首頁資訊 Lancet：1990年至2022年體重過輕和肥胖的全球趨勢：對2.22億兒童、青少年和成人的3663項人口代表性研究的匯總分析

Lancet：1990年至2022年體重過輕和肥胖的全球趨勢：對2.22億兒童、青少年和成人的3663項人口代表性研究的匯總分析

來源：泰然健康網(wǎng) 時間：2024年12月02日 22:54

本文由小咖機器人翻譯整理

期刊來源：Lancet

原文鏈接：https://doi.org/10.1016/S0140-6736(23)02750-2

摘要內(nèi)容如下：

背景

體重過輕和肥胖與整個生命過程中的不良健康后果有關(guān)。我們估計了從1990年到2022年200個國家和地區(qū)的成人和學齡兒童和青少年的體重不足或過瘦和肥胖的個體和綜合患病率及其變化。

方法

我們使用了3663項基于人群的研究的數(shù)據(jù)，這些研究有2.22億參與者，測量了普通人群代表性樣本的身高和體重。我們使用貝葉斯分層模型來估計從1990年到2022年200個國家和地區(qū)的不同BMI類別的流行趨勢，分別針對成人（年齡≥20歲）和學齡兒童和青少年（年齡5-19歲）。對于成人，我們報告了體重過輕（BMI<18.5 kg/m2）和肥胖（BMI≥30 kg/m2）的個體和合并患病率。對于學齡兒童和青少年，我們報告了消瘦（BMI<2 SD，低于WHO生長參考值的中位數(shù)）和肥胖（BMI>2 SD，高于中位數(shù)）。

調(diào)查結(jié)果

從1990年到2022年，在11個國家（6%）的女性和17個國家（9%）的男性中，成人體重不足和肥胖的綜合患病率有所下降，觀察到的變化是真實下降的后驗概率至少為0.80。在后驗概率至少為0.80的162個國家（81%）的女性和140個國家（70%）的男性中，合并患病率增加。2022年，體重不足和肥胖的綜合流行率在加勒比、波利尼西亞和密克羅尼西亞的島國以及中東和北非國家最高。2022年，在177個國家（89%）的女性和145個國家（73%）的男性中，肥胖率高于體重不足，后驗概率至少為0.80，而在16個國家（8%）的女性和39個國家（20%）的男性中，肥胖率高于體重不足。從1990年到2022年，在5個國家的女孩（3%）和15個國家的男孩（8%）中，瘦和肥胖的綜合患病率下降，后驗概率至少為0.80；在140個國家的女孩（70%）和137個國家的男孩（69%）中，瘦和肥胖的綜合患病率上升，后驗概率至少為0.80。2022年學齡兒童和青少年消瘦和肥胖綜合患病率最高的國家是波利尼西亞、密克羅尼西亞和加勒比地區(qū)的男性和女性，以及智利和卡塔爾的男性。在南亞的一些國家，如印度和巴基斯坦，綜合流行率也很高，盡管這些國家的消瘦程度有所下降，但仍然很普遍。2022年，學齡兒童和青少年的肥胖比瘦更普遍，在133個國家的女孩（67%）和125個國家的男孩（63%）中，后驗概率至少為0.80，而在35個國家（18%）和42個國家（21%）中，情況正好相反。在幾乎所有國家，無論是成年人還是學齡兒童和青少年，雙重負擔的增加都是由肥胖的增加引起的，而雙重負擔的減少則是由體重過輕或過瘦的減少引起的。

解釋

在大多數(shù)國家，體重不足和肥胖的綜合負擔因肥胖增加而加重，而在南亞和非洲部分地區(qū)，體重不足和過瘦現(xiàn)象仍然普遍存在。需要進行健康營養(yǎng)轉(zhuǎn)型，增加獲得營養(yǎng)食品的機會，以解決體重不足的剩余負擔，同時遏制和扭轉(zhuǎn)肥胖的增加。

英文原文如下：

Abstracts

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.

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