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Zhou B, Carrillo-Larco RM, Danaei G, Riley LM, Paciorek CJ, Stevens GA, Gregg EW, Bennett JE, Solomon B, Singleton RK, Sophiea MK, Iurilli MLC, Lhoste VPF, Cowan MJ, Savin S, Woodward M, Balanova Y, Cifkova R, Damasceno A, Elliott P, Farzadfar F, He J, Ikeda N, Kengne AP, Khang YH, Kim HC, Laxmaiah A, Lin HH, Margozzini Maira P, Miranda JJ, Neuhauser H, Sundström J, Varghese C, Widyahening IS, Zdrojewski T, Abarca-Gómez L, Abdeen ZA, Abdul Rahim HF, Abu-Rmeileh NM, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad NA, Ahmadi A, Ahmadi N, Ahmadi N, Ahmadizar F, Ahmed SH, Ahrens W, Ajlouni K, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Aly E, Amarapurkar DN, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Anjana RM, Ansari-Moghaddam A, Ansong D, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Auvinen J, Avdićová M, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Bahijri S, Balakrishna N, Bamoshmoosh M, Banach M, Banadinović M, Bandosz P, Banegas JR, Baran J, Barbagallo CM, Barceló A, Barkat A, Barreto M, Barros AJD, Barros MVG, Bartosiewicz A, Basit A, Bastos JLD, Bata I, Batieha AM, Batyrbek A, Baur LA, Beaglehole R, Belavendra A, Ben Romdhane H, Benet M, Benson LS, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bezerra J, Bhagyalaxmi A, Bhargava SK, Bia D, Biasch K, Bika Lele EC, Bikbov MM, Bista B, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Bobak M, Boeing H, Boggia JG, Boissonnet CP, Bojesen SE, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Bovet P, Boyer CB, Braeckman L, Brajkovich I, Branca F, Breckenkamp J, Brenner H, Brewster LM, Briceño Y, Brito M, Bruno G, Bueno-de-Mesquita HB, Bueno G, Bugge A, Burns C, Bursztyn M, Cabrera de León A, Cacciottolo J, Cameron C, Can G, Cândido APC, Capanzana MV, Čapková N, Capuano E, Capuano V, Cardoso VC, Carlsson AC, Carvalho J, Casanueva FF, Censi L, Cervantes-Loaiza M, Chadjigeorgiou CA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Chee ML, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Cheraghian B, Cherkaoui Dekkaki I, Chetrit A, Chien KL, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cinteza E, Claessens F, Clarke J, Clays E, Cohen E, Concin H, Cooper C, Coppinger TC, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Crujeiras AB, Cruz JJ, Csilla S, Cui L, Cureau FV, Cuschieri S, D'Arrigo G, d'Orsi E, Dallongeville J, Dankner R, Dantoft TM, Dauchet L, Davletov K, De Backer G, De Bacquer D, De Curtis A, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder D, De Smedt D, Deepa M, Deev AD, DeGennaro VJ, Delisle H, Demarest S, Dennison E, Deschamps V, Dhimal M, Di Castelnuovo AF, Dias-da-Costa JS, Diaz A, Dickerson TT, Dika Z, Djalalinia S, Do HTP, Dobson AJ, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dörr M, Doua K, Dragano N, Drygas W, Duante CA, Duboz P, Duda RB, Dulskiene V, Dushpanova A, Džakula A, Dzerve V, Dziankowska-Zaborszczyk E, Eddie R, Eftekhar E, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ati J, Eldemire-Shearer D, Eliasen M, Elosua R, Erasmus RT, Erbel R, Erem C, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Faeh D, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Fattahi MR, Fawwad A, Felix-Redondo FJ, Felix SB, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari M, Ferrario MM, Ferreccio C, Ferreira HS, Ferrer E, Ferrieres J, Figueiró TH, Fink G, Fischer K, Foo LH, Forsner M, Fouad HM, Francis DK, Franco MDC, Frikke-Schmidt R, Frontera G, Fuchs FD, Fuchs SC, Fujita Y, Fumihiko M, Furdela V, Furer A, Furusawa T, Gaciong Z, Galbarczyk A, Galenkamp H, Galvano F, Gao J, Gao P, Garcia-de-la-Hera M, Garcia P, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gazzinelli A, Gehring U, Geleijnse JM, George R, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Ghimire A, Gialluisi A, Giampaoli S, Gieger C, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Goldberg M, Goldsmith RA, Gomez LF, Gomula A, Gonçalves H, Gonçalves M, Gonçalves Cordeiro da Silva B, Gonzalez-Chica DA, Gonzalez-Gross M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gorbea MB, Gottrand F, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grosso G, Gruden G, Gu D, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutierrez L, Gutzwiller F, Ha S, Hadaegh F, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hange D, Hanif AAM, Hantunen S, Hao J, Hardman CM, Hari Kumar R, Hashemi-Shahri SM, Hata J, Haugsgjerd T, Hayes AJ, He Y, Heier M, Hendriks ME, Henrique RDS, Henriques A, Hernandez Cadena L, Herqutanto, Herrala S, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Holdsworth M, Homayounfar R, Horasan Dinc G, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huiart L, Huisman M, Husseini AS, Huybrechts I, Hwalla N, Iacoviello L, Iannone AG, Ibrahim MM, Ibrahim Wong N, Ikram MA, Iotova V, Irazola VE, Ishida T, Isiguzo GC, Islam M, Islam SMS, Iwasaki M, Jackson RT, Jacobs JM, Jaddou HY, Jafar T, James K, Jamrozik K, Janszky I, Janus E, Jarvelin MR, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jha AK, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Johansson M, Jokelainen JJ, Jonas JB, Jørgensen T, Joshi P, Joukar F, Jóżwiak J, Juolevi A, Jurak G, Jureša V, Kaaks R, Kafatos A, Kajantie EO, Kalmatayeva Z, Kalpourtzi N, Kalter-Leibovici O, Kampmann FB, Kannan S, Karaglani E, Kårhus LL, Karki KB, Katibeh M, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Keil U, Keinan Boker L, Keinänen-Kiukaanniemi S, Kelishadi R, Kemper HCG, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khaw KT, Kheiri B, Kheradmand M, Khosravi A, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim DW, Kim J, Klakk H, Klimek M, Klumbiene J, Knoflach M, Kolle E, Kolsteren P, Kontto JP, Korpelainen R, Korrovits P, Kos J, Koskinen S, Kouda K, Kowlessur S, Koziel S, Kratenova J, Kriaucioniene V, Kristensen PL, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kuciene R, Kujala UM, Kulaga Z, Kumar RK, Kurjata P, Kusuma YS, Kutsenko V, Kuulasmaa K, Kyobutungi C, Laatikainen T, Lachat C, Laid Y, Lam TH, Landrove O, Lanska V, Lappas G, Larijani B, Latt TS, Le Coroller G, Le Nguyen Bao K, Le TD, Lee J, Lee J, Lehmann N, Lehtimäki T, Lemogoum D, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin X, Lin YT, Lind L, Lingam V, Linneberg A, Lissner L, Litwin M, Lo WC, Loit HM, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukačević Lovrenčić I, Lukrafka JL, Luksiene D, Lundqvist A, Lundqvist R, Lunet N, Lustigová M, Luszczki E, Ma G, Ma J, Machado-Coelho GLL, Machado-Rodrigues AM, Macia E, Macieira LM, Madar AA, Maggi S, Magliano DJ, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Malekzadeh F, Malekzadeh R, Malhotra R, Mallikharjuna Rao K, Malyutina SK, Maniego LV, Manios Y, Mann JI, Mansour-Ghanaei F, Manzato E, Marcil A, Mårild SB, Marinović Glavić M, Marques-Vidal P, Marques LP, Marrugat J, Martorell R, Mascarenhas LP, Matasin M, Mathiesen EB, Mathur P, Matijasevich A, Matlosz P, Matsha TE, Mavrogianni C, Mbanya JCN, Mc Donald Posso AJ, McFarlane SR, McGarvey ST, McLachlan S, McLean RM, McLean SB, McNulty BA, Mediene Benchekor S, Medzioniene J, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisinger C, Mendoza Montano C, Menezes AMB, Menon GR, Mereke A, Meshram II, Metspalu A, Meyer HE, Mi J, Michels N, Mikkel K, Milkowska K, Miller JC, Minderico CS, Mini GK, Mirjalili MR, Mirrakhimov E, Mišigoj-Duraković M, Modesti PA, Moghaddam SS, Mohajer B, Mohamed MK, Mohamed SF, Mohammad K, Mohammadi MR, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Mohd Yusoff MF, Mohebbi I, Mohebi F, Moitry M, Møllehave LT, Molnár D, Momenan A, Mondo CK, Monterrubio-Flores E, Monyeki KDK, Moon JS, Moosazadeh M, Moreira LB, Morejon A, Moreno LA, Morgan K, Moschonis G, Mossakowska M, Mostafa A, Mostafavi SA, Mota J, Motlagh ME, Motta J, Moura-dos-Santos MA, Mridha MK, Msyamboza KP, Mu TT, Muhihi AJ, Muiesan ML, Müller-Nurasyid M, Murphy N, Mursu J, Musa KI, Musić Milanović S, Musil V, Mustafa N, Nabipour I, Naderimagham S, Nagel G, Naidu BM, Najafi F, Nakamura H, Námešná J, Nang EEK, Nangia VB, Narake S, Ndiaye NC, Neal WA, Nejatizadeh A, Nenko I, Neovius M, Nguyen CT, Nguyen ND, Nguyen QV, Nguyen QN, Nieto-Martínez RE, Niiranen TJ, Nikitin YP, Ninomiya T, Nishtar S, Njelekela MA, Noale M, Noboa OA, Noorbala AA, Norat T, Nordendahl M, Nordestgaard BG, Noto D, Nowak-Szczepanska N, Nsour MA, Nunes B, O'Neill TW, O'Reilly D, Ochimana C, Oda E, Odili AN, Oh K, Ohara K, Ohtsuka R, Olié V, Olinto MTA, Oliveira IO, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Ortiz PJ, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pahomova E, Paiva KMD, Pająk A, Palli D, Palmieri L, Pan WH, Panda-Jonas S, Panza F, Paoli M, Papandreou D, Park SW, Park S, Parnell WR, Parsaeian M, Pasquet P, Patel ND, Pavlyshyn H, Pećin I, Pednekar MS, Pedro JM, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peres KGDA, Peres MA, Peters A, Petkeviciene J, Peykari N, Pham ST, Pichardo RN, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Polašek O, Porta M, Poudyal A, Pourfarzi F, Pourshams A, Poustchi H, Pradeepa R, Price AJ, Price JF, Providencia R, Puhakka SE, Puiu M, Punab M, Qasrawi RF, Qorbani M, Queiroz D, Quoc Bao T, Radić I, Radisauskas R, Rahimikazerooni S, Rahman M, Raitakari O, Raj M, Rakhimova EM, Ramachandra Rao S, Ramachandran A, Ramos E, Rampal L, Rampal S, Rangel Reina DA, Rarra V, Rech CR, Redon J, Reganit PFM, Regecová V, Revilla L, Rezaianzadeh A, Ribeiro R, Riboli E, Richter A, Rigo F, Rinke de Wit TF, Ritti-Dias RM, Robitaille C, Rodríguez-Artalejo F, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Roggenbuck U, Rojas-Martinez R, Romaguera D, Romeo EL, Rosengren A, Roy JGR, Rubinstein A, Ruidavets JB, Ruiz-Betancourt BS, Ruiz-Castell M, Rusakova IA, Russo P, Rutkowski M, Sabanayagam C, Sabbaghi H, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saidi O, Sakarya S, Saki N, Salanave B, Salazar Martinez E, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sans S, Santos DA, Santos IS, Santos LC, Santos MP, Santos R, Saramies JL, Sardinha LB, Sarganas G, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schargrodsky H, Schipf S, Schmidt CO, Schnohr P, Schöttker B, Schramm S, Schultsz C, Schutte AE, Sebert S, Sein AA, Sen A, Senbanjo IO, Sepanlou SG, Servais J, Shalnova SA, Shamah-Levy T, Shamshirgaran M, Shanthirani CS, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shayesteh AA, Shi Z, Shibuya K, Shimizu-Furusawa H, Shin DW, Shirani M, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Silva CRDM, Silva DAS, Simon M, Simons J, Simons LA, Sjöström M, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobngwi E, Söderberg S, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Song Y, Sørensen TIA, Sørgjerd EP, Sorić M, Sossa Jérome C, Soumaré A, Sparboe-Nilsen B, Sparrenberger K, Staessen JA, Starc G, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stronks K, Strufaldi MW, Suka M, Sun CA, Sung YT, Suriyawongpaisal P, Sy RG, Syddall HE, Sylva RC, Szklo M, Tai ES, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarqui-Mamani CB, Taylor A, Taylor J, Tebar WR, Tell GS, Tello T, Tham YC, Thankappan KR, 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Mohamud WN, Wanderley Júnior RDS, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Wei W, Weres A, Werner B, Whincup PH, Widhalm K, Wiecek A, Wilks RJ, Willeit J, Willeit P, Williams EA, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong TY, Woo J, Wu FC, Wu S, Wyszynska J, Xu H, Xu L, Yaacob NA, Yan W, Yang L, Yang X, Yang Y, Yasuharu T, Ye X, Yiallouros PK, Yoosefi M, Yoshihara A, You SL, Younger-Coleman NO, Yusoff AF, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zapata ME, Zaw KK, Zejglicova K, Zeljkovic Vrkic T, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhen S, Zheng Y, Zholdin B, Zhu D, Zins M, Zitt E, Zocalo Y, Zoghlami N, Zuñiga Cisneros J, Ezzati M. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398:957-980. [PMID: 34450083 PMCID: PMC8446938 DOI: 10.1016/s0140-6736(21)01330-1] [Citation(s) in RCA: 938] [Impact Index Per Article: 312.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING WHO.
