In a comprehensive assessment of trends in body-mass index (BMI) in 199 countries, Mariel Finucane and -colleagues (Feb 12, p 557) show that mean BMI and prevalence of overweight have increased since 1980, concluding that "interventions and policies that can curb or reverse the increase...are needed in most countries". Caution, however, is warranted in interpreting the country-specific or region-specific average trends, especially in low-to-middle-income countries. The most recent, nationally representative data on adult women from 54 low-to-middle-income countries, with objectively measured BMI, unequivocally show a positive association between BMI or overweight and socioeconomic status in 52 countries. In a subsample of 37 countries with several surveys over time, increases in BMI and overweight prevalence seem to persist in groups with high socioeconomic status in most countries (figure). Even though increasing BMI is no longer confined to high-income countries, it remains concentrated among high-income people within low-to-middle-income countries.
展开▼
