Gona Philimon N, Kimokoti Ruth W, Gona Clara M, Ballout Suha, Rao Sowmya R, Mapoma Chabila C, Lo Justin, Mokdad Ali H
College of Nursing & Health Sciences University of Massachusetts Boston Boston MA USA.
Department of Nutrition Simmons College Boston MA USA.
Obes Sci Pract. 2021 May 13;7(5):509-524. doi: 10.1002/osp4.519. eCollection 2021 Oct.
High body mass index (BMI) is associated with stroke, ischemic heart disease (IHD), and type 2 diabetes mellitus (T2DM). An epidemiological analysis of the prevalence of high BMI, stroke, IHD, and T2DM was conducted for 16 Southern Africa Development Community (SADC) using Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study data.
GBD obtained data from vital registration, verbal autopsy, and ICD codes. Prevalence of high BMI (≥25 kg/m), stroke, IHD, and T2DM attributed to high BMI were calculated. Cause of Death Ensemble Model and Spatiotemporal Gaussian regression was used to estimate mortality due to stroke, IHD, and T2DM attributable to high BMI.
Obesity in adult females increased 1.54-fold from 12.0% (uncertainty interval [UI]: 11.5-12.4) to 18.5% (17.9-19.0), whereas in adult males, obesity nearly doubled from 4.5 (4.3-4.8) to 8.8 (8.5-9.2). In children, obesity more than doubled in both sexes, and overweight increased by 27.4% in girls and by 37.4% in boys. Mean BMI increased by 0.7 from 22.4 (21.6-23.1) to 23.1 (22.3-24.0) in adult males, and by 1.0 from 23.8 (22.9-24.7) to 24.8 (23.8-25.8) in adult females. South Africa 44.7 (42.5-46.8), Swaziland 33.9 (31.7-36.0) and Lesotho 31.6 (29.8-33.5) had the highest prevalence of obesity in 2019. The corresponding prevalence in males for the three countries were 19.1 (17.5-20.7), 19.3 (17.7-20.8), and 9.2 (8.4-10.1), respectively. The DRC and Madagascar had the least prevalence of adult obesity, from 5.6 (4.8-6.4) and 7.0 (6.1-7.9), respectively in females in 2019, and in males from 4.9 (4.3-5.4) in the DRC to 3.9 (3.4-4.4) in Madagascar.
The prevalence of high BMI is high in SADC. Obesity more than doubled in adults and nearly doubled in children. The 2019 mean BMI for adult females in seven countries exceeded 25 kg/m. SADC countries are unlikely to meet UN2030 SDG targets. Prevalence of high BMI should be studied locally to help reduce morbidity.
高体重指数（BMI）与中风、缺血性心脏病（IHD）和2型糖尿病（T2DM）相关。利用全球疾病、伤害及风险因素负担（GBD）研究数据，对16个南部非洲发展共同体（SADC）国家的高BMI、中风、IHD和T2DM患病率进行了流行病学分析。
GBD从生命登记、口头尸检和国际疾病分类（ICD）编码中获取数据。计算了高BMI（≥25kg/m）、中风、IHD以及归因于高BMI的T2DM的患病率。采用死因综合模型及时空高斯回归来估计归因于高BMI的中风、IHD和T2DM导致的死亡率。
成年女性肥胖率从12.0%（不确定区间[UI]：11.5 - 12.4）增长了1.54倍，至18.5%（17.9 - 19.0）；而成年男性肥胖率几乎翻倍，从4.5（4.3 - 4.8）增至8.8（8.5 - 9.2）。儿童中，肥胖率在两性中均增长超过一倍，超重率在女孩中增长27.4%，在男孩中增长37.4%。成年男性平均BMI从22.4（21.6 - 23.1）增至23.1（22.3 - 24.0），增长了0.7；成年女性平均BMI从23.8（22.9 - 24.7）增至24.8（23.8 - 25.8），增长了1.0。2019年，南非肥胖率最高，为44.7（42.5 - 46.8），斯威士兰为33.9（31.7 - 36.0），莱索托为31.6（29.8 - 33.5）。这三个国家男性的相应患病率分别为19.1（17.5 - 20.7）、19.3（17.7 - 20.8）和9.2（8.4 - 10.1）。刚果民主共和国和马达加斯加成年肥胖率最低，2019年成年女性肥胖率分别为5.6（4.8 - 6.4）和7.0（6.1 - 7.9），刚果民主共和国男性肥胖率为4.9（4.3 - 5.4），马达加斯加为3.9（3.4 - 4.4）。
南部非洲发展共同体国家高BMI患病率较高。成年人肥胖率增长超过一倍，儿童肥胖率几乎翻倍。2019年，七个国家成年女性的平均BMI超过25kg/m。南部非洲发展共同体国家不太可能实现联合国2030年可持续发展目标。应在当地研究高BMI患病率，以帮助降低发病率。