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Iurilli MLC, Zhou B, Bennett JE, Carrillo-Larco RM, Sophiea MK, Rodriguez-Martinez A, Bixby H, Solomon BD, Taddei C, Danaei G, Di Cesare M, Stevens GA, Riley LM, Savin S, Cowan MJ, Bovet P, Damasceno A, Chirita-Emandi A, Hayes AJ, Ikeda N, Jackson RT, Khang YH, Laxmaiah A, Liu J, Miranda JJ, Saidi O, Sebert S, Sorić M, Starc G, Gregg EW, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Ghaffar SA, Rahim HFA, Abu-Rmeileh NM, Garba JA, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Lahou B, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiri P, Amougou N, Amouyel P, Bo Andersen L, Anderssen SA, Ängquist L, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Auvinen J, Avdicová M, Avi S, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Jørgensen MB, Baharudin A, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Baran J, Barbagallo CM, Barceló A, Barkat A, Barros AJD, Barros MVG, Basit A, Bastos JLD, Bata I, Batieha AM, Batista RL, Battakova Z, Batyrbek A, Baur LA, Beaglehole R, Bel-Serrat S, Belavendra A, Romdhane HB, Benedics J, Benet M, Bergh IH, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bezerra J, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bhutta ZA, Bi H, Bi Y, Bia D, Lele ECB, Bikbov MM, Bista B, Bjelica DJ, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Bobak M, Boddy LM, Boehm BO, Boeing H, Boggia JG, Bogova E, Boissonnet CP, Bojesen SE, Bonaccio M, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Braeckevelt L, Braeckman L, Bragt MCE, Brajkovich I, Branca F, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Brinduse L, Brophy S, Bruno G, Bueno-de-Mesquita HB, Bugge A, Buoncristiano M, Burazeri G, Burns C, de León AC, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Cañete F, Capanzana MV, Capková N, Capuano E, Capuano V, Cardol M, Cardoso VC, Carlsson AC, Carmuega E, Carvalho J, Casajús JA, Casanueva FF, Celikcan E, Censi L, Cervantes-Loaiza M, Cesar JA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Rahim NCA, Li Chee M, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Cheraghian B, Chetrit A, Chikova-Iscener E, Chiolero A, Chiou ST, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cilia M, Cinteza E, Claessens F, Clarke J, Clays E, Cohen E, Concin H, Confortin SC, Cooper C, Coppinger TC, Corpeleijn E, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Crujeiras AB, Csilla S, Cucu AM, Cui L, Cureau FV, Czenczek-Lewandowska E, D'Arrigo G, d'Orsi E, Dacica L, Re Saavedra MÁD, Dallongeville J, Damsgaard CT, Dankner R, 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Velika B, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Villalpando S, Vineis P, Vioque J, Virtanen JK, Visser M, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Voutilainen A, Voutilainen S, Vrijheid M, Vrijkotte TGM, Wade AN, Wagner A, Waldhör T, Walton J, Wambiya EOA, Bebakar WMW, Mohamud WNW, de Souza Wanderley Júnior R, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Wedderkopp N, Weerasekera D, Weghuber D, Wei W, Weres A, Werner B, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu J, Wu LJ, Wu S, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yaseri M, Yasuharu T, Ye X, Yiallouros PK, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Md Yusof S, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Ko Zaw K, Zdrojewski T, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Cisneros JZ, Zuziak M, Ezzati M, Filippi S. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. eLife 2021; 10:e60060. [PMID: 33685583 PMCID: PMC7943191 DOI: 10.7554/elife.60060] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023] Open
Abstract
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nayu Ikeda
- National Institutes of Biomedical Innovation, Health and Nutrition
| | | | | | | | - Jing Liu
- Capital Medical University Beijing An Zhen Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Shoaib Afzal
- University of Copenhagen
- Copenhagen University Hospital
| | | | | | | | | | | | | | - Ali Ahmadi
- Shahrekord University of Medical Sciences
| | | | | | | | | | - Kamel Ajlouni
- National Center for Diabetes, Endocrinology and Genetics
| | | | | | | | | | | | | | | | | | | | | | | | - Eman Aly
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | - Parisa Amiri
- Research Center for Social Determinants of Health
| | | | | | | | | | | | | | | | | | - Joana Araújo
- Institute of Public Health of the University of Porto
| | | | | | | | | | | | | | | | | | | | | | | | - Shina Avi
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abdul Basit
- Baqai Institute of Diabetology and Endocrinology
| | | | | | | | | | | | | | | | | | | | | | | | - Judith Benedics
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | - Hongsheng Bi
- Shandong University of Traditional Chinese Medicine
| | - Yufang Bi
- Shanghai Jiao-Tong University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - João Breda
- World Health Organization Regional Office for Europe
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laura Censi
- Council for Agricultural Research and Economics
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Angela Chetrit
- The Gertner Institute for Epidemiology and Health Policy Research
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Cora L Craig
- Canadian Fitness and Lifestyle Research Institute
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rachel Dankner
- The Gertner Institute for Epidemiology and Health Policy Research
| | | | | | | | - Luc Dauchet
- University of Lille
- Lille University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jia Li Duan
- Beijing Center for Disease Prevention and Control
| | | | | | | | | | | | | | - Anar Dushpanova
- Scuola Superiore Sant'Anna
- Al-Farabi Kazakh National University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Günther Fink
- Swiss Tropical and Public Health Institute
- University of Basel
| | | | | | | | - Heba M Fouad
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | | | | | | | | | | | | | | | | | | | | | - Mihai Gafencu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcel Goldberg
- Institut National de la Santé et de la Recherche Médicale
- Paris University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yin Guo
- Capital Medical University Beijing Tongren Hospital
| | | | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jie Hao
- Beijing Institute of Ophthalmology
| | | | | | | | | | | | | | - Yuan He
- National Research Institute for Health and Family Planning
| | - Yuna He
- Chinese Center for Disease Control and Prevention
| | | | | | | | | | | | - Ana Henriques
- Institute of Public Health of the University of Porto
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jost B Jonas
- Institute of Molecular and Clinical Ophthalmology Basel
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yves Kameli
- French National Research Institute for Sustainable Development
| | | | | | | | | | | | | | | | | | - Joanne Katz
- Johns Hopkins Bloomberg School of Public Health
| | | | | | | | | | | | | | | | | | - Roya Kelishadi
- Research Institute for Primordial Prevention of Non-communicable Disease
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Slawomir Koziel
- PASs Hirszfeld Institute of Immunology and Experimental Therapy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Edwige Landais
- French National Research Institute for Sustainable Development
| | - Vera Lanska
- Institute for Clinical and Experimental Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xu Lin
- University of Chinese Academy of Sciences
| | | | | | | | | | | | - Lijuan Liu
- Capital Medical University Beijing Tongren Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xu Ma
- National Research Institute for Health and Family Planning
| | | | | | | | | | - Stefania Maggi
- Institute of Neuroscience of the National Research Council
| | | | | | | | | | - Bernard Maire
- French National Research Institute for Sustainable Development
| | | | | | - Päivi Mäki
- Finnish Institute for Health and Welfare
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jaume Marrugat
- CIBERCV
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jie Mi
- Capital Institute of Pediatrics
| | | | | | | | | | | | | | - GK Mini
- Women’s Social and Health Studies Foundation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marie Moitry
- University of Strasbourg
- Strasbourg University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jorge Motta
- Instituto Conmemorativo Gorgas de Estudios de la Salud
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jana Námešná
- Banska Bystrica Regional Authority of Public Health
| | | | | | | | | | | | | | | | | | | | - Keiu Nelis
- National Institute for Health Development
| | - Liis Nelis
- National Institute for Health Development
| | | | | | | | | | | | | | | | - Yury P Nikitin
- SB RAS Federal Research Center Institute of Cytology and Genetics
| | - Guang Ning
- Shanghai Jiao-Tong University School of Medicine
| | | | | | - Marianna Noale
- Institute of Neuroscience of the National Research Council
| | | | | | | | | | | | | | | | | | | | - Eha Nurk
- National Institute for Health Development
| | | | | | | | | | | | | | - Kyungwon Oh
- Korea Centers for Disease Control and Prevention
| | | | - Claes Ohlsson
- University of Gothenburg
- Sahlgrenska University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Domenico Palli
- Institute for Cancer Research, Prevention and Clinical Network
| | | | | | | | | | | | - Francesco Panza
- IRCCS Ente Ospedaliero Specializzato in Gastroenterologia S. de Bellis
| | | | | | - Suyeon Park
- Korea Centers for Disease Control and Prevention
| | | | | | - Ionela M Pascanu
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS
| | | | | | | | | | | | | | | | | | | | | | - Raluca M Pop
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | - Miquel Porta
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Puiu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | - Manu Raj
- Amrita Institute of Medical Sciences
| | | | | | - Ivo Rakovac
- World Health Organization Regional Office for Europe
| | | | | | | | | | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Rito
