ESPE Yearbook of Paediatric Endocrinology

Brief Summary: Global data are still scarce on the combined burden of obesity and underweight, and its changes over time across countries and age groups. The previous prevalences of obesity and underweight were published in 2016 [1]. This analysis pooled representative, world-wide samples of the general population, including 3,663 studies with 222 million participants aged 5 years and older with weight and height measurements to estimate the combined and individual prevalence of underweight and obesity between 1990 to 2022. It used the WHO growth reference as standard for pediatrics (63 million participants aged 5-19 years).

From 1990 to 2022, the combined prevalence of obesity and underweight increased in most countries, mainly driven by a shift from underweight dominance to obesity dominance. This shift was largest in South Africa for girls and in China for boys. This shift was already seen in adults in 1990, and has now reached school-aged children and adolescents [2]. The global age standardized prevalence of pediatric obesity increased 4-fold, while those of pediatric thinness decreased more slowly. Some low-income and middle-income countries now have a higher obesity prevalence than industrialized, high-income countries.

Despite some differences in data quality and coverage across regions, this is an excellent-designed world-wide analysis indicating alarming rates of obesity in childhood and adulthood worldwide. Aside from effective, sustainable treatment programs, a major challenge is to reduce disease risk through primary prevention on all levels starting even in the youngest groups. This should involve improved access to affordable healthy foods, promoting healthy dietary habits/physical activity and implementing comprehensive, effective public health policies. To what extent public health strategies such as taxation on sugary drinks or restrictions on unhealthy food marketing, already implemented in few countries, impact obesity rates is currently evaluated [3]. Aside from obesity, persistent underweight in some countries endorse efforts to improve access to nutritious foods and addressing underlying socio-economic factors.

References: 1. NCD Risk Factor Collaboration (NCD-RisC); Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128-9 million children, adolescents, and adults. Lancet 2017, 390, 2627-2642. doi:10.1016/S0140-6736(17)32129-3.2. Jaacks, L.M.; Vandevijvere, S.; Pan, A.; McGowan, C.J.; Wallace, C.; Imamura, F.; Mozaffarian, D.; Swinburn, B.; Ezzati, M.; The obesity transition: stages of the global epidemic. Lancet Diabetes Endocrinol 2019, 7, 231–240. doi:10.1016/S2213-8587(19)30026-9.3. Taillie, L.S.; Busey, E., Stoltze, F.M.; Dillman Carpentier, F.R; Governmental policies to reduce unhealthy food marketing to children. Nutr Rev 2019, 77, 787–816. doi:10.1093/nutrit/nuz021.