Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.Wellcome Trust, AstraZeneca Young Health Programme.
Abstract Background Previous studies reported that famine exposure had an effect on metabolic syndrome (MetS). However, there is an inadequacy of study regarding the association between famine exposure, adulthood general obesity, and the risk of MetS. Methods A total of 8883 subjects aged ≥40 years from Jiading community in Shanghai were included. We defined famine exposure subgroups as nonexposed (1963–1974), fetal exposed (1959–1962), childhood exposed (1949–1958), and adolescence exposed (1941–1948). MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III (NCEP‐ATP III) criteria. Results Compared with the nonexposed group, the risks of MetS were increased in the fetal‐, childhood‐, and adolescence‐exposed groups with odds ratios (OR) and 95% confidence intervals (CI) of 1.48 (1.23–1.78), 1.89 (1.63–2.20), and 2.34 (1.99–2.74), respectively. After adjusting for sex, age, smoking status, drinking status, education, body mass index (BMI), and physical activity, the increased risk of MetS related to the fetal‐exposed and childhood‐exposed groups with OR and 95% CI of 1.42 (1.04–1.94) and 1.50 (1.02–2.21), respectively, were observed only in women. Famine exposure was significantly associated with MetS among individuals with a BMI < 23 kg/m 2 ( p for interaction between BMI categories and famine exposure = 0.0002 in the whole cohort), while there existed a gender difference ( p = 0.0023 in females, p = 0.4484 in males). When evaluating the joint effects of the combination of famine exposure in early life and general obesity in adulthood on MetS, we observed the highest estimate in participants with both adulthood general obesity and fetal famine exposure (OR 17.52; 95% CI, 10.07–30.48) compared with those without famine exposure nor adulthood obesity. Conclusions Obesity in adulthood significantly further aggravated the risk of MetS in individuals who experienced early life undernutrition, especially in females.
Background Exposure to light at night (LAN) is a potent disruptor of the circadian system. Whether LAN exposure exerts a sex- or age-specific influence on obesity needs investigation. Objectives To estimate the sex- and age-specific associations of exposure to outdoor LAN and obesity based on a national and cross-sectional survey. Methods The study included a nationally representative sample of 98,658 adults aged ≥ 18 years who had lived in their current residence for ≥ 6 months from 162 study sites across mainland China in 2010. Outdoor LAN exposure was estimated from satellite imaging data. General obesity was defined as body-mass index (BMI) ≥ 28 kg/m 2 and central obesity was defined as waist circumference ≥ 90 cm in men and ≥ 85 cm in women. Linear and logistic regression models were used to examine the associations between LAN exposure and prevalent obesity in sex and age categories. Results A monotonically increasing association of outdoor LAN with BMI, waist circumference was observed in all sex and age categories, except for adults aged 18-39 years. Significant associations of LAN exposure with prevalent obesity were observed in each sex and age category, especially in men and older people. Per 1-quintile increase in LAN was associated with 14% increased odds of general obesity in men (odds ratio, OR=1.14, 95% confidence interval, CI=1.07-1.23) and 24% in adults aged ≥ 60 years (OR=1.24, 95% CI=1.14-1.35). Per 1-quintile increase in LAN was associated with 19% increased odds of central obesity in men (OR=1.19, 95% CI=1.11-1.26) and 26% in adults aged ≥ 60 years (OR=1.26, 95% CI=1.17-1.35). Conclusions Increased chronic outdoor LAN exposure was associated with increased prevalence of obesity in sex- and age- specific Chinese populations. Public health policies on reducing light pollution at night might be considered in obesity prevention.