- National Institute of Health Doutor Ricardo Jorge
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paola Russo
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | - Nader Saki
- Ahvaz Jundishapur University of Medical Sciences
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Savvas Savva
- Research and Education Institute of Child Health
| | - Mathilde Savy
- French National Research Institute for Sustainable Development
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aletta E Schutte
- University of New South Wales
- The George Institute for Global Health
| | | | | | | | - Abhijit Sen
- Center for Oral Health Services and Research Mid-Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alfonso Siani
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | | | | | | | | | - Liam Smeeth
- London School of Hygiene & Tropical Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Igor Spiroski
- Institute of Public Health
- Ss. Cyril and Methodius University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lucjan Szponar
- National Institute of Public Health – National Institute of Hygiene
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Pierre Traissac
- French National Research Institute for Sustainable Development
| | | | | | | | - Oanh TH Trinh
- University of Medicine and Pharmacy at Ho Chi Minh City
| | | | | | | | | | | | | | | | | | | | | | - Gilad Twig
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | - Eunice Ugel
- Universidad Centro-Occidental Lisandro Alvarado
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anette Varbo
- Copenhagen University Hospital
- University of Copenhagen
| | | | | | | | - Tomas Vega
- Consejería de Sanidad Junta de Castilla y León
| | | | | | | | | | | | | | | | - Lucie Viet
- National Institute for Public Health and the Environment
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ningli Wang
- Capital Medical University Beijing Tongren Hospital
| | | | | | | | | | | | | | - Adelheid Weber
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Bogdan Wojtyniak
- National Institute of Public Health - National Institute of Hygiene
| | | | | | | | | | - Jean Woo
- The Chinese University of Hong Kong
| | | | | | - Jianfeng Wu
- Shandong University of Traditional Chinese Medicine
| | | | | | - Haiquan Xu
- Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs
| | - Liang Xu
- Beijing Institute of Ophthalmology
| | | | | | - Weili Yan
- Children's Hospital of Fudan University
| | | | | | - Yang Yang
- Shanghai Educational Development Co. Ltd
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yi Zeng
- Peking University
- Duke University
| | | | | | - Dong Zhao
- Capital Medical University Beijing An Zhen Hospital
| | | | - Wenhua Zhao
- Chinese Center for Disease Control and Prevention
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention
| | | | | | | | - Maigeng Zhou
- Chinese Center for Disease Control and Prevention
| | - Dan Zhu
- Inner Mongolia Medical University
| | - Marie Zins
- Institut National de la Santé et de la Recherche Médicale
- Paris University
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Meisinger C, Menezes AMB, Menon GR, Mensink GBM, Menzano MT, Mereke A, Meshram II, Metspalu A, Mi J, Michaelsen KF, Michels N, Mikkel K, Milkowska K, Miller JC, Minderico CS, Mini GK, Miquel JF, Miranda JJ, Mirjalili MR, Mirkopoulou D, Mirrakhimov E, Mišigoj-Durakovic M, Mistretta A, Mocanu V, Modesti PA, Moghaddam SS, Mohajer B, Mohamed MK, Mohamed SF, Mohammad K, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Mohd Yusoff MF, Mohebbi I, Mohebi F, Moitry M, Molbo D, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monroy-Valle M, Monterrubio-Flores E, Monyeki KDK, Moon JS, Moosazadeh M, Moreira LB, Morejon A, Moreno LA, Morgan K, Morin SN, Mortensen EL, Moschonis G, Mossakowska M, Mostafa A, Mota-Pinto A, Mota J, Motlagh ME, Motta J, Moura-dos-Santos MA, Mridha MK, Msyamboza KP, Mu TT, Muc M, Mugoša B, Muiesan ML, Mukhtorova P, Müller-Nurasyid M, Murphy N, Mursu J, Murtagh EM, Musa KI, Music Milanovic S, Musil V, Mustafa N, Nabipour I, Naderimagham S, Nagel G, Naidu BM, Najafi F, Nakamura H, Námešná J, Nang EEK, Nangia VB, Nankap M, Narake S, Nardone P, Nauck M, Neal WA, Nejatizadeh A, Nelis K, Nelis L, Nenko I, Neovius M, Nervi F, Nguyen CT, Nguyen D, Nguyen QN, Nieto-Martínez RE, Nikitin YP, Ning G, Ninomiya T, Nishtar S, Noale M, Noboa OA, Nogueira H, Norat T, Nordendahl M, Nordestgaard BG, Noto D, Nowak-Szczepanska N, Nsour MA, Nuhoglu I, Nurk E, O'Neill TW, O'Reilly D, Obreja G, Ochimana C, Ochoa-Avilés AM, Oda E, Oh K, Ohara K, Ohlsson C, Ohtsuka R, Olafsson Ö, Olinto MTA, Oliveira IO, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Ortiz AP, Ortiz PJ, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pagkalos I, Pahomova E, Paiva KMD, Pajak A, Palli D, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Panza F, Papandreou D, Park SW, Park S, Parnell WR, Parsaeian M, Pascanu IM, Pasquet P, Patel ND, Pednekar MS, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peres MA, Pérez-Farinós N, Pérez CM, Peterkova V, Peters A, Petersmann A, Petkeviciene J, Petrauskiene A, Pettenuzzo E, Peykari N, Pham ST, Pichardo RN, Pierannunzio D, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Poh BK, Pohlabeln H, Pop RM, Popovic SR, Porta M, Posch G, Poudyal A, Poulimeneas D, Pouraram H, Pourfarzi F, Pourshams A, Poustchi H, Pradeepa R, Price AJ, Price JF, Providencia R, Puder JJ, Pudule I, Puhakka SE, Puiu M, Punab M, Qasrawi RF, Qorbani M, Quoc Bao T, Radic I, Radisauskas R, Rahimikazerooni S, Rahman M, Rahman M, Raitakari O, Raj M, Rakhimova E, Rakhmatulloev S, Rakovac I, Ramachandra Rao S, Ramachandran A, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Rarra V, Rascon-Pacheco RA, Rasmussen M, Rech CR, Redon J, Reganit PFM, Regecová V, Revilla L, Rezaianzadeh A, Ribas-Barba L, Ribeiro R, Riboli E, Richter A, Rigo F, Rinaldo N, Rinke de Wit TF, Rito A, Ritti-Dias RM, Rivera JA, Robitaille C, Roccaldo R, Rodrigues D, Rodríguez-Artalejo F, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Roggenbuck U, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Romeo EL, Rosario RV, Rosengren A, Rouse I, Roy JGR, Rubinstein A, Rühli FJ, Ruidavets JB, Ruiz-Betancourt BS, Ruiz Moreno E, Rusakova IA, Russell Jonsson K, Russo P, Rust P, Rutkowski M, Sabanayagam C, Sacchini E, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saidi O, Saki N, Salanave B, Salazar Martinez E, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Samoutian M, Sánchez-Abanto J, Sandjaja, Sans S, Santa Marina L, Santos DA, Santos IS, Santos LC, Santos MP, Santos O, Santos R, Santos Sanz S, Saramies JL, Sardinha LB, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Savy M, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schaffrath Rosario A, Schargrodsky H, Schienkiewitz A, Schindler K, Schipf S, Schmidt CO, Schmidt IM, Schnohr P, Schöttker B, Schramm S, Schramm S, Schröder H, Schultsz C, Schutte AE, Sebert S, Sein AA, Selamat R, Sember V, Sen A, Senbanjo IO, Sepanlou SG, Sequera V, Serra-Majem L, Servais J, Ševcíková L, Shalnova SA, Shamah-Levy T, Shamshirgaran M, Shanthirani CS, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shayesteh AA, Shengelia L, Shi Z, Shibuya K, Shimizu-Furusawa H, Shin DW, Shin Y, Shirani M, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Silva AM, Silva DAS, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skodje G, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobek G, Sobngwi E, Sodemann M, Söderberg S, Soekatri MYE, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Song Y, Sørensen TIA, Sørgjerd EP, Soric M, Sossa Jérome C, Soto-Rojas VE, Soumaré A, Sovic S, Sparboe-Nilsen B, Sparrenberger K, Spinelli A, Spiroski I, Staessen JA, Stamm H, Starc G, Stathopoulou MG, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stevanovic R, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stoyanova E, Stratton G, Stronks K, Strufaldi MW, Sturua L, Suárez-Medina R, Suka M, Sun CA, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Swinburn BA, Sy RG, Syddall HE, Sylva RC, Szklo M, Szponar L, Tai ES, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Taxová Braunerová R, Taylor A, Taylor J, Tchibindat F, Tebar WR, Tell GS, Tello T, Thankappan KR, Theobald H, Theodoridis X, Thijs L, Thomas N, Thuesen BH, Tichá L, Timmermans EJ, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Torheim LE, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Traissac P, Tran TTH, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsugane S, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Tynelius P, Tzotzas T, Tzourio C, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, Van der Heyden J, van der Schouw YT, Van Herck K, Van Minh H, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Varona-Pérez P, Vasan SK, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Villalpando S, Vineis P, Vioque J, Virtanen JK, Visser M, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Völzke H, Voutilainen A, Voutilainen S, Vrijheid M, Vrijkotte TGM, Wade AN, Wagner A, Waldhör T, Walton J, Wambiya EOA, Wan Bebakar WM, Wan Mohamud WN, Wanderley Júnior RDS, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Wedderkopp N, Weerasekera D, Weghuber D, Wei W, Weres A, Werner B, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu J, Wu LJ, Wu S, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yaseri M, Yasuharu T, Ye X, Yiallouros PK, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zdrojewski T, Zeljkovic Vrkic T, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zocalo Y, Zuñiga Cisneros J, Zuziak M, Ezzati M. Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants. Lancet 2020; 396:1511-1524. [PMID: 33160572 PMCID: PMC7658740 DOI: 10.1016/s0140-6736(20)31859-6] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/03/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. METHODS For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. FINDINGS We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. INTERPRETATION The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. FUNDING Wellcome Trust, AstraZeneca Young Health Programme, EU.
