh, Rahul Malhotra, Kodavanti Mallikharjuna Rao, Sofia Malyutina, Yannis Manios, Jim I Mann, Enzo Manzato, Paula Margozzini, Anastasia Markaki, Oonagh Markey, Larissa P Marques, Pedro Marques-Vidal, Jaume Marrugat, Yves Martin-Prevel, Rosemarie Martin, Reynaldo Martorell, Eva Martos, Stefano Marventano, Shariq R Masoodi, Ellisiv B Mathiesen, Alicia Matijasevich, Tandi E Matsha, Artur Mazur, Jean Claude N Mbanya, Shelly R McFarlane, Stephen T McGarvey, Martin McKee, Stela McLachlan, Rachael M McLean, Scott B McLean, Breige A McNulty, Safiah Md Yusof, Sounnia Mediene-Benchekor, Jurate Medzioniene, Aline Meirhaeghe, Jørgen Meisfjord, Christa Meisinger, Ana Maria B Menezes, Geetha R Menon, Gert BM Mensink, Indrapal I Meshram, Andres Metspalu, Haakon E Meyer, Jie Mi, Kim F Michaelsen, Nathalie Michels, Kairit Mikkel, Jody C Miller, Cláudia S Minderico, Juan Francisco Miquel, J Jaime Miranda, Daphne Mirkopoulou, Erkin Mirrakhimov, Marjeta Mišigoj-Durakovic, Antonio Mistretta, Veronica Mocanu, Pietro A Modesti, Mostafa K Mohamed, Kazem Mohammad, Noushin Mohammadifard, Viswanathan Mohan, Salim Mohanna, Muhammad Fadhli Mohd Yusoff, Drude Molbo, Line T Møllehave, Niels C Møller, Dénes Molnár, Amirabbas Momenan, Charles K Mondo, Eric A Monterrubio, Kotsedi Daniel K Monyeki, Jin Soo Moon, Leila B Moreira, Alain Morejon, Luis A Moreno, Karen Morgan, Erik Lykke Mortensen, George Moschonis, Malgorzata Mossakowska, Aya Mostafa, Jorge Mota, Anabela Mota-Pinto, Mohammad Esmaeel Motlagh, Jorge Motta, Thet Thet Mu, Magdalena Muc, Maria Lorenza Muiesan, Martina Müller-Nurasyid, Neil Murphy, Jaakko Mursu, Elaine M Murtagh, Vera Musil, Iraj Nabipour, Gabriele Nagel, Balkish M Naidu, Harunobu Nakamura, Jana Námešná, Ei Ei K Nang, Vinay B Nangia, Martin Nankap, Sameer Narake, Paola Nardone, Eva Maria Navarrete-Muñoz, William A Neal, Ilona Nenko, Martin Neovius, Flavio Nervi, Chung T Nguyen, Nguyen D Nguyen, Quang Ngoc Nguyen, Ramfis E Nieto-Martínez, Guang Ning, Toshiharu Ninomiya, Sania Nishtar, Marianna Noale, Oscar A Noboa, Teresa Norat, Sawada Norie, Davide Noto, Mohannad Al Nsour, Dermot O'Reilly, Galina Obreja, Eiji Oda, Glenn Oehlers, Kyungwon Oh, Kumiko Ohara, Örn Olafsson, Maria Teresa Anselmo Olinto, Isabel O Oliveira, Maciej Oltarzewski, Mohd Azahadi Omar, Altan Onat, Sok King Ong, Lariane M Ono, Pedro Ordunez, Rui Ornelas, Ana P Ortiz, Merete Osler, Clive Osmond, Sergej M Ostojic, Afshin Ostovar, Johanna A Otero, Kim Overvad, Ellis Owusu-Dabo, Fred Michel Paccaud, Cristina Padez, Elena Pahomova, Andrzej Pajak, Domenico Palli, Alberto Palloni, Luigi Palmieri, Wen-Harn Pan, Songhomitra Panda-Jonas, Arvind Pandey, Francesco Panza, Dimitrios Papandreou, Soon-Woo Park, Winsome R Parnell, Mahboubeh Parsaeian, Ionela M Pascanu, Nikhil D Patel, Ivan Pecin, Mangesh S Pednekar, Nasheeta Peer, Petra H