Excess bodyweight is a major public health concern. However, few worldwide comparative
analyses of long-term trends of body-mass index (BMI) have been done, and none have
used recent national health examination surveys. We estimated worldwide trends in
population mean BMI.
We estimated trends and their uncertainties of mean BMI for adults 20 years and older
in 199 countries and territories. We obtained data from published and unpublished
health examination surveys and epidemiological studies (960 country-years and 9·1
million participants). For each sex, we used a Bayesian hierarchical model to estimate
mean BMI by age, country, and year, accounting for whether a study was nationally
Between 1980 and 2008, mean BMI worldwide increased by 0·4 kg/m(2) per decade (95%
uncertainty interval 0·2-0·6, posterior probability of being a true increase >0·999)
for men and 0·5 kg/m(2) per decade (0·3-0·7, posterior probability >0·999) for women.
National BMI change for women ranged from non-significant decreases in 19 countries
to increases of more than 2·0 kg/m(2) per decade (posterior probabilities >0·99) in
nine countries in Oceania. Male BMI increased in all but eight countries, by more
than 2 kg/m(2) per decade in Nauru and Cook Islands (posterior probabilities >0·999).
Male and female BMIs in 2008 were highest in some Oceania countries, reaching 33·9
kg/m(2) (32·8-35·0) for men and 35·0 kg/m(2) (33·6-36·3) for women in Nauru. Female
BMI was lowest in Bangladesh (20·5 kg/m(2), 19·8-21·3) and male BMI in Democratic
Republic of the Congo 19·9 kg/m(2) (18·2-21·5), with BMI less than 21·5 kg/m(2) for
both sexes in a few countries in sub-Saharan Africa, and east, south, and southeast
Asia. The USA had the highest BMI of high-income countries. In 2008, an estimated
1·46 billion adults (1·41-1·51 billion) worldwide had BMI of 25 kg/m(2) or greater,
of these 205 million men (193-217 million) and 297 million women (280-315 million)
Globally, mean BMI has increased since 1980. The trends since 1980, and mean population
BMI in 2008, varied substantially between nations. Interventions and policies that
can curb or reverse the increase, and mitigate the health effects of high BMI by targeting
its metabolic mediators, are needed in most countries.
Bill & Melinda Gates Foundation and WHO.
Copyright © 2011 Elsevier Ltd. All rights reserved.