Marwan El Ghoch. MD
The prevalence of overweight and obesity is increasing worldwide, however the burden of this disease remains uncertain. A recent study, published in the New England journal of Medicine, assembled data from 195 countries to model trends in overweight and obesity, and related morbidity and mortality. The study revealed two main findings.
First, investigators showed that the prevalence of obesity has more than doubled globally since 1980, and now is 5% in children and 12% in adults. Specifically, the prevalence of obesity has doubled in more than 70 countries and has continuously increased mostly in the others, in both adolescent and adult population. The most worrisome finding is the approximate tripling of obesity seen in youth and young adults comes from developing and middle-income countries such as China, Brazil, and Indonesia, since the early onset of obesity is likely to translate into a high cumulative incidence of type 2 diabetes, hypertension, and chronic kidney disease in adults.
Second, the high BMI accounted for 4.0 million deaths globally, and more than two thirds of deaths related to high BMI were due to cardiovascular disease. Asians have been shown to have a higher absolute risk of diabetes and hypertension and African Americans to have a lower risk of cardiovascular disease than other groups. However once chronic conditions such as diabetes and cardiovascular disease develop, the associated relative risk of death may vary according to location. For instance, it was recently seen that the relative risk of death associated with diabetes in Mexico widely exceeds that in the United States and Europe.
Despite these interesting findings, there are still gaps in the available data, and public health decision are needed for implementing at least three main interventions: (i) efficient and continuous surveillance systems to assess risk factors, prevalence, care, and outcomes of chronic diseases; (ii) cohorts in more diverse populations to capture variation in progression to outcomes; and (iii) platforms for natural experimental studies to determine which of the interventions are working locally and why are for sure needed.
Source: Health Effects of Overweight and Obesity in 195 Countries over 25 Years. (2017). New England Journal of Medicine. doi:10.1056/NEJMoa1614362