Spatial-temporal trends in global childhood overweight and obesity from 1975 to 2030: a weight mean center and projection analysis of 191 countries.

BACKGROUND: The geographic information science-based interactive map provided good prospects for the public health to study disease prevalence. The purpose of this study is to understand global spatial-temporal trends of childhood overweight and obesity and underlying causes help formulating intervention strategies. METHODS: This multiple cross-sectional study included data on childhood overweight and obesity prevalence, gross national income per capita, and urbanization rate for 191 countries from 1975-2016. Autoregressive integrated moving average model, standard deviational ellipse model and mixed-effects models were used to explore spatial-temporal trends of childhood overweight and obesity and associations with gross national income per capita and urbanization rate. RESULTS: Globally, childhood overweight and obesity rate would reach 30.0% in 2030 (boys: 34.2%, girls: 27.4%). By 2030, it would reach 58.3% in middle- and high-income countries and 68.1% in Western Pacific region. Spatial-temporal trendline for childhood overweight and obesity in 1975-2030 exhibited a "C" shape, migrating from 1975 (15.6。E, 24.6。N) to 2005 (10.6。E, 21.7。N), then to 2030 (14.8。E, 17.4。N). The trendline for urbanization rate was also an irregular "C", and the turning point appeared five years earlier than childhood overweight and obesity. CONCLUSIONS: Globally, childhood overweight and obesity prevalence will continue to increase. Its weight mean center migrated from western countries to Asia and Africa following economic development.

Health policy and public health implications of obesity in China.

China has experienced many drastic social and economic changes and shifts in people's lifestyles since the 1990s, in parallel with the fast rising prevalence of obesity. About half of adults and a fifth of children have overweight or obesity according to the Chinese criteria, making China the country with the highest number of people with overweight or obesity in the world. Assuming that observed time trends would continue in the future, we projected the prevalence of and the number of people affected by overweight and obesity by 2030, and the associated medical costs. The rising incidence of obesity and number of people affected, as well as the related health and economic consequences, place a huge burden on China's health-care system. China has made many efforts to tackle obesity, including the implementation of relevant national policies and programmes. However, these measures are inadequate for controlling the obesity epidemic. In the past decade, China has attached great importance to public health, and the Healthy China 2030 national strategy initiated in 2016 provides a historical opportunity to establish comprehensive national strategies for tackling obesity. China is well positioned to explore an effective model to overcome the obesity epidemic; however, strong commitment and leadership from central and local governments are needed, as well as active participation of all related society sectors and individual citizens. TRANSLATION: For the Chinese translation of the paper see Supplementary Materials section.

Double Burden of Malnutrition and Nutrition Transition in Asia: A Case Study of 4 Selected Countries with Different Socioeconomic Development.

Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.