Abstract The purpose of this study was to investigate whether thePhyllostachys edulis-Carya illinoinensisco-plantation is a feasible forest model. Two treatments and one control were evaluated. The control was a low-densityC. illinoinensisforest (CK), and the treatments were a high-densityC. illinoinensis forest(DF), and aC. illinoinensis-P. edulisco-plantation forest (MF). Gas exchange and chlorophyll fluorescence parameters, leaf physiology, macromorphology, and anatomical structure ofC. illinoinensiswere measured and principal component analysis (PCA) was used to evaluate treatment effects. The highest net photosynthetic rate (Pn), which was 13.72 .µmol CO2·m-2·s-1, was recorded forC. illinoinensisunder the CK treatment, while the corresponding values for MF and DF treatments were 8.98 and 5.25 µmol CO2·m-2·s-1, respectively. The JIP test revealed that plastoquinone libraries were inhibited under both MF and DF, particularly in the latter. Compared with CK, antioxidant substances in MF and DF leaves increased to a certain extent, again, particularly in the latter. Leaf macromorphology and anatomical structures under the different treatments also changed to acclimated to different environments. The leaf area of MF became lower, and the vascular tissue of DF petiole became larger. Finally, based on the main data, the order of the PCA scores was CK > MF > DF. The results indicated that both co-plantation and high-density planting caused both interspecific and intraspecific competition. Photosynthesis was inhibited inC. illinoinensisto varying degrees under both cultivation models. Nonetheless, the stress levels inC. illinoinensiswere significantly lower under the co-plantation forest than under high-density planting. These findings indicate thatC. illinoinensisgrowth was not severely inhibited by co-plantation withP. edulis, as it still developed well. Hence, co-plantation ofP. edulisandC. illinoinensisis a promising mixed-forest model.
In China, data on the prevalence of metabolic syndrome have been rare recently. The objective of the study was to evaluate the prevalence of metabolic syndrome and its components in 2010. The study covered all 31 provinces of mainland China and consisted of a nationally representative population sample of 98,658 Chinese adults aged ≥18 years. Of these, 97,098 participants were eligible for the data analysis reported here. Estimates of the prevalence of metabolic syndrome and its components were calculated. To further explore whether metabolic syndrome is associated with the 10-year coronary heart disease risk, sex-stratified logistic regression models were used. The prevalence of the metabolic syndrome was 33.9% (31.0% in men and 36.8% in women), which indicates that metabolic syndrome affects approximately 454 million adults in China. More than half of total adult population was suffering from low high-density lipoprotein cholesterol (HDL-C), and nearly half of participants had high blood pressure. Abdominal obesity and low HDL-C were more prevalent in women than in men, whereas high blood pressure, high blood glucose, and high triglycerides were more common in men. Metabolic syndrome was associated with a higher 10-year coronary heart disease risk after adjustment for potential risk factors and each component of metabolic syndrome as continuous variables. Our results showed a high prevalence of metabolic syndrome and its components in the general adult population in mainland China. Metabolic syndrome was independently associated with a higher 10-year risk of developing coronary heart disease.
To compare the probability of achieving diabetes remission in individuals with different phenotypes of insulin sensitivity, insulin secretion, and beta cell function and further detect the effects of diet, exercise, and lifestyle education intervention on these indexes. Three-hundred and one participants who had glycated haemoglobin (HbA1c) data at baseline and after intervention were included for this post hoc analysis. We used the multi-way analysis of variance to assess the differences between the diabetes remission and non-remission groups or between intervention groups in changes of the indexes of insulin sensitivity, insulin secretion, and beta cell function. Furthermore, logistic regression analysis was used to identify the association between the diabetes remission and baseline and change of each insulin index. Participants with a higher disposition index (DI) or higher adaptation index at baseline were more likely to achieve diabetes remission. The diabetes remission group had a significantly greater increase in AUCc-pep0-30/AUCgluc0-30, DI, and adaptation index compared with the non-remission group, while there were no between-group differences in indexes of insulin sensitivity. Participants with greater increases in insulin secretion and beta cell function were more likely to achieve diabetes remission. Indexes of beta cell function improved in all intervention groups, while the diet intervention induced significant improvement compared with lifestyle education. These findings supported the importance of aggressively implementing intensive lifestyle interventions for individuals with type 2 diabetes at an early stage of the disease, when beta cell function was not yet significantly impaired, to promote achieving diabetes remission.
Sex differences in blood pressure (BP) levels and hypertension are important and the role of socioeconomic status (SES) in sex differences of hypertension remains unclear.
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