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Mouratidou T, Mesana Graffe MI, Huybrechts I, De Decker E, De Craemer M, Androutsos O, Manios Y, Galcheva S, Lateva M, Gurzkowska B, Kułaga Z, Birnbaum J, Koletzko B, Moreno LA. Reproducibility and relative validity of a semiquantitative food frequency questionnaire in European preschoolers: The ToyBox study. Nutrition 2019; 65:60-67. [PMID: 31029924 DOI: 10.1016/j.nut.2019.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/09/2019] [Accepted: 03/13/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to examine the reproducibility and relative validity of a semiquantitative food frequency questionnaire (FFQ) in assessing food group estimates. METHODS Food group estimates were assessed via a 37-item FFQ and a 3-d food record (FR). Pearson's correlation coefficients for log-transformed values were calculated to assess the reproducibility and Spearman's rank correlation coefficients for log-transformed values were calculated to assess the validity. Kindergartens from six European countries participated in the preparatory substudies of the ToyBox intervention study; data from preschool children 4 to 6 y of age (n = 196, reproducibility study; n = 324, validation study) were obtained. RESULTS In the reproducibility study, positive Pearson's correlation coefficients for single and aggregated food groups ranged from 0.14 for pasta and rice to 0.90 for cooked vegetables. In the validation study, the FR gave higher estimates of 40 of the 50 food items (single and aggregated) examined compared with those obtained from the FFQ. Positive crude Spearman rank correlation coefficients ranged from 0.01 for total beverages (added sugar) and rice to 0.62 for tea. Corrections for the deattenuation effect did not improve observed correlations. Quartiles and tertiles were calculated for a small number of food groups (N = 14) owing to zero consumption in the rest of the groups. CONCLUSIONS Moderately good reproducibility and low-moderate relative validity of the FFQ used in preschool children was observed. Relative validity, however, varied by food and beverage group; for some of the "key" foods/drinks targeted in the ToyBox intervention (e.g., biscuits), the validity was good. The findings should be considered in future epidemiologic and intervention studies in preschool children.
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Affiliation(s)
- Theodora Mouratidou
- Instituto Agroalimentario de Aragón (IA2). University of Zaragoza, Zaragoza, Spain
| | - María Isabel Mesana Graffe
- Instituto Agroalimentario de Aragón (IA2). University of Zaragoza, Zaragoza, Spain; Instituto de Investigqación Sanitaria de Aragón, Centro de Investigación Biomédica de Aragón (CIBA) Avda. San Juan Bosco, 13. 50009. Zaragoza, Spain; Red de Salud Materno-infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain; Red de Salud Materno-infantil y del Desarrollo.
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium; International Agency for Research on Cancer, Lyon, France
| | - Ellen De Decker
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Yanis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | | | | | | | | | - Julia Birnbaum
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Luis Alberto Moreno
- Instituto Agroalimentario de Aragón (IA2). University of Zaragoza, Zaragoza, Spain; Instituto de Investigqación Sanitaria de Aragón, Centro de Investigación Biomédica de Aragón (CIBA) Avda. San Juan Bosco, 13. 50009. Zaragoza, Spain; Red de Salud Materno-infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición
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Grajda A, Kułaga Z, Gurzkowska B, Góźdź M, Wojtyło M, Litwin M. The weight status of school-age children and its association with gross domestic product. Dev Period Med 2019; 21:179-185. [PMID: 29077557 PMCID: PMC8522949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/05/2017] [Indexed: 11/08/2023]
Abstract
THE AIM To examine the possible relationship between the prevalence of underweight, overweight and obesity of Polish children and adolescents and the gross domestic product per capita (GDP). MATERIAL AND METHODS This report is based on the results of a nationwide, representative population study. An area of the country, the so-called Eastern Poland, where GDP per capita is less than 80% of the national average, was designated, based on the data from the Central Statistical Office of Poland (CSOP) and was compared with the rest of the country. The frequency of underweight, normal weight, overweight and obesity, as well as the odds ratio were calculated for gender and region of residence. The body mass index (BMI) for age and sex was standardized and expressed as z-score. The statistical significance of standardized mean differences of BMI depending on the area was examined using the t-test. RESULTS There were significant differences in the prevalence of underweight, overweight and obesity between the regions analyzed. The region of Eastern Poland was characterized by a lower risk of overweight and obesity and an increased risk of underweight in comparison with the rest of the country. CONCLUSIONS Identification of the diverse prevalence of overweight and underweight depending on the region and determined according to the economic status is an opportunity to modify and adapt the strategy of implementing programs aimed at promoting healthy behaviours.
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Affiliation(s)
- Aneta Grajda
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Zbigniew Kułaga
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Beata Gurzkowska
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Magdalena Góźdź
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Małgorzata Wojtyło
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Mieczysław Litwin
- Nephrology and Hypertension Department of the Children’s Memorial Health Institute, Warsaw, Poland
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Zhou B, Bentham J, Di Cesare M, Bixby H, Danaei G, Hajifathalian K, Taddei C, Carrillo-Larco RM, Djalalinia S, Khatibzadeh S, Lugero C, Peykari N, Zhang WZ, Bennett J, Bilano V, Stevens GA, Cowan MJ, Riley LM, Chen Z, Hambleton IR, Jackson RT, Kengne AP, Khang YH, Laxmaiah A, Liu J, Malekzadeh R, Neuhauser HK, Sorić M, Starc G, Sundström J, Woodward M, Ezzati M, Abarca-Gómez L, Abdeen ZA, Abu-Rmeileh NM, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Aguilar-Salinas CA, Agyemang C, Ahmad NA, Ahmadvand A, Ahrens W, Ajlouni K, Akhtaeva N, Al-Raddadi R, Ali MM, Ali O, Alkerwi A, Aly E, Amarapurkar DN, Amouyel P, Amuzu A, Andersen LB, Anderssen SA, Ängquist LH, Anjana RM, Ansong D, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arlappa N, Arveiler D, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Avdicová M, Azevedo A, Azizi F, Babu BV, Bahijri S, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Barbagallo CM, Barceló A, Barkat A, Barros AJD, Barros MV, Bata I, Batieha AM, Batyrbek A, Baur LA, Beaglehole R, Romdhane HB, Benet M, Benson LS, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bi Y, Bikbov M, Bista B, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Blokstra A, Bo S, Bobak M, Boeing H, Boggia JG, Boissonnet CP, Bongard V, Borchini R, Bovet P, Braeckman L, Brajkovich I, Branca F, Breckenkamp J, Brenner H, Brewster LM, Bruno G, Bueno-de-Mesquita HB, Bugge A, Burns C, Bursztyn M, de León AC, Cacciottolo J, Cai H, Cameron C, Can G, Cândido APC, Capuano V, Cardoso VC, Carlsson AC, Carvalho MJ, Casanueva FF, Casas JP, Caserta CA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Dekkaki IC, Chetrit A, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Cho Y, Christofaro DG, Chudek J, Cifkova R, Cinteza E, Claessens F, Clays E, Concin H, Cooper C, Cooper R, Coppinger TC, Costanzo S, Cottel D, Cowell C, Craig CL, Crujeiras AB, Cruz JJ, D'Arrigo G, d'Orsi E, Dallongeville J, Damasceno A, Danaei G, Dankner R, Dantoft TM, Dauchet L, Davletov K, De Backer G, De Bacquer D, de Gaetano G, De Henauw S, de Oliveira PD, De Smedt D, Deepa M, Dehghan A, Delisle H, Deschamps V, Dhana K, Di Castelnuovo AF, Dias-da-Costa JS, Diaz A, Dickerson TT, Djalalinia S, Do HTP, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Doua K, Drygas W, Dulskiene V, Džakula A, Dzerve V, Dziankowska-Zaborszczyk E, Eggertsen R, Ekelund U, El Ati J, Elliott P, Elosua R, Erasmus RT, Erem C, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Evans A, Faeh D, Fall CH, Farzadfar F, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrari M, Ferreccio C, Ferrieres J, Finn JD, Fischer K, Föger B, Foo LH, Forslund AS, Forsner M, Fouad HM, Francis DK, do Carmo Franco M, Franco OH, Frontera G, Fuchs FD, Fuchs SC, Fujita Y, Furusawa T, Gaciong Z, Galvano F, Garcia-de-la-Hera M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gates L, Geleijnse JM, Ghasemian A, Ghimire A, Giampaoli S, Gianfagna F, Gill TK, Giovannelli J, Goldsmith RA, Gonçalves H, Gonzalez-Gross M, González-Rivas JP, Gorbea MB, Gottrand F, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grøntved A, Grosso G, Gruden G, Grujic V, Gu D, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter M, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutierrez L, Gutzwiller F, Hadaegh F, Halkjær J, Hambleton IR, Hardy R, Hari Kumar R, Hata J, Hayes AJ, He J, He Y, Elisabeth M, Henriques A, Cadena LH, Herrala S, Heshmat R, Hihtaniemi IT, Ho SY, Ho SC, Hobbs M, Hofman A, Dinc GH, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Than Htike MM, Hu Y, Huerta JM, Huisman M, Husseini AS, Huybrechts I, Hwalla N, Iacoviello L, Iannone AG, Ibrahim MM, Wong NI, Ikeda N, Ikram MA, Irazola VE, Islam M, al-Safi Ismail A, Ivkovic V, Iwasaki M, Jackson RT, Jacobs JM, Jaddou H, Jafar T, Jamrozik K, Janszky I, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jeong SL, Jiang CQ, Joffres M, Johansson M, Jokelainen JJ, Jonas JB, Jørgensen T, Joshi P, Jóźwiak J, Juolevi A, Jurak G, Jureša V, Kaaks R, Kafatos A, Kajantie EO, Kalter-Leibovici O, Kamaruddin NA, Karki KB, Kasaeian A, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva G, Keil U, Boker LK, Keinänen-Kiukaanniemi S, Kelishadi R, Kemper HCG, Kengne AP, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khang YH, Khateeb M, Khaw KT, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim J, Kim YY, Klumbiene J, Knoflach M, Kolle E, Kolsteren P, Korrovits P, Koskinen S, Kouda K, Kowlessur S, Koziel S, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kuciene R, Kuh D, Kujala UM, Kulaga Z, Krishna Kumar R, Kurjata P, Kusuma YS, Kuulasmaa K, Kyobutungi C, Laatikainen T, Lachat C, Lam TH, Landrove O, Lanska V, Lappas G, Larijani B, Laugsand LE, Laxmaiah