Obesity is already the most common form of malnutrition in most countries | Health & Wellness

There is an epidemic that is crossing the globe from end to end and is devastating more than the covid: if the coronavirus crisis has left, according to the World Health Organization (WHO), 774 million cases in the world, obesity already affects to more than a billion people. A study published this Thursday in The Lancet reveals that excess weight, a risk factor for dozens of diseases, is already the most common form of malnutrition in most countries: cases in children have quadrupled in three decades and in adults, they have almost tripled. In one way or another, food problems become entrenched and, although the number of underweight people on the planet has decreased (due to the drop in malnutrition, for example), the rise of overweight and obesity once again unbalances the food balance. healthy in the world.

Insufficient nutrition is as bad as excess weight. They are two sides of the same coin: malnutrition, which is associated with health problems throughout life. Malnutrition poses a risk of premature death and obesity is also a risk factor for diseases such as cancer or diabetes and hypertension, a precursor, in turn, of cardiovascular diseases. Furthermore, in childhood, excess fat increases the risk of perpetuating obesity in adulthood and accelerates the appearance of mechanical (due to the weight on the joints) and metabolic problems.

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The research published in The Lancet, which compiles data from more than 3,600 studies and analyzes the evolution of obesity and underweight in the world between 1990 and 2022, reveals a consolidation of two parallel phenomena: while the numbers of underweight fall—that is, low weight for the age of an individual, as a result of insufficient nutrition—obesity is gaining ground, both in rich and low-income countries. “What the study shows us is that malnutrition is being controlled very well in the world, except in some African countries. Better living conditions and economic development accompany this reduction, as occurred in Spain in the 1950s. But, no country in the world has managed to reduce obesity. This article shows that the problem is going wrong,” says Fernando Rodríguez Artalejo, professor of Public Health at the Autonomous University of Madrid and one of the signatories of this research.

In practice, the result of this x-ray drawn by the study is that, as a whole, the prevalence of these malnutrition conditions skyrockets, the authors warn: “The combined prevalence of these forms of malnutrition has increased in most countries. , with the notable exception of countries in South and Southeast Asia and, for some age and sex groups, in sub-Saharan Africa. Decreases in double burden were largely due to declines in the prevalence of underweight, while increases were due to increases in obesity, leading to a transition from the prevalence of underweight to obesity in many countries,” the authors summarize in the article.

On a world map, a growing prevalence of obesity dominates almost all territories. The study, led by Imperial College London and in which more than a thousand scientists from around the world have participated, brings the number of people in the world suffering from this ailment to 878 million adults and 160 million children. This means that, between 1990 and 2022, the prevalence in minors went from 1.7% to 6.9% in girls and from 2.1% to 9.3% in boys; in adults, rates jumped from 8.8% to 18.5% in women and from 4.8 to 14% in men. “It is not surprising. You go out into the street and see it. It was what was expected,” says Rodríguez Artalejo. And he continues: “The reasons? The study does not analyze data, it only speculates, but it points to the increase in cheap ultra-processed food in a context that makes it easier to eat at all hours. And the same thing happens in poor countries. This is what globalization has,” he explains.

According to the study, the prevalence of obesity in the last three decades has grown in the vast majority of territories (especially in the United States, Brunei, some countries in the Caribbean, the Middle East and North Africa). Polynesian countries, such as Tonga, Samoa and Niue, have the highest obesity rates at all ages, with prevalences above 60% in adults. In minors, Chile is also one of the countries where obesity has grown the most and reports rates of 33% in men, for example. The United States, a paradigm of the expansion of obesity in high-income areas, is also high in the ranking: four out of every 10 American adults suffer from this ailment.

The “striking” case of Spanish women

Spain dances in the middle of the table: the prevalence in adults is 13% in women and 19% in men; in children, it ranges between 9% in girls and 12% in boys. But the researchers highlight a particular phenomenon in this environment: both here and in France, there is a slight decrease in obesity figures in women, “although the reasons are unknown,” they admit.

The experts consulted ask not to raise bells in the air. “We must be cautious when interpreting the result and not think that the battle against obesity has been won. This may suggest that there is a greater degree of awareness,” agrees Manuel Tena, group leader of the Networked Biomedical Research Center (CIBER) for Obesity and Nutrition. Rodríguez Artalejo admits that it is “eye-catching”, but points out that “it is probably not representative of Spain as a whole throughout the study period because it is based on small and regional studies.” “We are seeing a huge obesity epidemic that we are beginning to control, but we are no better than 30 years ago,” he says.

For its part, the prevalence of low weight in adults in these 30 years fell in 150 countries (globally, in women it went from 14.5% to 7% and in men, from 13.7% to 6.2 %). That is, 347 million people were underweight in 2022, which represents a decrease of about 45 million compared to 1990 and “despite the growth of the world population,” the researchers point out. India, China, Indonesia, Ethiopia, Bangladesh and Japan women record the highest numbers of underweight adults in 2022. In children, the prevalence of underweight fell from 10.3% to 8.2% in girls and 16.7% to 10.8% in children: in 2022, 185 million children were underweight.

The authors admit some limitations in the study, such as the lack of data in some countries or the use of the body mass index (BMI) as an indicator, since it is “imperfect” to measure excess body fat (obesity is considered, a BMI over 30 and underweight, less than 18). However, they defend their findings and propose, for example, that the phenomenon that crystallizes their research, towards the appearance of obesity at increasingly younger ages, “could be due to consumption outside the home and access to commercial foods and processed in school-age children and adolescents followed those in adults during this period.” They also raise the hypothesis that “some leisure games and sports have been replaced by sedentary activities,” although they admit that data on these trends are scarce.

Researchers call to combat malnutrition in Africa and South Asia, where “food insecurity persists” and warn, above all, of the “urgent need to prevent obesity.” In this sense, they criticize that efforts focused on individual behaviors in the food environment have not had much effect. The authors criticize the lack of access to healthy products, especially for the low-income population.

Regarding the explosion of promising anti-obesity drugs, they predict that the impact will be “low worldwide in the short term due to the high cost” of these therapies. Jaume Marrugat, epidemiologist at the Hospital del Mar Research Institute and also a signatory of this study, defends, however, the potential of these therapies to turn, at least in high-income countries, the obesity curve. “These terribly effective drugs. Contrary to what we thought in 2015, the forecast is that we will see an inflection and we may see a decline in obesity. I hope I’m not wrong because, if not, what’s coming to us will be a drama.”