Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Am J Clin Nutr. 2023 Jan;117(1):141-148. doi: 10.1016/j.ajcnut.2022.10.012. Epub 2023 Jan 6.
In the United States, the prevalence of obesity among adults has increased 3-fold since the 1980s, but patterns of incidence of new cases of obesity are not known.
To examine the incidence of new cases of obesity: overall, by demographic and educational subgroups, by weight status, and changes during this century.
We analyzed adult (≥20 y) anthropometric records from the US nationally representative Panel Study of Income Dynamics from 2001 to 2017. Among those not having obesity (body mass index, BMI, ≥30 kg/m) at first observation, we used Poisson models to estimate the incidence of obesity [cases/1000 person-years (PYs)] and incidence rate ratio (IRR).
Among 13,888 adults followed for 115,797 PYs, the incidence of obesity in 2001-2017 was 28.1/1000 PYs (95% CI: 26.7, 29.7). Over the periods 2001-2005, 2005-2009, and 2009-2013, the incidence of obesity was stable, but in 2013-2017 the incidence increased by 18% compared to 2009-2013 [IRR: 1.18 (95% CI: 1.06, 1.30)]. Blacks had higher obesity incidence [47.9/1000 PYs (95% CI: 42.7, 53.1)] than Whites [26.2/1000 PYs (95% CI: 24.6, 27.9)]. Risk was particularly high among Black females [57.9/1000 PYs (95% CI: 49.1, 66.8)] and Black young adults (20-29 y) [65.5/1000 PYs (95% CI: 54.2, 76.7)]. Across race, obesity incidence was highest in young adults (20-29 y) [34.1/1000 PYs (95% CI: 31.5, 36.7)] and declined with age [age 70+ y: 18.9/1000 PYs (95% CI: 16.6, 21.8)]. Those with overweight had an obesity risk 7 times higher than those with normal weight [62.1/1000 PYs (95% CI: 58.8, 65.3) vs. 8.8/1000 PYs (95% CI: 8.1, 9.6)]. Those with less than high-school education had higher obesity incidence than those with education beyond high-school [39.4/1000 PYs (95% CI: 34.4, 44.4) vs. 24.7/1000 PYs (95% CI: 23.1, 26.3)].
Incidence of obesity was stable over the first 13 y of the last 2 decades but increased by 18% in 2013-2017. Blacks and younger adults were at highest risk, and those with overweight were also at high risk for developing obesity.
在美国，成年人肥胖患病率自 20 世纪 80 年代以来增加了 3 倍，但新病例肥胖的发病模式尚不清楚。
检查新病例肥胖的发病情况：总体情况、按人口统计学和教育亚组、按体重状况以及本世纪的变化。
我们分析了来自美国全国代表性收入动态面板研究的成年（≥20 岁）人体测量记录，从 2001 年到 2017 年。在首次观察时没有肥胖（体重指数，BMI，≥30kg/m）的人群中，我们使用泊松模型估计肥胖的发病率[病例/1000 人年（PYs）]和发病率比（IRR）。
在 13888 名成年人中，随访 115797PYs，2001-2017 年肥胖的发病率为 28.1/1000PYs（95%CI：26.7，29.7）。在 2001-2005 年、2005-2009 年和 2009-2013 年期间，肥胖的发病率保持稳定，但在 2013-2017 年，与 2009-2013 年相比，肥胖的发病率增加了 18%[IRR：1.18（95%CI：1.06，1.30）]。黑人的肥胖发病率高于白人[47.9/1000PYs（95%CI：42.7，53.1）]，而白人的肥胖发病率为 26.2/1000PYs（95%CI：24.6，27.9）。黑人女性（57.9/1000PYs（95%CI：49.1，66.8））和黑人年轻成年人（20-29 岁）（65.5/1000PYs（95%CI：54.2，76.7））的风险尤其高。在所有种族中，肥胖的发病率在年轻人（20-29 岁）中最高（34.1/1000PYs（95%CI：31.5，36.7）），并随着年龄的增长而下降[70 岁以上年龄组：18.9/1000PYs（95%CI：16.6，21.8）]。超重者患肥胖症的风险是体重正常者的 7 倍[62.1/1000PYs（95%CI：58.8，65.3）vs. 8.8/1000PYs（95%CI：8.1，9.6）]。受教育程度低于高中的人肥胖发病率高于受教育程度高于高中的人[39.4/1000PYs（95%CI：34.4，44.4）vs. 24.7/1000PYs（95%CI：23.1，26.3）]。
在过去 20 年的前 13 年中，肥胖的发病率保持稳定，但在 2013-2017 年增加了 18%。黑人及年轻成年人的风险最高，超重者也有很高的肥胖风险。
