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.
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.
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DOI：
10.1016/s0140-6736(16)30054-x
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发表时间：
2016-04-02
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通讯作者：
NCD Risk Factor Collaboration (NCD-RisC)
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作者：
NCD Risk Factor Collaboration (NCD-RisC)
体重不足、严重和病态肥胖与不良健康后果的风险极高有关。我们估计了平均体重指数（BMI）的趋势，它表征了人口分布，以及所有国家成年人的一套完整BMI类别的患病率。我们使用一致的方案分析了基于人群的研究，这些研究测量了18岁及以上成年人的身高和体重。我们将贝叶斯分层模型应用于这些数据，以估计1975年至2014年平均BMI和BMI类别患病率的趋势。（<18.5 kg/m2 [体重不足]，18.5 kg/m2至<20 kg/m2，20 kg/m2至<25 kg/m2，25 kg/m2至<30 kg/m2，30 kg/m2至<35 kg/m2，35 kg/m2至<40 kg/m2，≥40 kg/m2 [病态肥胖]），在21个区域组织的200个国家和地区按性别分列。我们计算了如果2000年后的趋势继续下去，到2025年将肥胖率上升遏制在2010年水平的目标的后验概率。我们使用了1698个基于人口的数据源，在200个国家中的186个国家中有超过1920万成年参与者（990万男性和930万女性）。全球年龄标准化平均BMI男性从1975年的21.7 kg/m2（95%可信区间21.3 - 22.1）增加到2014年的24.2 kg/m2（24.0 - 24.4），女性从1975年的22.1 kg/m2（21.7 - 22.5）增加到2014年的24.4 kg/m2（24.2 - 24.6）。2014年，男性的区域平均BMI范围从中非和南亚的21.4 kg/m2到波利尼西亚和密克罗尼西亚的29.2 kg/m2（28.6 - 29.8）;女性的范围从南亚的21.8 kg/m2（21.4 - 22.3）到波利尼西亚和密克罗尼西亚的32.2 kg/m2（31.5 - 32.8）。在这40年中，年龄标准化的全球体重不足患病率在男性中从13.8%（10.5 - 17.4）降至8.8%（7.4 - 10.3），在女性中从14.6%（11.6 - 17.9）降至9.7%（8.3 - 11.1）。2014年，南亚的体重不足发生率最高，男性为23.4%（17.8 - 29.2），女性为24.0%（18.9 - 29.3）。男性肥胖的标准化患病率从1975年的3.2%（2.4 - 4.1）增加到2014年的10.8%（9.7 - 12.0），女性从6.4%（5.1 - 7.8）增加到14.9%（13.6 - 16.1）。全世界2.3%（2.0 - 2.7）的男性和5.0%（4.4 - 5.6）的女性严重肥胖（即BMI ≥35 kg/m2）。在全球范围内，男性病态肥胖的患病率为0.64%（0.46 - 0.86），女性为1.6%（1.3 - 1.9）。如果2000年后的趋势继续下去，实现全球肥胖目标的可能性几乎为零。相反，如果这些趋势继续下去，到2025年，全球男性肥胖患病率将达到18%，女性超过21%;严重肥胖男性将超过6%，女性超过9%。然而，在世界最贫穷的地区，特别是南亚，体重不足的现象仍然普遍存在。Wellcome Trust，Grand Challenges Canada.
Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world’s men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world’s poorest regions, especially in south Asia. Wellcome Trust, Grand Challenges Canada.