A, Le Nguyen Bao K, Le TD, Leclercq C, Lee J, Lee J, Lehtimäki T, León-Muñoz LM, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lind L, Linneberg A, Lissner L, Litwin M, Liu J, Lorbeer R, Lotufo PA, Lozano JE, Luksiene D, Lundqvist A, Lunet N, Lytsy P, Ma G, Ma J, Machado-Coelho GLL, Machi S, Maggi S, Magliano DJ, Magriplis E, Majer M, Makdisse M, Malekzadeh R, Malhotra R, Mallikharjuna Rao K, Malyutina S, Manios Y, Mann JI, Manzato E, Margozzini P, Marques-Vidal P, Marques LP, Marrugat J, Martorell R, Mathiesen EB, Matijasevich A, Matsha TE, Mbanya JCN, Mc Donald Posso AJ, McFarlane SR, McGarvey ST, McLachlan S, McLean RM, McLean SB, McNulty BA, Mediene-Benchekor S, Medzioniene J, Meirhaeghe A, Meisinger C, Menezes AMB, Menon GR, Meshram II, Metspalu A, Meyer HE, Mi J, Mikkel K, Miller JC, Minderico CS, Francisco J, Miranda JJ, Mirrakhimov E, Mišigoj-Durakovic M, Modesti PA, Mohamed MK, Mohammad K, Mohammadifard N, Mohan V, Mohanna S, Mohd Yusoff MF, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monyeki KDK, Moon JS, Moreira LB, Morejon A, Moreno LA, Morgan K, Moschonis G, Mossakowska M, Mostafa A, Mota J, Esmaeel Motlagh M, Motta J, Msyamboza KP, Mu TT, Muiesan ML, Müller-Nurasyid M, Murphy N, Mursu J, Musil V, Nabipour I, Nagel G, Naidu BM, Nakamura H, Námešná J, Nang EEK, Nangia VB, Narake S, Nauck M, Navarrete-Muñoz EM, Ndiaye NC, Neal WA, Nenko I, Neovius M, Nervi F, Neuhauser HK, Nguyen CT, Nguyen ND, Nguyen QN, Nguyen QV, Nieto-Martínez RE, Niiranen TJ, Ning G, Ninomiya T, Nishtar S, Noale M, Noboa OA, Noorbala AA, Norat T, Noto D, Al Nsour M, O'Reilly D, Oda E, Oehlers G, Oh K, Ohara K, Olinto MTA, Oliveira IO, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pahomova E, Pajak A, Palli D, Palmieri L, Pan WH, Panda-Jonas S, Panza F, Papandreou D, Park SW, Parnell WR, Parsaeian M, Patel ND, Pecin I, Pednekar MS, Peer N, Peeters PH, Peixoto SV, Peltonen M, Pereira AC, Peters A, Petersmann A, Petkeviciene J, Peykari N, Pham ST, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pitakaka F, Piwonska A, Plans-Rubió P, Polašek O, Porta M, Portegies MLP, Pourshams A, Poustchi H, Pradeepa R, Prashant M, Price JF, Puder JJ, Puiu M, Punab M, Qasrawi RF, Qorbani M, Bao TQ, Radic I, Radisauskas R, Rahman M, Raitakari O, Raj M, Ramachandra Rao S, Ramachandran A, Ramos E, Rampal L, Rampal S, Rangel Reina DA, Redon J, Reganit PFM, Ribeiro R, Riboli E, Rigo F, Rinke de Wit TF, Ritti-Dias RM, Robinson SM, Robitaille C, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Rojas-Martinez R, Romaguera D, Ronkainen K, Rosengren A, Roy JGR, Rubinstein A, Sandra Ruiz-Betancourt B, Rutkowski M, Sabanayagam C, Sachdev HS, Saidi O, Sakarya S, Salanave B, Salazar Martinez E, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sans S, Santos DA, Santos IS, Nunes dos Santos R, Santos R, Saramies JL, Sardinha LB, Sarganas G, Sarrafzadegan N, Saum KU, Savva S, Scazufca M, Schargrodsky H, Schipf S, Schmidt CO, Schöttker B, Schultsz C, Schutte AE, Sein AA, Sen A, Senbanjo IO, Sepanlou SG, Sharma SK, Shaw JE, Shibuya K, Shin DW, Shin Y, Si-Ramlee K, Siantar R, Sibai AM, Santos Silva DA, Simon M, Simons J, Simons LA, Sjöström M, Skovbjerg S, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Smith MC, Snijder MB, So HK, Sobngwi E, Söderberg S, Solfrizzi V, Sonestedt E, Song Y, Sørensen TIA, Soric M, Jérome CS, Soumare A, Staessen JA, Starc G, Stathopoulou MG, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stronks K, Strufaldi MW, Sun CA, Sundström J, Sung YT, Suriyawongpaisal P, Sy RG, Shyong Tai E, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarqui-Mamani CB, Tautu OF, Taylor A, Theobald H, Theodoridis X, Thijs L, Thuesen BH, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Tormo MJ, Torrent M, Traissac P, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Tynelius P, Tzourio C, Ueda P, Ugel EE, Ulmer H, Uusitalo HMT, Valdivia G, Valvi D, van der Schouw YT, Van Herck K, Van Minh H, van Rossem L, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Vatten L, Vega T, Velasquez-Melendez G, Veronesi G, Monique Verschuren WM, Verstraeten R, Victora CG, Viet L, Viikari-Juntura E, Vineis P, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vlasoff T, Vollenweider P, Voutilainen S, Wade AN, Wagner A, Walton J, Wan Bebakar WM, Wan Mohamud WN, Wanderley RS, Wang MD, Wang Q, Wang YX, Wang YW, Wannamethee SG, Wareham N, Wedderkopp N, Weerasekera D, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wijga AH, Wilks RJ, Willeit J, Willeit P, Williams EA, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong JYY, Wong TY, Woo J, Woodward M, Giwercman Wu A, Wu FC, Wu S, Xu H, Yan W, Yang X, Ye X, Yiallouros PK, Yoshihara A, Younger-Coleman NO, Yusoff AF, Zainuddin AA, Zambon S, Zampelas A, Zdrojewski T, Zeng Y, Zhao D, Zhao W, Zheng W, Zheng Y, Zhu D, Zhussupov B, Zimmermann E, Cisneros JZ. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants. Int J Epidemiol 2018; 47:872-883i. [PMID: 29579276 PMCID: PMC6005056 DOI: 10.1093/ije/dyy016] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. METHODS We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. RESULTS In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. CONCLUSIONS Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.
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Manios Y, Androutsos O, Katsarou C, Vampouli EA, Kulaga Z, Gurzkowska B, Iotova V, Usheva N, Cardon G, Koletzko B, Moreno LA, De Bourdeaudhuij I. Prevalence and sociodemographic correlates of overweight and obesity in a large Pan-European cohort of preschool children and their families: the ToyBox study. Nutrition 2018; 55-56:192-198. [PMID: 30121021 DOI: 10.1016/j.nut.2018.05.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/26/2018] [Accepted: 05/04/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Health inequalities are observed among different regions and socioeconomic groups. The present study aimed to record the prevalence of overweight and obesityamong preschoolers across six European countries in relation to sociodemographic and family factors. METHODS A total of 7554 preschool-aged children and their parents participated in the ToyBox-study. Children's weight and height were measured and parents self-reported their weight, height, and family sociodemographic data using questionnaires. Data were obtained in May and June 2012. RESULTS The prevalence of overweight and obesity ranged from 10.0% in Germany to 20.6% in Greece and was found to be higher in children from low socioeconomic status (SES) families as well as children with two overweight or obese parents. Children from low-SES families and children with overweight or obese parents were more likely to be overweight or obese compared with their peers from medium- or high-SES families or those with normal-weight parents, respectively. CONCLUSIONS In a large sample of European preschoolers, the prevalence of overweight and obesity was found to be higher in Southern and Eastern European countries compared with Central and Northern European countries. Higher prevalence was recorded among low-SES families and in children with overweight or obese parents, which indicates that these areas and vulnerable groups need to be prioritized to close the gap in health and social inequalities and provide more effective prevention of early childhood obesity.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece.
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Christina Katsarou
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Eleni Anna Vampouli
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | | | | | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Natalya Usheva
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
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Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, Adams RJ, Aekplakorn W, Afsana K, Aguilar-Salinas CA, Agyemang C, Ahmadvand A, Ahrens W, Ajlouni K, Akhtaeva N, Al-Hazzaa HM, Al-Othman AR, Al-Raddadi R, Al Buhairan F, Al Dhukair S, Ali MM, Ali O, Alkerwi A, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amouyel P, Amuzu A, Andersen LB, Anderssen SA, Andrade DS, Ängquist LH, Anjana RM, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arlappa N, Arveiler D, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Avdicová M, Azevedo A, Azizi F, Babu BV, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Barbagallo CM, Barceló A, Barkat A, Barros AJD, Barros MVG, Bata I, Batieha AM, Batista RL, Batyrbek A, Baur LA, Beaglehole R, Romdhane HB, Benedics J, Benet M, Bennett JE, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bhatti Z, Bhutta ZA, Bi H, Bi Y, Biehl A, Bikbov M, Bista B, Bjelica DJ, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Blokstra A, Bo S, Bobak M, Boddy LM, Boehm BO, Boeing H, Boggia JG, Boissonnet CP, Bonaccio M, Bongard V, Bovet P, Braeckevelt L, Braeckman L, Bragt MCE, Brajkovich I, Branca F, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Brinduse L, Bruno G, Bueno-de-Mesquita HB, Bugge A, Buoncristiano M, Burazeri G, Burns C, de León AC, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Capanzana M, Capuano V, Cardoso VC, Carlsson AC, Carvalho MJ, Casanueva FF, Casas JP, Caserta CA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Chetrit A, Chikova-Iscener E, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Cho Y, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cinteza E, Claessens F, Clays E, Concin H, Confortin SC, Cooper C, Cooper R, Coppinger TC, Costanzo S, Cottel D, Cowell C, Craig CL, Crujeiras AB, Cucu A, D'Arrigo G, d'Orsi E, Dallongeville J, Damasceno A, Damsgaard CT, Danaei G, Dankner R, Dantoft TM, Dastgiri S, Dauchet L, Davletov K, De Backer G, De Bacquer D, De Curtis A, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder K, De Smedt D, Deepa M, Deev AD, Dehghan A, Delisle H, Delpeuch F, Deschamps V, Dhana K, Di Castelnuovo AF, Dias-da-Costa JS, Diaz A, Dika Z, Djalalinia S, Do HTP, Dobson AJ, Donati MB, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Doua K, Drygas W, Duan JL, Duante C, Duleva V, Dulskiene V, Dzerve V, Dziankowska-Zaborszczyk E, Egbagbe EE, Eggertsen R, Eiben G, Ekelund U, El Ati J, Elliott P, Engle-Stone R, Erasmus RT, Erem C, Eriksen L, Eriksson JG, la Peña JED, Evans A, Faeh D, Fall CH, Sant'Angelo VF, Farzadfar F, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrari M, Ferreccio C, Ferrieres J, Finn JD, Fischer K, Flores EM, Föger B, Foo LH, Forslund AS, Forsner M, Fouad HM, Francis DK, Franco MDC, Franco OH, Frontera G, Fuchs FD, Fuchs SC, Fujita Y, Furusawa T, Gaciong Z, Gafencu M, Galeone D, Galvano F, Garcia-de-la-Hera M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gates L, Geiger