Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019

Chong B 1 , Jayabaskaran J 1 , Kong G 1 , Chan YH 2 , Chin YH 1 , Goh R 1 Show all authors , Kannan S 1 , Ng CH 1 , Loong S 1 , Kueh MTW 3 , Lin C 1 , Anand VV 1 , Lee ECZ 1 , Chew HSJ 4 , Tan DJH 1 , Chan KE 1 , Wang JW 5 , Muthiah M 6 , Dimitriadis GK 7 , Hausenloy DJ 1 , Mehta AJ 8 , Foo R 1 , Lip G 9 , Chan MY 1 , Mamas MA 10 , le Roux CW 11 , Chew NWS 1

Affiliations 

  • 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 2 Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore
  • 3 Royal College of Surgeons in Ireland & University College Dublin Malaysia Campus, Malaysia
  • 4 Department of Cardiology, National University Heart Centre, National University Health System, Singapore
  • 5 Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 6 Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
  • 7 Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
  • 8 Division of Cardiology, Virginia Commonwealth University, Richmond, VA, USA
  • 9 Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
  • 10 Institute of Population Health, University of Manchester, Manchester, UK
  • 11 Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
EClinicalMedicine, 2023 Mar;57:101850.
PMID: 36864983 DOI: 10.1016/j.eclinm.2023.101850

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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