Cardiovasculaire Geneeskunde.nl

Wereldwijde toename in obesitas, echter gunstige trends in bloeddruk en cholesterol

Nieuws - Feb. 4, 2011

Achtergrond:
De trends in Body Mass Index (BMI), serumcholesterol niveaus, en systolische bloeddrukniveaus voor volwassenen ouder dan 25 jaar werden berekend in 199 landen en gebieden[1].
Methoden:
De data werd verkregen uit gepubliceerde en ongepubliceerde epidemiologische surveys.
Resultaten:
In mannen steeg de leeftijdsgecorrigeerde BMI 0,4 kg/m2 per decennium en 0,5 kg/m2 bij vrouwen. De hoogste BMI's werden in Oceanië gerapporteerd, waaronder de Cook eilanden, Nauru, Samoa, Tonga en Polynesië. Onder de landen met een hoog-inkomen bleek de VS de hoogst gemeten BMI te hebben, 28,3 kg/m2, overeenkomend met de definitie van overgewicht.
De nieuwe BMI data zijn gepubliceerd tezamen met data over mondiale trends in cholesterol en bloeddruk[2,3]. In tegenstelling tot de obesitastrends werden er de afgelopen 30 jaar dalingen gezien in bloeddrukniveaus, met de grootste dalingen in Noord-Amerika, Australazië, en West-Europa. Mondiaal gezien veranderden de gemiddelde totaal-cholesterolniveaus weinig. De grootste dalingen in cholesterolniveaus werden gezien in westerse, hoog-inkomen landen, maar ook Oost- en Centraal Europa.
Conclusies:
Deze data laten zien dat obesitas een mondiale epidemie is. Daarbij zijn er er interessante verschillen te zien tussen mannen en vrouwen tussen de verschillende landen. Ook stijgt bijvoorbeeld in Aziatische landen het BMI nauwelijks, terwijl cholesterolniveaus daar juist wel stijgen.

Lees onderstaand het volledig artikel.
 

 

Global obesity rising, but blood-pressure and cholesterol trends suggest some good news


 

London, UK - The global obesity epidemic continues unabated, with new research showing that in the past 30 years obesity has increased in all regions of the world[1]. As of 2008, approximately 1.5 billion individuals worldwide are now considered overweight, including 500 million people considered obese, but this scary news is accompanied by some positive findings showing that blood-pressure levels have been reduced worldwide and cholesterol levels have remained essentially flat in the past three decades.

The researchers, part of the Global Burden of Metabolic Risk Factors of Chronic Disease Collaborating Group, led by senior investigator Dr Majid Ezzati (Imperial College London, UK), report that age-standardized body-mass index (BMI) increased by approximately 0.4 kg/m2 per decade in men and 0.5 kg/m2 in women, with male and female BMIs highest in the Oceania countries, such as the Cook Islands, Nauru, Samoa, Tonga, and French Polynesia. Among high-income countries, the US had the highest BMI, at 28.3 kg/m2, meeting the definition for overweight. Women in France, Italy, Greece, and Switzerland all came in under the overweight cutoff, with the mean of each country just under 25 kg/m2. BMI for men was lowest in the Democratic Republic of Congo, at 19.9 kg/m2, and lowest for women in Bangladesh, at 20.5 kg/m2. The new BMI data are published in addition to reports on the global trends of cholesterol and blood-pressure levels [2,3]. In contrast to the obesity epidemic, the group reports systolic blood-pressure levels declined globally over the past 30 years, with the largest reductions in North America, Australasia, and Western Europe. Globally, mean total-cholesterol levels changed little, but investigators did observe the largest decreases in Western high-income countries, as well as in Eastern and Central Europe.



All three papers—the reports on global BMI, total cholesterol, and blood-pressure trends—are published online February 3, 2011 in the Lancet, accompanied by an editorial by Drs Sonia Anand and Salim Yusuf (McMaster University, Hamilton, ON) [4].