H, Geleijnse JM, Ghasemian A, Giampaoli S, Gianfagna F, Gill TK, Giovannelli J, Giwercman A, Godos J, Gogen S, Goldsmith RA, Goltzman D, Gonçalves H, González-Leon M, González-Rivas JP, Gonzalez-Gross M, Gottrand F, Graça AP, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grøntved A, Grosso G, Gruden G, Grujic V, Gu D, Gualdi-Russo E, Guallar-Castillón P, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter M, Guo X, Guo Y, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutierrez L, Gutzwiller F, Hadaegh F, Hadjigeorgiou CA, Si-Ramlee K, Halkjær J, Hambleton IR, Hardy R, Kumar RH, Hassapidou M, Hata J, Hayes AJ, He J, Heidinger-Felso R, Heinen M, Hendriks ME, Henriques A, Cadena LH, Herrala S, Herrera VM, Herter-Aeberli I, Heshmat R, Hihtaniemi IT, Ho SY, Ho SC, Hobbs M, Hofman A, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Petrescu CH, Huisman M, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Iannone AG, Ibarluzea JM, Ibrahim MM, Ikeda N, Ikram MA, Irazola VE, Islam M, Ismail AAS, Ivkovic V, Iwasaki M, Jackson RT, Jacobs JM, Jaddou H, Jafar T, Jamil KM, Jamrozik K, Janszky I, Jarani J, Jasienska G, Jelakovic A, Jelakovic B, Jennings G, Jeong SL, Jiang CQ, Jiménez-Acosta SM, Joffres M, Johansson M, Jonas JB, Jørgensen T, Joshi P, Jovic DP, Józwiak J, Juolevi A, Jurak G, Jureša V, Kaaks R, Kafatos A, Kajantie EO, Kalter-Leibovici O, Kamaruddin NA, Kapantais E, Karki KB, Kasaeian A, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva G, Keil U, Boker LK, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Kengne AP, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khang YH, Khateeb M, Khaw KT, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim J, Kim YY, Klimont J, Klumbiene J, Knoflach M, Koirala B, Kolle E, Kolsteren P, Korrovits P, Kos J, Koskinen S, Kouda K, Kovacs VA, Kowlessur S, Koziel S, Kratzer W, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kuciene R, Kuh D, Kujala UM, Kulaga Z, Kumar RK, Kunešová M, Kurjata P, Kusuma YS, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Landrove O, Lanska V, Lappas G, Larijani B, Laugsand LE, Lauria L, Laxmaiah A, Bao KLN, Le TD, Lebanan MAO, Leclercq C, Lee J, Lee J, Lehtimäki T, León-Muñoz LM, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lind L, Linneberg A, Lissner L, Litwin M, Liu J, Loit HM, Lopes L, Lorbeer R, Lotufo PA, Lozano JE, Luksiene D, Lundqvist A, Lunet N, Lytsy P, Ma G, Ma J, Machado-Coelho GLL, Machado-Rodrigues AM, Machi S, Maggi S, Magliano DJ, Magriplis E, Mahaletchumy A, Maire B, Majer M, Makdisse M, Malekzadeh R, Malhotra R, Rao KM, Malyutina S, Manios Y, Mann JI, Manzato E, Margozzini P, Markaki A, Markey O, Marques LP, Marques-Vidal P, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Marventano S, Masoodi SR, Mathiesen EB, Matijasevich A, Matsha TE, Mazur A, Mbanya JCN, McFarlane SR, McGarvey ST, McKee M, McLachlan S, McLean RM, McLean SB, McNulty BA, Yusof SM, Mediene-Benchekor S, Medzioniene J, Meirhaeghe A, Meisfjord J, Meisinger C, Menezes AMB, Menon GR, Mensink GBM, Meshram II, Metspalu A, Meyer HE, Mi J, Michaelsen KF, Michels N, Mikkel K, Miller JC, Minderico CS, Miquel JF, Miranda JJ, Mirkopoulou D, Mirrakhimov E, Mišigoj-Durakovic M, Mistretta A, Mocanu V, Modesti PA, Mohamed MK, Mohammad K, Mohammadifard N, Mohan V, Mohanna S, Yusoff MFM, Molbo D, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monterrubio EA, Monyeki KDK, Moon JS, Moreira LB, Morejon A, Moreno LA, Morgan K, Mortensen EL, Moschonis G, Mossakowska M, Mostafa A, Mota J, Mota-Pinto A, Motlagh ME, Motta J, Mu TT, Muc M, Muiesan ML, Müller-Nurasyid M, Murphy N, Mursu J, Murtagh EM, Musil V, Nabipour I, Nagel G, Naidu BM, Nakamura H, Námešná J, Nang EEK, Nangia VB, Nankap M, Narake S, Nardone P, Navarrete-Muñoz EM, Neal WA, Nenko I, Neovius M, Nervi F, Nguyen CT, Nguyen ND, Nguyen QN, Nieto-Martínez RE, Ning G, Ninomiya T, Nishtar S, Noale M, Noboa OA, Norat T, Norie S, Noto D, Nsour MA, O'Reilly D, Obreja G, Oda E, Oehlers G, Oh K, Ohara K, Olafsson Ö, Olinto MTA, Oliveira IO, Oltarzewski M, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Ortiz AP, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pahomova E, Pajak A, Palli D, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Panza F, Papandreou D, Park SW, Parnell WR, Parsaeian M, Pascanu IM, Patel ND, Pecin I, Pednekar MS, Peer N, Peeters PH, Peixoto SV, Peltonen M, Pereira AC, Perez-Farinos N, Pérez CM, Peters A, Petkeviciene J, Petrauskiene A, Peykari N, Pham ST, Pierannunzio D, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Plans-Rubió P, Poh BK, Pohlabeln H, Pop RM, Popovic SR, Porta M, Portegies MLP, Posch G, Poulimeneas D, Pouraram H, Pourshams A, Poustchi H, Pradeepa R, Prashant M, Price JF, Puder JJ, Pudule I, Puiu M, Punab M, Qasrawi RF, Qorbani M, Bao TQ, Radic I, Radisauskas R, Rahman M, Rahman M, Raitakari O, Raj M, Rao SR, Ramachandran A, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Rascon-Pacheco RA, Redon J, Reganit PFM, Ribas-Barba L, Ribeiro R, Riboli E, Rigo F, de Wit TFR, Rito A, Ritti-Dias RM, Rivera JA, Robinson SM, Robitaille C, Rodrigues D, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Ronkainen K, Rosengren A, Rouse I, Roy JGR, Rubinstein A, Rühli FJ, Ruiz-Betancourt BS, Russo P, Rutkowski M, Sabanayagam C, Sachdev HS, Saidi O, Salanave B, Martinez ES, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sandjaja, Sans S, Marina LS, Santos DA, Santos IS, Santos O, dos Santos RN, Santos R, Saramies JL, Sardinha LB, Sarrafzadegan N, Saum KU, Savva S, Savy M, Scazufca M, Rosario AS, Schargrodsky H, Schienkiewitz A, Schipf S, Schmidt CO, Schmidt IM, Schultsz C, Schutte AE, Sein AA, Sen A, Senbanjo IO, Sepanlou SG, Serra-Majem L, Shalnova SA, Sharma SK, Shaw JE, Shibuya K, Shin DW, Shin Y, Shiri R, Siani A, Siantar R, Sibai AM, Silva AM, Silva DAS, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skovbjerg S, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Smith MC, Snijder MB, So HK, Sobngwi E, Söderberg S, Soekatri MYE, Solfrizzi V, Sonestedt E, Song Y, Sørensen TIA, Soric M, Jérome CS, Soumare A, Spinelli A, Spiroski I, Staessen JA, Stamm H, Starc G, Stathopoulou MG, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stratton G, Stronks K, Strufaldi MW, Suárez-Medina R, Sun CA, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Swinburn BA, Sy RG, Szponar L, Tai ES, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Tautu OF, Braunerová RT, Taylor A, Tchibindat F, Theobald H, Theodoridis X, Thijs L, Thuesen BH, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Tormo MJ, Tornaritis MJ, Torrent M, Toselli S, Traissac P, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsugane S, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Tynelius P, Tzotzas T, Tzourio C, Ueda P, Ugel EE, Ukoli FAM, Ulmer H, Unal B, Uusitalo HMT, Valdivia G, Vale S, Valvi D, van der Schouw YT, Van Herck K, Van Minh H, van Rossem L, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Vatten L, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Viikari-Juntura E, Vineis P, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vlasoff T, Vollenweider P, Völzke H, Voutilainen S, Vrijheid M, Wade AN, Wagner A, Waldhör T, Walton J, Bebakar WMW, Mohamud WNW, Wanderley RS, Wang MD, Wang Q, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Wedderkopp N, Weerasekera D, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wijga AH, Wilks RJ, Willeit J, Willeit P, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong JYY, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu J, Wu S, Xu H, Xu L, Yamborisut U, Yan W, Yang X, Yardim N, Ye X, Yiallouros PK, Yngve A, Yoshihara A, You QS, Younger-Coleman NO, Yusoff F, Yusoff MFM, Zaccagni L, Zafiropulos V, Zainuddin AA, Zambon S, Zampelas A, Zamrazilová H, Zdrojewski T, Zeng Y, Zhao D, Zhao W, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zhussupov B, Zimmermann E, Cisneros JZ, Bentham J, Di Cesare M, Bilano V, Bixby H, Zhou B, Stevens GA, Riley LM, Taddei C, Hajifathalian K, Lu Y, Savin S, Cowan MJ, Paciorek CJ, Chirita-Emandi A, Hayes AJ, Katz J, Kelishadi R, Kengne AP, Khang YH, Laxmaiah A, Li Y, Ma J, Miranda JJ, Mostafa A, Neovius M, Padez C, Rampal L, Zhu A, Bennett JE, Danaei G, Bhutta ZA, Ezzati M. 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. Lancet 2017; 390:2627-2642. [PMID: 29029897 PMCID: PMC5735219 DOI: 10.1016/s0140-6736(17)32129-3] [Citation(s) in RCA: 3623] [Impact Index Per Article: 517.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/12/2017] [Accepted: 07/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND 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. METHODS 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). FINDINGS 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. INTERPRETATION 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. FUNDING Wellcome Trust, AstraZeneca Young Health Programme.
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Grajda A, Kułaga Z, Gurzkowska B, Góźdź M, Wojtyło M, Litwin M. The weight status of school-age children and its association with gross domestic product. Dev Period Med 2017. [PMID: 29077557 PMCID: PMC8522949 DOI: 10.34763/devperiodmed.20172103.179185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
THE AIM To examine the possible relationship between the prevalence of underweight, overweight and obesity of Polish children and adolescents and the gross domestic product per capita (GDP). MATERIAL AND METHODS This report is based on the results of a nationwide, representative population study. An area of the country, the so-called Eastern Poland, where GDP per capita is less than 80% of the national average, was designated, based on the data from the Central Statistical Office of Poland (CSOP) and was compared with the rest of the country. The frequency of underweight, normal weight, overweight and obesity, as well as the odds ratio were calculated for gender and region of residence. The body mass index (BMI) for age and sex was standardized and expressed as z-score. The statistical significance of standardized mean differences of BMI depending on the area was examined using the t-test. RESULTS There were significant differences in the prevalence of underweight, overweight and obesity between the regions analyzed. The region of Eastern Poland was characterized by a lower risk of overweight and obesity and an increased risk of underweight in comparison with the rest of the country. CONCLUSIONS Identification of the diverse prevalence of overweight and underweight depending on the region and determined according to the economic status is an opportunity to modify and adapt the strategy of implementing programs aimed at promoting healthy behaviours.
