Obesity is already the most common form of malnutrition in most countries | Health and wellness

There is an epidemic that crosses the globe from end to end and is more destructive than Covid: if the coronavirus crisis has left, according to the World Health Organization (WHO), 774 million cases in the world, obesity is already affecting even more people. than a billion people. The study, published this Thursday in Lancet shows that being overweight, a risk factor for dozens of diseases, is already the most common form of malnutrition in most countries, with cases quadrupling in children over three decades and nearly tripling in adults. One way or another, food problems are perpetuated and, although the number of underweight people on the planet has decreased (due to a decrease in the level of malnutrition, for example), the increase in overweight and obesity will once again unbalance the food balance. world.

Poor nutrition is just as bad as being overweight. These are two sides of the same coin: poor nutrition, which is associated with health problems throughout life. Malnutrition creates a risk of premature death, and obesity is also a risk factor for diseases such as cancer or diabetes and hypertension, which in turn are precursors to cardiovascular disease. In addition, excess fat in childhood increases the risk of persisting obesity in adulthood and accelerates the onset of mechanical (due to stress on the joints) and metabolic problems.

Research published in Lancet

, which pools data from more than 3,600 studies and analyzes the evolution of obesity and underweight globally between 1990 and 2022, reveals the consolidation of two parallel phenomena: while the number of underweight people is falling, that is, low weight for age in As a result of undernutrition, obesity is on the rise in both rich and low-income countries. “The study shows us that malnutrition is very well controlled throughout the world, with the exception of some African countries. This reduction is accompanied by improvements in living conditions and economic development, as happened in Spain in the 1950s. However, not a single country in the world has managed to reduce obesity levels. This paper shows that the problem is going wrong,” says Fernando Rodríguez Artalejo, a professor of public health at the Autonomous University of Madrid and one of the signatories of the study.

In practice, the result of this study is that the overall prevalence of these forms of malnutrition is rising sharply, the authors warn: “The cumulative prevalence of these forms of malnutrition has increased in most countries. notable exceptions are countries in South and Southeast Asia and, for some age and sex groups, sub-Saharan Africa. The decline in the double burden was largely due to a decrease in the prevalence of underweight, while the increase was due to an increase in obesity, leading to a shift from underweight to obesity in many countries,” the authors summarize in the paper.

On the world map, the growing prevalence of obesity dominates almost all territories. The study, conducted by Imperial College London and involving more than a thousand scientists from around the world, brings the number of people worldwide suffering from the disease to 878 million adults and 160 million children. This means that between 1990 and 2022, the prevalence among minors increased from 1.7% to 6.9% among girls and from 2.1% to 9.3% among boys; in adults, the rate jumped from 8.8% to 18.5% in women and from 4.8 to 14% in men. “It’s not surprising. You go out and see it. It was what was expected,” says Rodríguez Artalejo. And he continues: “The reasons? The study doesn’t analyze the data, it just speculates, but it points to an increase in cheap ultra-processed food in a context that makes it easier to consume it at any time. And the same thing happens in poor countries. That’s what globalization has,” he explains.

According to the study, the prevalence of obesity has increased over the past three decades in the vast majority of territories (especially the United States, Brunei, some countries in the Caribbean, the Middle East and North Africa). Polynesian countries such as Tonga, Samoa and Niue have the highest rates of obesity at all ages, with prevalence exceeding 60% among adults. Among minors, Chile is also one of the countries where obesity has increased the most: for example, the obesity rate among men is 33%. The United States, a model for the prevalence of obesity in high-income areas, also ranks high, with four out of every 10 American adults affected by the disease.

The ‘astonishing’ case of Spanish women

Spain dances in the middle of the table: adult prevalence is 13% in women and 19% in men; in children it ranges from 9% in girls to 12% in boys. But the researchers highlight a particular phenomenon in this environment: both here and in France there has been a slight decline in obesity rates among women, “although the reasons are unknown,” they admit.

Experts interviewed ask not to raise the bells into the air. “We must be careful when interpreting the results and not think that the battle against obesity has been won. This may indicate a higher degree of awareness,” agrees Manuel Tena, group leader of the Networked Center for Biomedical Research (CIBER) group on obesity and nutrition. Rodríguez Artalejo admits that it is “attractive” but notes that “it is probably not representative of Spain as a whole throughout the study period, as it is based on small and regional studies.” “We have a huge obesity epidemic that is starting to get under control, but we are no better off than we were 30 years ago,” he says.

In turn, the prevalence of low weight in adults decreased in 150 countries over these 30 years (overall, it rose from 14.5% to 7% for women and from 13.7% to 6.2% for men). That is, 347 million people were underweight in 2022, representing a decrease of about 45 million since 1990 and “despite global population growth,” the researchers note. In India, China, Indonesia, Ethiopia, Bangladesh and Japan, women will have the highest proportion of underweight adults in 2022. Among children, the prevalence of underweight decreased from 10.3% to 8.2% in girls and from 16.7% to 10.8% in children: 185 million children were underweight.

The authors acknowledge some limitations in the study, such as missing data in some countries or using body mass index (BMI) as a measure because it is “imperfect” for measuring excess body fat (obesity is considered a measure of obesity). BMI more than 30 and underweight less than 18). However, they defend their findings and suggest, for example, that the phenomenon that crystallizes their research, namely the emergence of obesity at younger and younger ages, “may be related to consumption outside the home and access to commercial and processed foods at school.” age.” children and adolescents followed adults during this period.” They also hypothesize that “some leisure games and sports have been replaced by sedentary activities,” although they acknowledge that there is limited data on these trends.

Researchers are calling for a fight against malnutrition in Africa and South Asia, where “food insecurity persists”, and warn of the “urgent need to prevent obesity” above all else. In this sense, they criticize that efforts aimed at individual behavior in food environments have had little effect. The authors criticize the lack of access to healthy foods, especially for low-income populations.

Regarding the explosion of promising anti-obesity drugs, they predict that impact will be “low worldwide in the short term due to the high cost” of these treatments. Jaume Marrugat, an epidemiologist at the Hospital del Mar Research Institute and a signatory of the study, defends, however, the potential of these treatments to bend, at least in high-income countries, the obesity curve. “These drugs are terribly effective. Contrary to what we thought in 2015, the forecast is that we will see a turnaround and perhaps see a decline in obesity. I hope I’m not wrong, because otherwise we’re in for some drama.”

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