本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(23)02750-2

摘要内容如下：

背景

体重过轻和肥胖与整个生命过程中的不良健康后果有关。我们估计了从1990年到2022年200个国家和地区的成人和学龄儿童和青少年的体重不足或过瘦和肥胖的个体和综合患病率及其变化。

方法

我们使用了3663项基于人群的研究的数据，这些研究有2.22亿参与者，测量了普通人群代表性样本的身高和体重。我们使用贝叶斯分层模型来估计从1990年到2022年200个国家和地区的不同BMI类别的流行趋势，分别针对成人（年龄≥20岁）和学龄儿童和青少年（年龄5-19岁）。对于成人，我们报告了体重过轻（BMI<18.5 kg/m2）和肥胖（BMI≥30 kg/m2）的个体和合并患病率。对于学龄儿童和青少年，我们报告了消瘦（BMI<2 SD，低于WHO生长参考值的中位数）和肥胖（BMI>2 SD，高于中位数）。

调查结果

从1990年到2022年，在11个国家（6%）的女性和17个国家（9%）的男性中，成人体重不足和肥胖的综合患病率有所下降，观察到的变化是真实下降的后验概率至少为0.80。在后验概率至少为0.80的162个国家（81%）的女性和140个国家（70%）的男性中，合并患病率增加。2022年，体重不足和肥胖的综合流行率在加勒比、波利尼西亚和密克罗尼西亚的岛国以及中东和北非国家最高。2022年，在177个国家（89%）的女性和145个国家（73%）的男性中，肥胖率高于体重不足，后验概率至少为0.80，而在16个国家（8%）的女性和39个国家（20%）的男性中，肥胖率高于体重不足。从1990年到2022年，在5个国家的女孩（3%）和15个国家的男孩（8%）中，瘦和肥胖的综合患病率下降，后验概率至少为0.80；在140个国家的女孩（70%）和137个国家的男孩（69%）中，瘦和肥胖的综合患病率上升，后验概率至少为0.80。2022年学龄儿童和青少年消瘦和肥胖综合患病率最高的国家是波利尼西亚、密克罗尼西亚和加勒比地区的男性和女性，以及智利和卡塔尔的男性。在南亚的一些国家，如印度和巴基斯坦，综合流行率也很高，尽管这些国家的消瘦程度有所下降，但仍然很普遍。2022年，学龄儿童和青少年的肥胖比瘦更普遍，在133个国家的女孩（67%）和125个国家的男孩（63%）中，后验概率至少为0.80，而在35个国家（18%）和42个国家（21%）中，情况正好相反。在几乎所有国家，无论是成年人还是学龄儿童和青少年，双重负担的增加都是由肥胖的增加引起的，而双重负担的减少则是由体重过轻或过瘦的减少引起的。

解释

在大多数国家，体重不足和肥胖的综合负担因肥胖增加而加重，而在南亚和非洲部分地区，体重不足和过瘦现象仍然普遍存在。需要进行健康营养转型，增加获得营养食品的机会，以解决体重不足的剩余负担，同时遏制和扭转肥胖的增加。

英文原文如下：

Abstracts

BACKGROUND  Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.

METHODS  We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median).

FINDINGS  From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness.

INTERPRETATION  The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.

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