TY - JOUR
T1 - The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean
T2 - a cross-sectional series study
AU - Jiwani, Safia S.
AU - Carrillo-Larco, Rodrigo M.
AU - Hernández-Vásquez, Akram
AU - Barrientos-Gutiérrez, Tonatiuh
AU - Basto-Abreu, Ana
AU - Gutierrez, Laura
AU - Irazola, Vilma
AU - Nieto-Martínez, Ramfis
AU - Nunes, Bruno P.
AU - Parra, Diana C.
AU - Miranda, J. Jaime
N1 - Funding Information:
RMC-L is supported by a Wellcome Trust International Training Fellowship (214185/Z/18/Z). TB-G acknowledges receiving support from the Lown Scholars Program at Harvard University. TB-G and AB-A have received additional support from Bloomberg Philanthropies (principal investigator Juan Rivera-Dommarco). JJM acknowledges having received support from the Alliance for Health Policy and Systems Research (HQHSR1206660), the Bernard Lown Scholars in Cardiovascular Health Program at Harvard T.H. Chan School of Public Health (BLSCHP-1902), Bloomberg Philanthropies, the National Fund for Scientific and Technological Development through CIENCIACTIVA and the National Commission for Scientific and Technological Research, British Council, British Embassy and the Newton-Paulet Fund (223-2018, 224-2018), DFID/MRC/Wellcome Global Health Trials (MR/M007405/1), Fogarty International Center (R21TW009982, D71TW010877), Grand Challenges Canada (0335-04), International Development Research Center Canada (IDRC 106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), Medical Research Council (MR/P008984/1, MR/P024408/1, MR/P02386X/1), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), Wellcome Trust (074833/Z/04/Z, 093541/Z/10/Z, 107435/Z/15/Z, 103994/Z/14/Z, 205177/Z/16/Z, 214185/Z/18/Z), and the World Diabetes Foundation (WDF15-1224). SSJ acknowledges Daniel Antiporta for statistical support. VI acknowledges the local teams in Marcos Paz, Bariloche, Temuco, and Uruguay for making the study possible. RN-M acknowledges the Internal Medicine Venezuelan Society and Venezuelan Cardiometabolic Health Study Research Group, especially Eunice Ugel for data management and statistical support. DCP acknowledges the Instituto Colombiano de Bienestar Familiar and PROFAMILIA for providing support and allowing the use of Encuesta Nacional de Demografía y Salud and Colombia's National Survey on Nutritional Status datasets and Daniel Ayala for invaluable support and input in data management and statistical analysis.
Publisher Copyright:
© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2019/12
Y1 - 2019/12
N2 - Background: The burden of obesity differs by socioeconomic status. We aimed to characterise the prevalence of obesity among adult men and women in Latin America and the Caribbean by socioeconomic measures and the shifting obesity burden over time. Methods: We did a cross-sectional series analysis of obesity prevalence by socioeconomic status by use of national health surveys done between 1998 and 2017 in 13 countries in Latin America and the Caribbean. We generated equiplots to display inequalities in, the primary outcome, obesity by wealth, education, and residence area. We measured obesity gaps as the difference in percentage points between the highest and lowest obesity prevalence within each socioeconomic measure, and described trends as well as changing patterns of the obesity burden over time. Findings: 479 809 adult men and women were included in the analysis. Obesity prevalence across countries has increased over time, with distinct patterns emerging by wealth and education indices. In the most recent available surveys, obesity was most prevalent among women in Mexico in 2016, and the least prevalent among women in Haiti in 2016. The largest gap between the highest and lowest obesity estimates by wealth was observed in Honduras among women (21·6 percentage point gap), and in Peru among men (22·4 percentage point gap), compared with a 3·7 percentage point gap among women in Brazil and 3·3 percentage points among men in Argentina. Urban residents consistently had a larger burden than their rural counterparts in most countries, with obesity gaps ranging from 0·1 percentage points among women in Paraguay to 15·8 percentage points among men in Peru. The trend analysis done in five countries suggests a shifting of the obesity burden across socioeconomic groups and different patterns by gender. Obesity gaps by education in Mexico have reduced over time among women, but increased among men, whereas the gap has increased among women but remains relatively constant among men in Argentina. Interpretation: The increase in obesity prevalence in the Latin American and Caribbean region has been paralleled with an unequal distribution and a shifting burden across socioeconomic groups. Anticipation of the establishment of obesity among low socioeconomic groups could provide opportunities for societal gains in primordial prevention. Funding: None.
AB - Background: The burden of obesity differs by socioeconomic status. We aimed to characterise the prevalence of obesity among adult men and women in Latin America and the Caribbean by socioeconomic measures and the shifting obesity burden over time. Methods: We did a cross-sectional series analysis of obesity prevalence by socioeconomic status by use of national health surveys done between 1998 and 2017 in 13 countries in Latin America and the Caribbean. We generated equiplots to display inequalities in, the primary outcome, obesity by wealth, education, and residence area. We measured obesity gaps as the difference in percentage points between the highest and lowest obesity prevalence within each socioeconomic measure, and described trends as well as changing patterns of the obesity burden over time. Findings: 479 809 adult men and women were included in the analysis. Obesity prevalence across countries has increased over time, with distinct patterns emerging by wealth and education indices. In the most recent available surveys, obesity was most prevalent among women in Mexico in 2016, and the least prevalent among women in Haiti in 2016. The largest gap between the highest and lowest obesity estimates by wealth was observed in Honduras among women (21·6 percentage point gap), and in Peru among men (22·4 percentage point gap), compared with a 3·7 percentage point gap among women in Brazil and 3·3 percentage points among men in Argentina. Urban residents consistently had a larger burden than their rural counterparts in most countries, with obesity gaps ranging from 0·1 percentage points among women in Paraguay to 15·8 percentage points among men in Peru. The trend analysis done in five countries suggests a shifting of the obesity burden across socioeconomic groups and different patterns by gender. Obesity gaps by education in Mexico have reduced over time among women, but increased among men, whereas the gap has increased among women but remains relatively constant among men in Argentina. Interpretation: The increase in obesity prevalence in the Latin American and Caribbean region has been paralleled with an unequal distribution and a shifting burden across socioeconomic groups. Anticipation of the establishment of obesity among low socioeconomic groups could provide opportunities for societal gains in primordial prevention. Funding: None.
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U2 - 10.1016/S2214-109X(19)30421-8
DO - 10.1016/S2214-109X(19)30421-8
M3 - Article
C2 - 31708145
AN - SCOPUS:85074411116
SN - 2214-109X
VL - 7
SP - e1644-e1654
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 12
ER -