国际NCD风险因素协作组近日研究了1990年至2022年全球体重不足和肥胖趋势。相关论文于2024年2月29日发表在《柳叶刀》杂志上。

体重过轻和肥胖与整个生命过程中的不良健康预后有关。研究组估计了从1990年到2022年，200个国家和地区的成年人、学龄儿童和青少年体重不足或消瘦和肥胖的个体和综合患病率及其变化。

他们使用了3663项基于人群研究的数据，这些研究有2.22亿参与者，测量了普通人群代表性样本的身高和体重。使用贝叶斯层次模型来估计1990年至2022年200个国家和地区不同BMI类别的流行趋势，分别针对成人（年龄≥20岁）和学龄儿童和青少年（年龄5-19岁）。对于成年人，研究组报告了体重不足（BMI＜18.5 kg/m²）和肥胖（BMI≥30 kg/m²）的个体和综合患病率。对于学龄儿童和青少年，报告了消瘦（BMI＜2 SD，低于世界卫生组织生长参考中位数）和肥胖（BMI＞2 SD，高于中位数）的患病率。

从1990年到2022年，11个国家（6%）的女性和17个国家（9%）的成年人体重过轻和肥胖的综合患病率下降，观察到的变化是真实下降的后验概率至少为0.80。162个国家（81%）的女性和140个国家（70%）的男性的综合患病率增加，后验概率至少为0.80。2022年，加勒比岛国、波利尼西亚和密克罗尼西亚以及中东和北非国家的体重不足和肥胖综合患病率最高。

2022年，177个国家（89%）的女性和145个国家（73%）的肥胖患病率高于体重过轻，后验概率至少为0.80，而16个国家（8%）的女性和39个国家（20%）的男性情况正好相反。从1990年到2022年，5个国家的女孩（3%）和15个国家的男孩（8%）的消瘦与肥胖综合患病率下降，后验概率至少为0.80，140个国家的女生（70%）和137个国家的男生（69%）的消瘦和肥胖综合发病率上升，后验概率至少为0.8。

2022年，学龄儿童和青少年中消瘦和肥胖综合患病率最高的国家是波利尼西亚、密克罗尼西亚和加勒比地区的男孩女孩，智利和卡塔尔的男孩。在南亚的一些国家，如印度和巴基斯坦，综合患病率也很高，尽管消瘦现象有所下降，但这些国家仍然很普遍。2022年，在133个国家的女孩（67%）和125个国家的男孩（63%）中，学龄儿童和青少年肥胖比苗条更普遍，后验概率至少为0.80，而在35个国家（18%）和42个国家（21%）中，情况正好相反。在几乎所有国家，无论是成人还是学龄儿童和青少年，双重负担的增加都是由肥胖的增加推动的，而双重负担的减少则是由体重过轻或消瘦的减少推动的。

研究结果表明，在大多数国家，由于肥胖的增加，体重过轻和肥胖的综合负担有所增加，而体重过轻和消瘦在南亚和非洲部分地区仍然普遍存在。需要健康的营养转型，增加获得营养食品的机会，以解决体重过轻的剩余负担，同时遏制和扭转肥胖的增加。

附：英文原文

Title: Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Author: Nowell H Phelps, Rosie K Singleton, Bin Zhou, Rachel A Heap, Anu Mishra, James E Bennett, Christopher J Paciorek, Victor PF Lhoste, Rodrigo M Carrillo-Larco, Gretchen A Stevens, Andrea Rodriguez-Martinez, Honor Bixby, James Bentham, Mariachiara Di Cesare, Goodarz Danaei, Archie W Rayner, Ana Barradas-Pires, Melanie J Cowan, Stefan Savin, Leanne M Riley, Carlos A Aguilar-Salinas, Jennifer L Baker, Amina Barkat, Zulfiqar A Bhutta, Francesco Branca, Roberta B Caixeta, Sarah Cuschieri, Farshad Farzadfar, Shubash Ganapathy, Nayu Ikeda, Violeta Iotova, Andre P Kengne, Young-Ho Khang, Avula Laxmaiah, Hsien-Ho Lin, Jun Ma, Jean Claude N Mbanya, J Jaime Miranda, Rajendra Pradeepa, Fernando Rodríguez-Artalejo, Maroje Sori, Maria Turley, Limin Wang, Karen Webster-Kerr, Julie Aarestrup, Leandra Abarca-Gómez, Mohsen Abbasi-Kangevari, Ziad A Abdeen, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F Abdul Rahim, Zulfiya Abdurrahmonova, Niveen M Abu-Rmeileh, Jamila Abubakar Garba, Benjamin Acosta-Cazares, Ishag Adam, Marzena Adamczyk, Robert J Adams, Seth Adu-Afarwuah, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Valirie N Agbor, Imelda A Agdeppa, Javad Aghazadeh-Attari, sa gren, Hassan Aguenaou, Charles Agyemang, Mohamad Hasnan Ahmad, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadi, Imran Ahmed, Soheir H Ahmed, Wolfgang Ahrens, Gulmira Aitmurzaeva, Kamel Ajlouni, Hazzaa M Al-Hazzaa, Halima Al-Hinai, Badreya Al-Lahou, Jawad A Al-Lawati, Rajaa Al-Raddadi, Deena Al Asfoor, Huda M Al Hourani, Nawal M Al Qaoud, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Maryam A Aldwairji, Sylvia Alexius, Mohamed M Ali, Anna V Alieva, Abdullah Alkandari, Alaa Alkerwi, Buthaina M Alkhatib, Kristine Allin, Shaker A Alomary, Husam F Alomirah, Arwa M Alshangiti, Mar Alvarez-Pedrerol, Eman Aly, Deepak N Amarapurkar, Pilar Amiano Etxezarreta, John Amoah, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A Anderssen, Odysseas Androutsos, Lars ngquist, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Elena Anufrieva, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Nega Assefa, Thor Aspelund, Felix K Assah, Batyrbek Assembekov, Maria Cecília F Assuno, May Soe Aung, Correia Júnior Marco Aurélio de Valois, Juha Auvinen, Mária Avdiová, Shina Avi, Kishwar Azad, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Bontha V Babu, Flora Bacopoulou, Maja Bksgaard Jrgensen, Azli Baharudin, Suhad Bahijri, Izet Bajramovic, Marta Bakacs, Nagalla Balakrishna, Yulia Balanova, Mohamed Bamoshmoosh, Maciej Banach, José R Banegas, Joanna Baran, Rafa Baran, Carlo M Barbagallo

Issue&Volume: 2024-02-29

Abstract:

Background

Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.

Methods

We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median).

Findings

From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness.

Interpretation

The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.

DOI: 10.1016/S0140-6736(23)02750-2

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02750-2/abstract