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

NCD Risk Factor Collaboration (NCD-RisC), Mark Woodward

Research output: Contribution to journalReview article

Abstract

Background 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. Methods 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/m2to <20 kg/m2, 20 kg/m2to <25 kg/m2, 25 kg/m2to <30 kg/m2, 30 kg/m2to <35 kg/m2, 35 kg/m2to <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. Findings 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/m2in 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. Interpretation 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.

Original languageEnglish (US)
Pages (from-to)1377-1396
Number of pages20
JournalThe Lancet
Volume387
Issue number10026
DOIs
StatePublished - Apr 2 2016

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Body Mass Index
Morbid Obesity
Thinness
Population
Obesity
Micronesia
Polynesia
Central Africa
Information Storage and Retrieval
Demography
Weights and Measures
Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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. / NCD Risk Factor Collaboration (NCD-RisC); Woodward, Mark.

In: The Lancet, Vol. 387, No. 10026, 02.04.2016, p. 1377-1396.

Research output: Contribution to journalReview article

@article{69d5f1c6df6b41efbd40080c647a80da,
title = "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",
abstract = "Background 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. Methods 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/m2to <20 kg/m2, 20 kg/m2to <25 kg/m2, 25 kg/m2to <30 kg/m2, 30 kg/m2to <35 kg/m2, 35 kg/m2to <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. Findings 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/m2in 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. Interpretation 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.",
author = "{NCD Risk Factor Collaboration (NCD-RisC)} and {Di Cesare}, Mariachiara and James Bentham and Stevens, {Gretchen A.} and Bin Zhou and Goodarz Danaei and Yuan Lu and Honor Bixby and Cowan, {Melanie J.} and Riley, {Leanne M.} and Kaveh Hajifathalian and L{\'e}a Fortunato and Cristina Taddei and Bennett, {James E.} and Nayu Ikeda and Khang, {Young Ho} and Catherine Kyobutungi and Avula Laxmaiah and Yanping Li and Lin, {Hsien Ho} and Miranda, {J. Jaime} and Aya Mostafa and Turley, {Maria L.} and Paciorek, {Christopher J.} and Marc Gunter and Majid Ezzati and Abdeen, {Ziad A.} and Hamid, {Zargar Abdul} and Abu-Rmeileh, {Niveen M.} and Benjamin Acosta-Cazares and Robert Adams and Wichai Aekplakorn and Aguilar-Salinas, {Carlos A.} and Alireza Ahmadvand and Wolfgang Ahrens and Ali, {Mohamed M.} and Ala'a Alkerwi and Mar Alvarez-Pedrerol and Eman Aly and Philippe Amouyel and Antoinette Amuzu and Andersen, {Lars Bo} and Anderssen, {Sigmund A.} and Andrade, {Dolores S.} and Anjana, {Ranjit Mohan} and Hajer Aounallah-Skhiri and Inger Ariansen and Tahir Aris and Nimmathota Arlappa and Mark Woodward and Joanne Katz",
year = "2016",
month = "4",
day = "2",
doi = "10.1016/S0140-6736(16)30054-X",
language = "English (US)",
volume = "387",
pages = "1377--1396",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "10026",

}

TY - JOUR

T1 - Trends in adult body-mass index in 200 countries from 1975 to 2014

T2 - A pooled analysis of 1698 population-based measurement studies with 19.2 million participants

AU - NCD Risk Factor Collaboration (NCD-RisC)

AU - Di Cesare, Mariachiara

AU - Bentham, James

AU - Stevens, Gretchen A.

AU - Zhou, Bin

AU - Danaei, Goodarz

AU - Lu, Yuan

AU - Bixby, Honor

AU - Cowan, Melanie J.

AU - Riley, Leanne M.

AU - Hajifathalian, Kaveh

AU - Fortunato, Léa

AU - Taddei, Cristina

AU - Bennett, James E.

AU - Ikeda, Nayu

AU - Khang, Young Ho

AU - Kyobutungi, Catherine

AU - Laxmaiah, Avula

AU - Li, Yanping

AU - Lin, Hsien Ho

AU - Miranda, J. Jaime

AU - Mostafa, Aya

AU - Turley, Maria L.

AU - Paciorek, Christopher J.

AU - Gunter, Marc

AU - Ezzati, Majid

AU - Abdeen, Ziad A.

AU - Hamid, Zargar Abdul

AU - Abu-Rmeileh, Niveen M.

AU - Acosta-Cazares, Benjamin

AU - Adams, Robert

AU - Aekplakorn, Wichai

AU - Aguilar-Salinas, Carlos A.

AU - Ahmadvand, Alireza

AU - Ahrens, Wolfgang

AU - Ali, Mohamed M.

AU - Alkerwi, Ala'a

AU - Alvarez-Pedrerol, Mar

AU - Aly, Eman

AU - Amouyel, Philippe

AU - Amuzu, Antoinette

AU - Andersen, Lars Bo

AU - Anderssen, Sigmund A.

AU - Andrade, Dolores S.

AU - Anjana, Ranjit Mohan

AU - Aounallah-Skhiri, Hajer

AU - Ariansen, Inger

AU - Aris, Tahir

AU - Arlappa, Nimmathota

AU - Woodward, Mark

AU - Katz, Joanne

PY - 2016/4/2

Y1 - 2016/4/2

N2 - Background 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. Methods 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/m2to <20 kg/m2, 20 kg/m2to <25 kg/m2, 25 kg/m2to <30 kg/m2, 30 kg/m2to <35 kg/m2, 35 kg/m2to <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. Findings 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/m2in 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. Interpretation 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.

AB - Background 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. Methods 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/m2to <20 kg/m2, 20 kg/m2to <25 kg/m2, 25 kg/m2to <30 kg/m2, 30 kg/m2to <35 kg/m2, 35 kg/m2to <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. Findings 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/m2in 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. Interpretation 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.

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U2 - 10.1016/S0140-6736(16)30054-X

DO - 10.1016/S0140-6736(16)30054-X

M3 - Review article

VL - 387

SP - 1377

EP - 1396

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10026

ER -