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Affiliation(s)
- Aneta Grajda
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland,Mieczysław Litwin Nephrology and Hypertension Department of The Children’s Memorial Health Institute Al. Dzieci Polskich 20, 04-730 Warsaw, Poland Phone: (+48 22) 815-11-45 Fax: (+48 22) 815-13-87
| | - Zbigniew Kułaga
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Beata Gurzkowska
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Magdalena Góźdź
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Małgorzata Wojtyło
- Public Health Department of the Children’s Memorial Health Institute, Warsaw, Poland
| | - Mieczysław Litwin
- Nephrology and Hypertension Department of the Children’s Memorial Health Institute, Warsaw, Poland,Mieczysław Litwin Nephrology and Hypertension Department of The Children’s Memorial Health Institute Al. Dzieci Polskich 20, 04-730 Warsaw, Poland Phone: (+48 22) 815-11-45 Fax: (+48 22) 815-13-87
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Gurzkowska B, Kułaga Z, Grajda A, Góźdź M, Wojtyło M, Litwin M. The relationship between selected socioeconomic factors and thinness among Polish school-aged children and adolescents. Eur J Pediatr 2017; 176:797-806. [PMID: 28451759 PMCID: PMC5432588 DOI: 10.1007/s00431-017-2912-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 04/06/2017] [Accepted: 04/17/2017] [Indexed: 11/26/2022]
Abstract
UNLABELLED The analysis was performed on a database including 17,427 records of subjects aged 7-18 years, randomly sampled from a population of Polish students. Thinness was determined using international cut-off points, defined to pass through body mass index of 18.5 kg/m2 at the age of 18. The weighted prevalence of thinness and odds ratios with 95% confidence interval were estimated for gender, birth weight, level of schooling and school location, gross domestic product (GDP) per inhabitant, family income and maternal education. Body height was analysed according to body mass and birth weight categories. The prevalence of thinness was higher among children with low birth weight and among girls. The prevalence of thinness decreased with increasing GDP per inhabitant. In analysis by level of schooling: primary-middle-secondary, prevalence of thinness decreased among boys and increased among girls. Thin students were significantly shorter than other students, and thin girls less likely participated in physical education. CONCLUSION Gender and socioeconomic factors are important determinants of thinness among Polish children and adolescents. Public health strategies should address family eating practices to prevent negative effects of weight deficit, especially among girls/children from low GDP regions. What is Known: • Socioeconomic factors and gender influence weight status of children and adolescents. What is New: • The first time the prevalence and determinants of thinness based on data from a nationally representative, weighted sample of Polish children aged 7-18 years were presented. • The analysis shows how gender and socioeconomics determinants influence the prevalence of thinness among children and adolescent in post-transformation country and can be used to international comparisons.
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Affiliation(s)
- Beata Gurzkowska
- Public Health Department, The Children’s Memorial Health Institute, al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Zbigniew Kułaga
- Public Health Department, The Children’s Memorial Health Institute, al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Aneta Grajda
- Public Health Department, The Children’s Memorial Health Institute, al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Magdalena Góźdź
- Public Health Department, The Children’s Memorial Health Institute, al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Małgorzata Wojtyło
- Public Health Department, The Children’s Memorial Health Institute, al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Mieczysław Litwin
- Department of Nephrology and Arterial Hypertension, The Children’s Memorial Health Institute, al. Dzieci Polskich 20, 04-730 Warsaw, Poland
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Grajda A, Kułaga Z, Gurzkowska B, Wojtyło M, Góźdź M, Litwin M. Preschool children blood pressure percentiles by age and height. J Hum Hypertens 2016; 31:400-408. [PMID: 28032626 DOI: 10.1038/jhh.2016.90] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 11/09/2022]
Abstract
We aimed to construct blood pressure (BP) references for the Polish preschool children and to compare them with the United States, German and European references. BP was measured oscillometrically using a validated device in 4378 randomly selected Polish children aged 3-6 years who were free of chronic diseases and behaved quietly during BP measurement. Height and weight were also measured. Gender-specific BP percentiles were constructed for age and height simultaneously with the use of quantile regression and a polynomial regression model. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure reference percentiles by gender, age and height are presented. The Polish preschool children's 90th and 95th SBP and DBP percentiles were mostly lower than those in the United States, German and IDEFICS study BP references. Compared with the German oscillometric BP reference and with the United States sphygmomanometric BP reference, differences in the 95th SBP percentiles ranged by age from -5 to 0 mm Hg and from -2 to -1 mm Hg, in boys and girls, respectively, whereas the differences in the 95th percentiles of DBP ranged from -7 to -1 mm Hg and from -5 to -1 mm Hg, in boys and girls, respectively. Polish preschool children's BP percentiles based on measurements with the use of a validated oscillometric device in a nationally representative sample are lower than those from the current United States, German and European references. When interpreting BP measurements in children, adequate referential values should be used.
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Affiliation(s)
- A Grajda
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - Z Kułaga
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - B Gurzkowska
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - M Wojtyło
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - M Góźdź
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - M Litwin
- Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
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Grajda A, Kułaga Z, Gurzkowska B, Góźdź M, Wojtyło M, Litwin M. Trends in external causes of child and adolescent mortality in Poland, 1999-2012. Int J Public Health 2016; 62:117-126. [PMID: 27766374 PMCID: PMC5288447 DOI: 10.1007/s00038-016-0908-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 09/29/2016] [Accepted: 10/11/2016] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To examine the pattern and trend of deaths due to external causes among Polish children and adolescents in 1999-2012, and to compare trends in Poland's neighboring countries. METHODS Death records were obtained from the Central Statistical Office of Poland. External causes mortality rates (MR) with 95 % confidence interval were calculated. The annual percentage change of MR was examined using linear regression. To compare MR with Belarus, Ukraine, Czech Republic and Germany, data from the European Mortality Database were used. RESULTS MR were the highest in the age 15-19 years (33.7/100,000) and among boys (22.7/100,000). Unintentional injuries including transport accidents, drowning, and suicides (especially in children over 10 years old), were the main cause of death in the analyzed groups. Between 1999 and 2012 annual MR for unintentional injuries declined substantially. MR due to injuries and poisoning in Poland were higher compared with Czech Republic and Germany and lower in comparison with Belarus and Ukraine. CONCLUSIONS Deaths due to unintentional injuries are still the leading cause of death among Polish children and adolescents. There are differences in death rates between Poland and neighboring countries.
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Affiliation(s)
- Aneta Grajda
- Department of Public Health, The Children's Memorial Health Institute, Warsaw, Poland
| | - Zbigniew Kułaga
- Department of Public Health, The Children's Memorial Health Institute, Warsaw, Poland.
| | - Beata Gurzkowska
- Department of Public Health, The Children's Memorial Health Institute, Warsaw, Poland
| | - Magdalena Góźdź
- Department of Public Health, The Children's Memorial Health Institute, Warsaw, Poland
| | - Małgorzata Wojtyło
- Department of Public Health, The Children's Memorial Health Institute, Warsaw, Poland
| | - Mieczysław Litwin
- Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
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Kułaga Z, Gurzkowska B, Grajda A, Wojtyło M, Góźdź M, Litwin M. The prevalence of overweight and obesity among Polish pre-school-aged children. Dev Period Med 2016; 20:143-149. [PMID: 27442700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED The aim of this study is to estimate the prevalence of overweight and obesity in a current, nationally representative, random sample of pre-school-aged children in Poland and to compare their overweight and obesity rates with their peers from the US and Norway. MATERIAL AND METHODS The height and weight were measured in a total of 5026 randomly sampled children aged 2-6 years and their Body Mass Index was calculated. The prevalence of overweight including obesity was determined using three definitions, i.e. those formulated by the International Obesity Task Force (IOTF), the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). RESULTS The overall prevalence of overweight including obesity in boys was 12.2%, 12.2%, 17.2% and in girls 15.0%, 10.0%, 19.1% according to the IOTF, WHO, CDC definition, respectively, and did not significantly differ in comparison with their US and Norwegian peers. The overall prevalence of obesity in boys was: 4.4%, 4.9%, 8.9% and in girls: 3.8%, 3.4%, 7.6%, according to the IOTF, WHO, CDC definition, respectively. Among Polish girls the obesity rate was higher compared to the female US peers. The obesity rate was higher in Polish boys compared to their Norwegian peers. CONCLUSION The estimates of the prevalence of overweight and obesity varied substantially by age group, gender and depending on the definition used. Obesity rates among Polish girls and boys were higher compared to their American and Norwegian peers. The influence of overweight definitions should be taken into account when studying childhood overweight and obesity. Overweight and obesity preventive programs should be implemented at preschool age.
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Affiliation(s)
- Zbigniew Kułaga
- Public Health Department of the Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland Phone: (+48 22) 815-11-45 Fax: (+48 22) 815-13-87 e-mail:
| | - Beata Gurzkowska
- Public Health Department of the Children's Memorial Health Institute, Warsaw, Poland
| | - Aneta Grajda
- Public Health Department of the Children's Memorial Health Institute, Warsaw, Poland
| | - Małgorzata Wojtyło
- Public Health Department of the Children's Memorial Health Institute, Warsaw, Poland
| | - Magdalena Góźdź
- Public Health Department of the Children's Memorial Health Institute, Warsaw, Poland
| | - Mieczysław Litwin
- Nephrology and Hypertension Department of the Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland e-mail:
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Kułaga Z, Grajda A, Gurzkowska B, Wojtyło M, Góźdź M, Litwin M. The prevalence of overweight and obesity among Polish school- aged children and adolescents. Przegl Epidemiol 2016; 70:641-651. [PMID: 28233966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
THE AIM The aim was to estimate the prevalence of overweight and obesity among Polish school-aged children and adolescents in a population-based, random sample. MATERIAL AND METHODS A total of 17 427 children and adolescents aged 7−18 years (8 327 boys) from a nationally representative random sample were examined from 2007 to 2009 in 416 schools in all regions of Poland. Height and weight were measured and body mass index was calculated. The prevalence of overweight and obesity was determined using three childhood obesity definitions: the Centers for Disease Control, the International Obesity Task Force, and the World Health Organization. RESULTS According to the definitions used, the prevalence of excess weight among children aged 7−12 years was in the range 21.7−30.4% and 18.4−23.2%, boys and girls, respectively. The prevalence of overweight and obesity among adolescents aged 13−18 years was in the range 14.6−19.4% and 10.3−13.0%, boys and girls, respectively, using international definitions of childhood overweight. The prevalence of obesity among children aged 7−12 years was in the range 5.5−13.1% and 3.6−6.4%, in boys and girls, respectively. The prevalence of obesity among adolescents aged 13−18 years was in the range3.4−5.0% and 2.0−2.6%, boys and girls, respectively. CONCLUSIONS The estimates of overweight and obesity prevalence varied substantially by age group, gender and the definition used. Comparing to the European countries, Poland had medium to high level of childhood and youth overweight and obesity prevalence. High prevalence of overweight and obesity among Polish children and adolescents requires implementation of public health approach to the problem.