In the editorial, the authors point out that considering all the risk factors together, "the forecast for cardiovascular disease burden in low-income and middle-income countries over the next few decades is dismal and [constitutes] a population emergency that will cost tens of millions of preventable deaths, unless rapid and widespread actions are taken by governments and healthcare systems worldwide."


The picture over the last 30 years

In all three studies, the researchers estimated the 1980-2008 trends in mean BMI, serum cholesterol levels, and systolic blood-pressure levels for adults aged 25 years and older in 199 countries and territories. The data were obtained from published and unpublished health examination and epidemiological surveys.


Worldwide, the mean BMI in 2008 was 23.8 kg/m2 for men and 24.1 kg/m2 for women in high-income regions, with a lower BMI observed in most low- and middle-income countries. In the high-income countries, male BMI increased the most in the US, at a rate 1.1 kg/m2 per decade in men and 1.2 kg/m2 per decade in women. Overall, 9.8% of men and 13.8% of women worldwide are considered obese, having a BMI >30 kg/m2.

Mean BMI for men increased in every region of the world, with the exception of Central Africa and South Asia. In fact, the researchers note that there was an increase in male BMI in all but eight countries, with males in Nauru and the Cook Islands having increases of more than 2 kg/m2 per decade. For women, the largest increase in BMI occurred in Oceania (such as the Cook, Solomon, and Marshall Islands, as well as Samoa, Tonga, and Fiji, among others), followed by increases in Southern and Central America. There was essentially no increase in mean BMI among women in Belgium, Finland, France, Switzerland, or Italy; Central and Eastern Europe; or Central Asia.

"The BMI news is not encouraging, but that being said, as interesting as that is the difference across the countries," Ezzati said. "A notable finding is that the BMI of women in a good part of Western Europe and Central Europe haven't really gone up much in the past 30 years. I think there are places that have been relatively stable—they are rare—so I think this variation is relevant. At the other extreme, we have places like the Pacific Islands, North Africa, the Middle East, parts of Latin America, and of course among the high-income countries, the US, followed Australia and New Zealand and perhaps the UK, that have gone up a lot. There are increases, some countries that are relatively flat, and then there are massive increases."

In 2008, the mean systolic blood pressure was 128.1 mm Hg for men and 124.4 mm Hg for women. From 1980, systolic blood pressure increased at a rate 0.8 mm Hg per decade in men and 1.0 mm Hg per decade in women. Blood pressure in women decreased, however, by 3.5 mm Hg per decade in Western Europe and Australia, as well as decreased in men in North America, Australasia, and Western Europe, declining by more than 2.0 mm Hg per decade. On the other hand, blood pressure increased in men and women in Oceania, East Africa, and South and Southeast Asia. For women, systolic blood pressure exceeded 135 mm Hg in some East and West African countries and exceeded 138 mm Hg in men living in Baltic countries or in East and West African countries. Among high-income countries, Portugal, Finland, and Norway have some of the highest systolic blood pressure levels.

 

Overall, mean total-cholesterol levels changed little from 1980 to 2008. In 2008, the mean total cholesterol level was 4.64 mmol/L (approximately 180.1 mg/dL) for men and 4.76 mmol/L (approximately 185.6 mg/dL) for women. Total-cholesterol levels declined in the high-income countries, such as Australasia, North America, and Western Europe, but increased in Japan, China, and Thailand.
 

1. Finucane MM, Stevens GA, Cowan MJ. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011; DOI: 10.1016/S0140-6736(10)62035-5. Available at: http://www.thelancet.com.
2. Danaei G, Finucane MM, Kin JK, et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet 2011; DOI:10.1016/S0140-6736(10)62036-3. Available at: http://www.thelancet.com
3. Farzadfar F, Finucane MM, Danaei G, et al. National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet 2011; DOI:10.1016/S0140-6736(10)62038-7. Available at: http://www.thelancet.com.
4. Anand SS, Yusuf S. Stemming the global tsunami of cardiovascular disease. Lancet 2011; DOI: 10.1016/S0140-6736(10)62346-X. Available at: http://www.thelancet.com.

 

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