Peeters, Sergio Viana Peixoto, Markku Peltonen, Alexandre C Pereira, Napoleon Perez-Farinos, Cynthia M Pérez, Annette Peters, Janina Petkeviciene, Ausra Petrauskiene, Niloofar Peykari, Son Thai Pham, Daniela 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Rodríguez-Artalejo, María del Cristo Rodriguez-Perez, Laura A Rodríguez-Villamizar, Rosalba Rojas-Martinez, Nipa Rojroongwasinkul, Dora Romaguera, Kimmo Ronkainen, Annika Rosengren, Ian Rouse, Joel GR Roy, Adolfo Rubinstein, Frank J Rühli, Blanca Sandra Ruiz-Betancourt, Paola Russo, Marcin Rutkowski, Charumathi Sabanayagam, Harshpal S Sachdev, Olfa Saidi, Benoit Salanave, Eduardo Salazar Martinez, Diego Salmerón, Veikko Salomaa, Jukka T Salonen, Massimo Salvetti, Jose Sánchez-Abanto, None Sandjaja, Susana Sans, Loreto Santa Marina, Diana A Santos, Ina S Santos, Osvaldo Santos, Renata Nunes dos Santos, Rute Santos, Jouko L Saramies, Luis B Sardinha, Nizal Sarrafzadegan, Kai-Uwe Saum, Savvas Savva, Mathilde Savy, Marcia Scazufca, Angelika Schaffrath Rosario, Herman Schargrodsky, Anja Schienkiewitz, Sabine Schipf, Carsten O Schmidt, Ida Maria Schmidt, Constance Schultsz, Aletta E Schutte, Aye Aye Sein, Abhijit Sen, Idowu O Senbanjo, Sadaf G Sepanlou, Luis Serra-Majem, Svetlana A Shalnova, Sanjib K Sharma, Jonathan E Shaw, Kenji Shibuya, Dong Wook Shin, Youchan Shin, Rahman Shiri, Alfonso Siani, Rosalynn Siantar, Abla M Sibai, Antonio M Silva, Diego Augusto Santos Silva, Mary Simon, Judith Simons, Leon A Simons, Agneta Sjöberg, Michael Sjöström, Sine Skovbjerg, Jolanta Slowikowska-Hilczer, Przemyslaw Slusarczyk, Liam Smeeth, Margaret C Smith, Marieke B Snijder, Hung-Kwan So, Eugène Sobngwi, Stefan Söderberg, Moesijanti YE Soekatri, Vincenzo Solfrizzi, Emily Sonestedt, Yi Song, Thorkild IA Sørensen, Maroje Soric, Charles Sossa Jérome, Aicha Soumare, Angela Spinelli, Igor Spiroski, Jan A Staessen, Hanspeter Stamm, Gregor Starc, Maria G Stathopoulou, Kaspar Staub, Bill Stavreski, Jostein Steene-Johannessen, Peter Stehle, Aryeh D Stein, George S Stergiou, Jochanan Stessman, Jutta Stieber, Doris Stöckl, Tanja Stocks, Jakub Stokwiszewski, Gareth Stratton, Karien Stronks, Maria Wany Strufaldi, Ramón Suárez-Medina, Chien-An Sun, Johan Sundström, Yn-Tz Sung, Jordi Sunyer, Paibul Suriyawongpaisal, Boyd A Swinburn, Rody G Sy, Lucjan Szponar, E Shyong Tai, Mari-Liis Tammesoo, Abdonas Tamosiunas, Eng Joo Tan, Xun Tang, Frank Tanser, Yong Tao, Mohammed Rasoul Tarawneh, Jakob Tarp, Carolina B Tarqui-Mamani, Oana-Florentina Tautu, Radka Taxová Braunerová, Anne Taylor, Félicité Tchibindat, Holger Theobald, Xenophon Theodoridis, Lutgarde Thijs, Betina H Thuesen, Anne Tjonneland, Hanna K Tolonen, Janne S Tolstrup, Murat Topbas, Roman Topór-Madry, María José Tormo, Michael J Tornaritis, Maties Torrent, Stefania Toselli, Pierre Traissac, Dimitrios