Browsing by Author "Di Cesare, Mariachiara"

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    Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants
    (2016) Di Cesare, Mariachiara; Zuñiga Cisneros, Julio; Ezzati, Majid; Ochoa Avilés, Angélica María
    Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m² [underweight], 18·5 kg/m² to <20 kg/m², 20 kg/m² to <25 kg/m², 25 kg/m² to <30 kg/m², 30 kg/m² to <35 kg/m², 35 kg/m² to <40 kg/m², ≥40 kg/m² [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m² (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m² (24·0–24·4) in 2014 in men, and from 22·1 kg/m² (21·7–22·5) in 1975 to 24·4 kg/m² (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m² in central Africa and south Asia to 29·2 kg/m² (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m² (21·4–22·3) in south Asia to 32·2 kg/m² (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world’s men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m²). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women.Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world’s poorest regions, especially in south Asia.Funding Wellcome Trust, Grand Challenges Canada.
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    Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: a pooled analysis of population-based surveys
    (2020) Miranda, Jaime J; Carrillo Larco, Rodrigo M; Ferreccio, Catterina; Hambleton, Ian R; Bentham, James; Lotufo, Paulo A; Bixby, Honor; Taddei, Cristina; Andrade Tenesaca, Dolores Susana; Bernabe Ortiz, Antonio; Bettiol, Heloisa; Boggia de Izaguirre, josé Gabriel; Donoso Moscoso, Silvana Patricia; Ochoa Avilés, Angélica María; Di Cesare, Mariachiara; Nieto Martínez, Ramfis; Bin, Zhou; Hajifathalian, Kaveh; Abarca Gómez, Leandra; Acosta Cazares, Benjamin; Aguilar Salinas, Carlos A.; Assuncao , Maria Cecília F.; Barceló, Alberto; Dornellas de Barros, Aluísio Jardim; Gomes de Barros, Mauro Virgilio; Bata, Iqbal; Batista, Rosangela L; Brewster, Lizzy M; Cardoso, Viviane C; Chan, Queenie; Destro Christofaro, Diego Giulliano
    Background Describing the prevalence and trends of cardiometabolic risk factors that are associated with noncommunicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014. Methods We did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg), and diabetes (fasting plasma glucose ≥7·0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas. Findings 389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3·9% (95% CI 2·2–6·3) in 1980, to 18·6% (14·3–23·3) in 2014, in men; and from 12·2% (8·2–17·0) in 1980, to 30·5% (25·7–35·5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5·2% (2·1–10·4) in men and 6·4% (2·6–10·4) in women in 1980, to 11·1% (6·4–17·3) in men and 13·6% (8·2–21·0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27·6% (22·3–33·2) in men and 19·9% (15·8–24·4) in women in 1980, to 15·5% (11·1–20·9) in men and 10·7% (7·7–14·5) in women in 2014. Interpretation Despite the generally high prevalence of cardiometabolic risk factors across the Americas, estimates also showed a high level of heterogeneity in the transition between countries. The increasing prevalence of obesity and diabetes observed over time requires appropriate measures to deal with these public health challenges. Our results support a diversification of health interventions across subregions and countrie