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2 Global Trends in Obesity
Pages 5-26

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From page 5...
... Asians develop diabetes at lower weights, at younger ages, and more rapidly compared with Western populations. Incorporating Asian-specific BMI and waist circumference cutoff points into screening programs could help reduce the burden of chronic disease in this population.
From page 6...
... She began by discussing global trends in body mass index (BMI) and obesity, pointing to contrasts in these trends between adults and children around the world.
From page 7...
... Reprinted with permission from Elsevier. FIGURE 2-2  Body mass index (BMI)
From page 8...
... . She reported that global obesity prevalence has risen approximately 2 percentage points per decade (NCD-RisC, 2016, 2017)
From page 9...
... . She suggested that this finding helps explain national differences in the prevalence of overweight and FIGURE 2-4  Trends in global age-standardized prevalence of body mass index (BMI)
From page 10...
... High BMI is among the top risk factors contributing to disability-adjusted life years in high-income countries, as well as across the world overall (GBD 2016 Risk Factor Collaborators, 2017) , she reported.
From page 11...
... . FIGURE 2-6  Prevalence of obesity (body mass index [BMI]
From page 12...
... . The development of diabetes at younger ages may help explain its rapidly rising prevalence in Asian regions, Malik suggested.
From page 13...
... The equivalent metabolic abnormalities observed among a white population with a BMI of 25, she elaborated, were observed at lower BMI cutoff points in the other ethnic groups, including as low as 19.6 for South Asians. "This is telling us that BMI alone is not the best indicator of cardiometabolic risk in most of these Asian populations," she observed.
From page 14...
... Asia's coexisting problem with underweight has implications for obesity policy, she added. Finally, she proposed incorporating Asian-specific BMI and waist circumference cutoff points in screening programs to help reduce the diabetes burden in Asian populations around the globe.
From page 15...
... health statistics. The national context differs in these countries in ways that can influence socioeconomic status, lifestyle, the food environment, and access to health care, she elaborated.
From page 16...
... , and abdominal obesity (waist circumference >102 cm in men and >88 cm in women) was lowest in rural Ghana, higher in urban Ghana, and highest in the three European cities.
From page 17...
... FIGURE 2-8  Ghanaians' prevalence of overweight and obesity (body mass index [BMI]
From page 18...
... 18 FIGURE 2-9  Ghanaians' age-standardized prevalence of overweight and obesity (body mass index [BMI]
From page 19...
... FIGURE 2-10  Ghanaians' age-standardized prevalence of type 2 diabetes (World Health Organization criteria) by locality.
From page 20...
... She cited as an example that if a person starts smoking or makes dietary or physical activity changes, that behavior can induce epigenetic changes that may increase health risk. According to Meeks, while the RODAM study described novel loci associated with obesity in its Ghanaian cohort (Meeks et al., 2017)
From page 21...
... If one examines the changes over time in dietary behaviors and intake patterns, she observed, warning signs emerge along the way. She also argued that shifts in the global food system, such as the commercial sector's increasing influence over the nutrition conditions in many countries, contribute to the environmental factors that are associated with increases in overweight and obesity alongside continued under­ utrition.
From page 22...
... Presented by Rachel Nugent, October 9, 2018.
From page 23...
... for their impact on both undernutrition and overweight/obesity: breastfeeding promotion, school nutrition programs, and food advertising. To close, Nugent recapped some of the challenges associated with the double burden: a complex set of drivers and conditions, uneven and noncomparable data sources on forms of malnutrition (with much more information available on undernutrition than on overweight and obesity, particularly in developing countries)
From page 24...
... ­ conomos advocated for more frequent data collection, adding that "we E can't look at data from 10 years ago and design programs." To address migrant health, Meeks proposed moving beyond the common assessment method of comparing migrants with their host population. She acknowledged that "many of those studies show indeed a higher burden in the migrant population," but, she argued, "to really pinpoint what underlying factors are driving this increased risk, we need to look at other designs as well," such as those that examine the roles of national context and migration.
From page 25...
... Epigenetics and Environments In response to a participant's question about whether epigenetic changes varied across the RODAM study cohort in the three European countries, Meeks replied that the small sample size of the study cohort that included epigenetic data precluded an examination of epigenetic differences among the European contexts. She noted, however, that her group has compared the epigenetic profiles of Ghanaians in rural Ghana, urban Ghana, and Europe and found that across the genome, many loci differed among those locations.
From page 26...
... Malik suggested that additional qualitative research could help clarify the factors influencing dietary choices and inform interventions to improve diet quality. Nugent asserted that qualitative research could help in understanding a culture's food behaviors and values-driven attachment to certain traditional foods, even though food consumption data may suggest that these foods are no longer commonly consumed.


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