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N Engl J Med. 2017 Jul 6;377(1):13-27. doi: 10.1056/NEJMoa1614362. Epub 2017 Jun 12.
Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.
We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.
In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.
The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.).
尽管肥胖症疫情的不断加剧在许多国家受到了广泛关注,但这种关注对肥胖症趋势及疾病负担的影响仍不明确。
我们分析了来自6850万人的数据,以评估1980年至2015年间儿童和成人超重及肥胖患病率的趋势。利用全球疾病负担研究的数据和方法,我们还根据年龄、性别、病因以及1990年至2015年间195个国家的体重指数(BMI),对与高BMI相关的疾病负担进行了量化。
2015年,共有1.077亿儿童和6.037亿成人肥胖。自1980年以来,70多个国家的肥胖患病率翻了一番,大多数其他国家的肥胖患病率也持续上升。尽管儿童肥胖患病率低于成人,但许多国家儿童肥胖的增长率高于成人肥胖的增长率。高BMI在全球导致400万人死亡,其中近40%发生在非肥胖者身上。与高BMI相关的死亡中,超过三分之二是由心血管疾病导致的。自1990年以来,与高BMI相关的疾病负担有所增加;然而,由于心血管疾病潜在死亡率的下降,这种增加的速度有所减缓。
BMI升高的患病率和疾病负担的迅速增加凸显了持续关注BMI监测以及识别、实施和评估基于证据的干预措施以解决这一问题的必要性。(由比尔及梅琳达·盖茨基金会资助。)