Chong Bryan, Jayabaskaran Jayanth, Kong Gwyneth, Chan Yiong Huak, Chin Yip Han, Goh Rachel, Kannan Shankar, Ng Cheng Han, Loong Shaun, Kueh Martin Tze Wah, Lin Chaoxing, Anand Vickram Vijay, Lee Ethan Cheng Zhe, Chew H S Jocelyn, Tan Darren Jun Hao, Chan Kai En, Wang Jiong-Wei, Muthiah Mark, Dimitriadis Georgios K, Hausenloy Derek J, Mehta Anurag J, Foo Roger, Lip Gregory, Chan Mark Y, Mamas Mamas A, le Roux Carel W, Chew Nicholas W S
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore.
EClinicalMedicine. 2023 Feb 16;57:101850. doi: 10.1016/j.eclinm.2023.101850. eCollection 2023 Mar.
Malnutrition and obesity are interdependent pathologies along the same spectrum. We examined global trends and projections of disability-adjusted life years (DALYs) and deaths from malnutrition and obesity until 2030.
Using data from the 2019 Global Burden of Disease study involving 204 countries and territories, trends in DALYs and deaths were described for obesity and malnutrition from 2000 to 2019, stratified by geographical regions (as defined by WHO) and Socio-Demographic Index (SDI). Malnutrition was defined according to the 10th revision of International Classification of Diseases codes for nutritional deficiencies, stratified by malnutrition type. Obesity was measured via body mass index (BMI) using metrics related to national and subnational estimates, defined as BMI ≥25 kg/m. Countries were stratified into low, low-middle, middle, high-middle, and high SDI bands. Regression models were constructed to predict DALYs and mortality up to 2030. Association between age-standardised prevalence of the diseases and mortality was also assessed.
In 2019, age-standardised malnutrition-related DALYs was 680 (95% UI: 507-895) per 100,000 population. DALY rates decreased from 2000 to 2019 (-2.86% annually), projected to fall 8.4% from 2020 to 2030. Africa and low SDI countries observed highest malnutrition-related DALYs. Age-standardised obesity-related DALY estimates were 1933 (95% UI: 1277-2640). Obesity-related DALYs rose 0.48% annually from 2000 to 2019, predicted to increase by 39.8% from 2020 to 2030. Highest obesity-related DALYs were in Eastern Mediterranean and middle SDI countries.
The ever-increasing obesity burden, on the backdrop of curbing the malnutrition burden, is predicted to rise further.
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营养不良和肥胖是同一谱系上相互依存的病症。我们研究了截至2030年全球营养不良和肥胖所致残疾调整生命年（DALY）及死亡的趋势和预测情况。
利用2019年全球疾病负担研究中涉及204个国家和地区的数据，描述了2000年至2019年肥胖和营养不良的DALY及死亡趋势，按地理区域（如世界卫生组织所定义）和社会人口指数（SDI）进行分层。营养不良根据国际疾病分类第十次修订本中营养缺乏症代码进行定义，并按营养不良类型分层。肥胖通过体重指数（BMI）进行衡量，使用与国家和次国家估计相关的指标，定义为BMI≥25kg/m²。国家被分为低、低中、中、高中和高SDI组。构建回归模型以预测到2030年的DALY和死亡率。还评估了疾病的年龄标准化患病率与死亡率之间的关联。
2019年，每10万人口中年龄标准化的与营养不良相关的DALY为680（95%不确定区间：507 - 895）。DALY率从2000年到2019年下降（每年 - 2.86%），预计从2020年到2030年将下降8.4%。非洲和低SDI国家观察到与营养不良相关的DALY最高。年龄标准化的与肥胖相关的DALY估计值为1933（95%不确定区间：1277 - 2640）。与肥胖相关的DALY从2000年到2019年每年上升0.48%，预计从2020年到2030年将增加39.8%。与肥胖相关的DALY最高的是东地中海和中SDI国家。
在控制营养不良负担的背景下，日益增加的肥胖负担预计将进一步上升。
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