Trichopoulos, Antonia Trichopoulou, Oanh TH Trinh, Atul Trivedi, Lechaba Tshepo, Maria Tsigga, Shoichiro Tsugane, Marshall K Tulloch-Reid, Fikru Tullu, Tomi-Pekka Tuomainen, Jaakko Tuomilehto, Maria L Turley, Per Tynelius, Themistoklis Tzotzas, Christophe Tzourio, Peter Ueda, Eunice E Ugel, Flora AM Ukoli, Hanno Ulmer, Belgin Unal, Hannu MT Uusitalo, Gonzalo Valdivia, Susana Vale, Damaskini Valvi, Yvonne T van der Schouw, Koen Van Herck, Hoang Van Minh, Lenie van Rossem, Natasja M Van Schoor, Irene GM van Valkengoed, Dirk Vanderschueren, Diego Vanuzzo, Lars Vatten, Tomas Vega, Toomas Veidebaum, Gustavo Velasquez-Melendez, Biruta Velika, Giovanni Veronesi, WM Monique Verschuren, Cesar G Victora, Giovanni Viegi, Lucie Viet, Eira Viikari-Juntura, Paolo Vineis, Jesus Vioque, Jyrki K Virtanen, Sophie Visvikis-Siest, Bharathi Viswanathan, Tiina Vlasoff, Peter Vollenweider, Henry Völzke, Sari Voutilainen, Martine Vrijheid, Alisha N Wade, Aline Wagner, Thomas Waldhör, Janette Walton, Wan Mohamad Wan Bebakar, Wan Nazaimoon Wan Mohamud, Rildo S Wanderley, Ming-Dong Wang, Qian Wang, Ya Xing Wang, Ying-Wei Wang, S Goya Wannamethee, Nicholas Wareham, Adelheid Weber, Niels Wedderkopp, Deepa Weerasekera, Peter H Whincup, Kurt Widhalm, Indah S Widyahening, Andrzej Wiecek, Alet H Wijga, Rainford J Wilks, Johann Willeit, Peter Willeit, Tom Wilsgaard, Bogdan Wojtyniak, Roy A Wong-McClure, Justin YY Wong, Jyh Eiin Wong, Tien Yin Wong, Jean Woo, Mark Woodward, Frederick C Wu, Jianfeng Wu, Shouling Wu, Haiquan Xu, Liang Xu, Uruwan Yamborisut, Weili Yan, Xiaoguang Yang, Nazan Yardim, Xingwang Ye, Panayiotis K Yiallouros, Agneta Yngve, Akihiro Yoshihara, Qi Sheng You, Novie O Younger-Coleman, Faudzi Yusoff, Muhammad Fadhli M Yusoff, Luciana Zaccagni, Vassilis Zafiropulos, Ahmad A Zainuddin, Sabina Zambon, Antonis Zampelas, Hana Zamrazilová, Tomasz Zdrojewski, Yi Zeng, Dong Zhao, Wenhua Zhao, Wei Zheng, Yingfeng Zheng, Bekbolat Zholdin, Maigeng Zhou, Dan Zhu, Baurzhan Zhussupov, Esther Zimmermann, Julio Zuñiga Cisneros, James Bentham, Mariachiara Di Cesare, Ver Bilano, Honor Bixby, Bin Zhou, Gretchen A Stevens, Leanne M Riley, Cristina Taddei, Kaveh Hajifathalian, Yuan Lu, Stefan Savin, Melanie J Cowan, Christopher J Paciorek, Adela Chirita-Emandi, Alison J Hayes, Joanne Katz, Roya Kelishadi, Andre Pascal Kengne, Young-Ho Khang, Avula Laxmaiah, Yanping Li, Jun Ma, J Jaime Miranda, Aya Mostafa, Martin Neovius, Cristina Padez, Lekhraj Rampal, Aubrianna Zhu, James E Bennett, Goodarz Danaei, Zulfiqar A Bhutta, Majid Ezzati
Journal: The Lancet (2017)

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.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).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.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.Wellcome Trust, AstraZeneca Young Health Programme.