New dynamics in global obesity facing low- and middle-income countries.
TL;DR: There is growing potential for increased cardiometabolic problems linked with a large rightward shift in the BMI distribution and increased waist circumference at each BMI level in LMICs.
Abstract: Levels of overweight and obesity across low- and middle-income countries (LMIC) have approached levels found in higher-income countries. This is particularly true in the Middle East and North Africa and in Latin America and the Caribbean. Using nationally representative samples of women aged 19-49, n = 815,609, this paper documents the annualized rate of increase of overweight from the first survey in early 1990 to the last survey in the present millennium. Overweight increases ranged from 0.31% per year to 0.92% per year for Latin America and the Caribbean and for the Middle East and North Africa, respectively. For a sample of eight countries, using quantile regression, we further demonstrate that mean body mass index (BMI) at the 95th percentile has increased significantly across all regions, representing predicted weight increases of 5-10 kg. Furthermore we highlight a major new concern in LMICs, documenting waist circumference increases of 2-4 cm at the same BMI (e.g. 25) over an 18-year period. In sum, this paper indicates growing potential for increased cardiometabolic problems linked with a large rightward shift in the BMI distribution and increased waist circumference at each BMI level.
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TL;DR: It is proposed here that the main driving force now shaping the global food system is transnational food manufacturing, retailing and fast food service corporations whose businesses are based on very profitable, heavily promoted ultra‐processed products, many in snack form.
Abstract: The relationship between the global food system and the worldwide rapid increase of obesity and related diseases is not yet well understood. A reason is that the full impact of industrialized food processing on dietary patterns, including the environments of eating and drinking, remains overlooked and underestimated. Many forms of food processing are beneficial. But what is identified and defined here as ultra-processing, a type of process that has become increasingly dominant, at first in high-income countries, and now in middle-income countries, creates attractive, hyper-palatable, cheap, ready-to-consume food products that are characteristically energy-dense, fatty, sugary or salty and generally obesogenic. In this study, the scale of change in purchase and sales of ultra-processed products is examined and the context and implications are discussed. Data come from 79 high- and middle-income countries, with special attention to Canada and Brazil. Results show that ultra-processed products dominate the food supplies of high-income countries, and that their consumption is now rapidly increasing in middle-income countries. It is proposed here that the main driving force now shaping the global food system is transnational food manufacturing, retailing and fast food service corporations whose businesses are based on very profitable, heavily promoted ultra-processed products, many in snack form.
1,092 citations
Cites background from "New dynamics in global obesity faci..."
...These shifts have been accompanied by dramatic increases of obesity and related chronic non-communicable diseases, most notably diabetes, at first in high- and middle-income countries (9), and now also in lower-income countries (10)....
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TL;DR: Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals.
Abstract: The linkage of individuals with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID-19, 75 studies were used to conduct a series of meta-analyses on the relationship of individuals with obesity-COVID-19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID-19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID-19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30-1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74-2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46-2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22-1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID-19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.
747 citations
TL;DR: For women who are already obese, renewed efforts should be made towards improved management during pregnancy, especially of blood glucose, and increased attention to post-partum weight management.
657 citations
TL;DR: This poster presents a poster presented at the 2015 United Nations General Assembly of the United Nations Educational, Scientific and Cultural Organisation (UNESCO) entitled “On the Road to Sustainable Development: Foundations of Reproductive Health and Research, 2nd Ed.”
536 citations
Cites background from "New dynamics in global obesity faci..."
...While obesity has historically been a condition associated with affluence, there is some evidence to suggest a shift in the burden of overweight and obesity from advantaged to disadvantaged populations (32)....
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...Recent studies have reported a shift in the burden of overweight and obesity from advantaged to disadvantaged populations (32)....
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References
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TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.
11,809 citations
TL;DR: The proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight (> or =25 kg/m2), but available data do not necessarily indicate a clear BMI cut-offs point for all Asians for overweight or obesity.
9,536 citations
"New dynamics in global obesity faci..." refers background in this paper
...Although lower BMI thresholds demonstrate disease risk in some populations, the World Health Organization (WHO) recommends the BMI cutoff point of ≥25 for international comparisons of overweight (13)....
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TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
9,324 citations