The obesity epidemic used to be an American thing. Either it’s highly contagious or everybody else in the world is doing more of whatever we have been doing wrong because it’s happening and worsening globally now. Recently reporting on the global obesity epidemic is a report using data from before and during the Global Burden of Disease study at the University of Washington. (1)
The Global Burden of Disease Study (GBD) is a comprehensive regional and global research program of disease burden that assesses mortality and disability from major diseases, injuries, and risk factors. GBD is a collaboration of over 1,800 researchers from 127 countries. This project was originally started by the World Bank and then taken over by The World Health Organization and researchers at Harvard. It is now under principal investigator Christopher J.L. Murray, and based out of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and funded by the Bill and Melinda Gates Foundation.
In complicated charts and maps going back to 1980 it can be seen that all over the world obesity seems to have peaked and maybe plateaued in adults but continues to rise in children. The climb for everyone seems to have started in about 1990. These charts are complicated, even overwhelming, because they are segregated according to sex and 5 levels of a Sociodemographic Index (SDI).
Some other things that can be gleaned from this messy picture are:
– Poor countries where the priority is not starving to death rather than preventing obesity are also getting fatter.
– The biggest disease burden resulting from high body mass index (BMI) is heart disease – nearly 70% overall but 60% of those are from obesity rather than just overweight.
– However the prevalence of obesity is increasing much faster than the diseases it mostly causes.
– The minimum risk BMI overall is 20 to 25. This contradicts the finding that in different ethnic groups and geographic locations and Sociodemographic indices the risk might vary.
– The major risks of increased BMI are because of it’s association with blood pressure, cholesterol, and blood sugar levels all of which are treated much easier than the BMI level.
Some pardaxes of the messy picture are:
– The reduced opportunities for exercise that comes from increased urbanization is less likely to be a major contributor because the changes in urbanization have widely preceded the global increases in obesity.
– Although the prevalence of obesity among children is everywhere a lot lower than among adults the rate of increase has been higher among children more recently.
– The US still has the highest rate of childhood obesity, 12.7%. But the rate of rise is highest, tripling, in the developing and middle-income countries like China, Brazil and Indonesia. (2)
– The highest level of adult obesity among the big countries was Egypt. You would think that with the political grief they are experiencing that they would be skinnier. Also they eat the Mediterranean diet that is supposed to be good for you. Go figure.
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- email@example.com or phone-354-6605.
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