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Chong B, Jayabaskaran J, Kong G, Chan YH, Chin YH, Goh R, Kannan S, Ng CH, Loong S, Kueh MTW, Lin C, Anand VV, Lee ECZ, Chew HJ, Tan DJH, Chan KE, Wang JW, Muthiah M, Dimitriadis GK, Hausenloy DJ, Mehta AJ, Foo R, Lip G, Chan MY, Mamas MA, le Roux CW, Chew NW. Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019. EClinicalMedicine 2023; 57:101850. [PMID: 36864983 PMCID: PMC9971264 DOI: 10.1016/j.eclinm.2023.101850] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND 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. METHODS 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/m2. 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. FINDINGS 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. INTERPRETATION The ever-increasing obesity burden, on the backdrop of curbing the malnutrition burden, is predicted to rise further. FUNDING None.
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Affiliation(s)
- Bryan Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rachel Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shankar Kannan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shaun Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Martin Tze Wah Kueh
- Royal College of Surgeons in Ireland & University College Dublin Malaysia Campus, Malaysia
| | - Chaoxing Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Vickram Vijay Anand
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ethan Cheng Zhe Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - H.S. Jocelyn Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiong-Wei Wang
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Cardiovascular Research Institute, National University Heart Centre, National University Health System, Singapore
- Nanomedicine Translational Research Programme, Centre for NanoMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mark Muthiah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Georgios K. Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
- Obesity, Type 2 Diabetes and Immunometabolism Research Group, Department of Diabetes, Faculty of Cardiovascular Medicine & Sciences, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Derek J. Hausenloy
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore
- National Heart Research Institute Singapore, National Heart Centre, Singapore
- The Hatter Cardiovascular Institute, University College London, London, UK
| | - Anurag J. Mehta
- Division of Cardiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Roger Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Gregory Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mark Y. Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Mamas A. Mamas
- Institute of Population Health, University of Manchester, Manchester, UK
- Keele Cardiac Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | - Carel W. le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Nicholas W.S. Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Corresponding author. Department of Cardiology, National University Heart Centre, National University Health System, 5 Lower Kent Ridge Road, 119074, Singapore.
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