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Affiliation(s)
- Zbigniew Kułaga
- The Children’s Memorial Health Institute, Public Health Department
| | - Aneta Grajda
- The Children’s Memorial Health Institute, Public Health Department
| | - Beata Gurzkowska
- The Children’s Memorial Health Institute, Public Health Department
| | | | - Magdalena Góźdź
- The Children’s Memorial Health Institute, Public Health Department
| | - Mieczysław Litwin
- The Children’s Memorial Health Institute, Department of Nephrology, Renal Transplantation and Hypertension
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Kułaga Z, Grajda A, Gurzkowska B, Góźdź M, Wojtyło M, Świąder A, Różdżyńska-Świątkowska A, Litwin M. Polish 2012 growth references for preschool children. Eur J Pediatr 2013; 172:753-61. [PMID: 23371392 PMCID: PMC3663205 DOI: 10.1007/s00431-013-1954-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 01/22/2013] [Indexed: 11/29/2022]
Abstract
UNLABELLED Growth references are useful in monitoring a child's growth, which is an essential part of child care. The aim of this paper is to provide updated growth references for Polish preschool children and to assess how well children in Poland match or diverge from the World Health Organization (WHO) growth standards/references and recent German height-for-age references. The height-, weight-, body mass index-for-age, and weight-for-height references were constructed with the LMS method using data from a recent, large, population-representative sample of 4,941 preschool children aged 3 to 6 years (the OLA study). In the case of boys, the third, 50th, and 97th height percentiles of new Polish and German references overlap almost completely, whereas the WHO growth standards/references percentiles are systematically lower. In the case of girls, comparison between the new Polish and German height references showed conformity on the third and 50th percentile, whereas body height values of the WHO standards/references are shorter. Polish children aged 3 to 6 years from for the nation representative sample, had significantly greater than zero mean z scores of height-, weight-, and BMI-for-age and weight-for-height, relative to the WHO growth standards/references. The number of children in the sample with height-for-age below -2 SD was significantly lower than expected and number of children with height-for-age above +2 SD was significantly higher than expected. CONCLUSION The OLA study growth references can be recommended as national references for preschool children in Poland.
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Affiliation(s)
- Zbigniew Kułaga
- Public Health Department, Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
| | - Aneta Grajda
- Public Health Department, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Beata Gurzkowska
- Public Health Department, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Magdalena Góźdź
- Public Health Department, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Małgorzata Wojtyło
- Public Health Department, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Anna Świąder
- Department of Paediatrics, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
| | | | - Mieczysław Litwin
- Nephrology and Hypertension Department, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
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Jaworski M, Kułaga Z, Płudowski P, Grajda A, Gurzkowska B, Napieralska E, Swiąder A, Pan H, Litwin M. Population-based centile curves for triceps, subscapular, and abdominal skinfold thicknesses in Polish children and adolescents--the OLAF study. Eur J Pediatr 2012; 171:1215-21. [PMID: 22430352 PMCID: PMC3401503 DOI: 10.1007/s00431-012-1717-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 02/29/2012] [Indexed: 11/30/2022]
Abstract
UNLABELLED Skinfold thicknesses are used as valid anthropometric indicators of regional body fatness. Actual population-based values for skinfold thicknesses for Polish children are not available. The purpose of this study was to provide population-based values for triceps, subscapular, and abdominal skinfold thicknesses in healthy children and adolescents. A total number of 17,416 boys and girls aged 6.5-18.5 years, randomly selected from whole Polish population of children and adolescents, were enrolled in the study. Skinfold thicknesses (triceps, subscapular, and abdominal) were measured using Harpenden skinfold caliper. All measurements were taken after the training of participating investigators. The LMS method was used to fit percentile curves across age for each skinfold. Q tests for fit were used to assess the global goodness of fit of our final models. The study shows for the first time smoothed population-based values of body fat distribution indices for Polish children and adolescents 7-18 years of age. Reported skinfold centiles are higher compared to previously established for Warsaw children and very close to the actual US data. CONCLUSION Our study provided for the first time population-based values for skinfold thicknesses evaluation in a way allowing to calculate reliable Z scores. The early detection of abnormal fat stores, using our population-based values and respective Z scores, may be now implemented for practice.
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Affiliation(s)
- Maciej Jaworski
- Department of Biochemistry and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
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Gurzkowska B, Grajda A, Kułaga Z, Napieralska E, Litwin M. Distribution of body mass index categories among Polish children and adolescents from rural and urban areas. Med Wieku Rozwoj 2011; 15:250-257. [PMID: 22006480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To demonstrate differences in nutritional status of school-aged children and adolescents depending on school localization (urban/rural), school level (elementary/middle) and gender. MATERIALS AND METHODS Results of current health survey 'Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland' - PL0080 OLAF were used in the analysis. Data were analysed by SAS. 9.2 for Windows, EpiInfo 3.5.1 and LMSgrowth. The frequency and the Odds Ratio of underweight, overweight, obesity and normal weight were calculated by school localization, school level and gender. RESULTS Data from 13 129 pupils were used in the analysis: 5 118 from elementary schools in urban areas, 3638 from elementary schools in rural areas, 2792 from middle schools in urban areas and 1581 from middle schools in rural areas. The frequency of normal weight was lower in urban compared with rural elementary schools (67.2% vs 70.0%; OR=0.88; p=0.005). The frequency of underweight, overweight and obesity was higher in urban compared with rural elementary schools, both boys and girls. The frequency of obesity was higher in urban middle schools than rural (3.0% vs 1.6%; OR=1.88; p=0.006). In the case of boys, statistically significant difference in frequency of overweight and obesity (together) was noted in urban middle schools compared to rural middle schools (16.7% vs 11.9%; OR=1.48; p=0.003). In the case of girls, the frequency of underweight was lower in urban compared with rural middle schools (12.7% vs 15.9%; OR= 0.77; p=0.032). CONCLUSIONS Knowing differences in the nutritional status between pupils in urban and rural areas gives the opportunity to modify nutritional education programmes depending on needs identified in the particular type of area and target groups. In urban regions, in both elementary and middle schools, boys are a risk group for excess body weight, and require more attention in preventive undertakings. In rural areas, girls in middle schools should be targeted for preventive measures dealing with underweight.
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Affiliation(s)
- Beata Gurzkowska
- The Children's Memorial Health Institute, Public Health Division, Warszawa.
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Grajda A, Kułaga Z, Gurzkowska B, Napieralska E, Litwin M. Regional differences in the prevalence of overweight, obesity and underweight among polish children and adolescents. Med Wieku Rozwoj 2011; 15:258-265. [PMID: 22006473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of the study was to compare the prevalence of overweight, obesity, and underweight in children and adolescents from different provinces in Poland. MATERIALS AND METHODS Data from the recent, large, population-representative sample of school-aged children and adolescents (N=17573) OLAF study: "Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland" - PL0080 OLAF were used in the analysis. The survey was conducted in all provinces of Poland (N=16). Data were analyzed using SAS 9.2, EpiInfo 3.5.1 and LMSgrowth software packages. The frequency of overweight, obesity, and underweight were determined. For overweight and obesity (jointly) and underweight the odds ratio (OR) was calculated for gender and voivodship of residence. The body mass index (BMI) was standardized and expressed as a z-score. The statistical significance of differences between BMI z-scores depending on voivodship of residence was assessed by the t-test. RESULTS Significant differences were found in the occurrence of overweight and obesity among the analysed regions, and voivodships with a lower (małopolskie, świętokrzyskie, lubelskie, and podkarpackie) and higher (mazowieckie) risk of overweight and obesity were identified. In case of underweight, łódzkie and podkarpackie (<0.040) provinces were higher risk areas, while mazowieckie (<0.001) had lower risk. The prevalence of overweight (including obesity) was higher compared to the prevalence of underweight in the majority of provinces (15 out of 16). CONCLUSIONS Analysis of regional differences in the prevalence of obesity, overweight and underweight in children and adolescents may point to the direction in which nationwide and local efforts should be made to reduce the inequalities stemming from nutritional status.
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Affiliation(s)
- Aneta Grajda
- Public Health Division, The Children's Memorial Health Institute, Warsaw.
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Kulaga Z, Litwin M, Tkaczyk M, Rózdzyńska A, Barwicka K, Grajda A, Swiader A, Gurzkowska B, Napieralska E, Pan H. The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references. BMC Public Health 2010; 10:109. [PMID: 20199693 PMCID: PMC2837854 DOI: 10.1186/1471-2458-10-109] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 03/04/2010] [Indexed: 12/02/2022] Open
Abstract
Background The growth of children is an indicator of health and society's wellbeing. Growth references are useful in monitoring a child's growth, which is a very important part of child care. Poland's growth references are not updated regularly. Although several growth reference ranges have been developed in Poland over recent years, sampling was restricted to urban populations of major cities. The aim of this study was to assess how well Polish children match with, or diverge from, regional charts and to compare them with international growth references. Methods Four Polish and two international (WHO 2007 and USCDC2000) growth references were used to calculate the height, weight and BMI z-scores in a recent, large, population-representative sample of school-aged children and adolescents in Poland. The distributions of z-scores were analysed with descriptive and inferential statistical methods. Results Mean height z-scores calculated with the use of the WHO 2007 and USCDC2000 references were positive and significantly different from zero over the entire age range. The mean height z-score was closest to zero in the Poznan reference for boys (0.05) and Warszawa reference for girls (0.01). Median weight z-scores were positive under all weight references over the entire age range with only the exception of 18-year-old girls' weight z-score calculated relative to USCDC2000. Median BMI z-scores were positive in males in early childhood, decreasing with age. In the case of girls, the median BMI z-score calculated using WHO 2007 and USCDC2000 was close to zero in early childhood, decreased in adolescents and reached minimum values at age 18 years. Median BMI z-scores calculated with the use of the Lodz reference fluctuated between 0.05 and 0.2 over the studied age range. Conclusions In this contemporary sample of Polish school-aged children, distributions of height, weight and BMI differed from those of children from the international growth references. These differences should be considered when using the references. There exist certain limitations to the analysis of height, weight, and BMI z-scores when Polish regional references are used.
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Affiliation(s)
- Zbigniew Kulaga
- Public Health Division, The Children's Memorial Health Institute, Warsaw, Poland
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Kułaga Z, Napieralska E, Gurzkowska B, Grajda A. [Trends in children and adolescents deaths due to suicide, event of undetermined intent and poisoning in Poland in the years 1999-2007]. Przegl Epidemiol 2010; 64:551-556. [PMID: 21473073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The purpose of the study was to examine children and adolescents sex- and age-specific trends in mortality due to suicide, undetermined death and poisoning from 1999 to 2007 in Poland. METHODS Anonymous deaths records were obtained from the Central Statistical Office and grouped according to the cause of death, age and sex. For each year and separately for 3-Year Moving Averages suicide and poisoning+undetermined death mortality rates were calculated. Time trends were analyzed by linear regression estimating annual percent change (APC) of the rates. Correlation between suicide and grouped poisoning and undetermined death was examined. RESULTS A significant increase was observed in girls aged 10-14 years suicide mortality (APC=17,0; p<0,05). Mortality due to suicide did not change significantly from 1999 to 2007 in boys aged 10-14 and 15-19 years, and girls 15-19 years of age. In these groups negative correlation between suicides and grouped poisoning and undetermined death was observed which may indicate hidden suicide in this category of death causes. CONCLUSIONS Monitoring suicide mortality should include observation of trends in undetermined death.
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Affiliation(s)
- Zbigniew Kułaga
- Zakład Zdrowia Publicznego Instytutu Pomnik-Centrum Zdrowia Dziecka.
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