The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean: a cross-sectional series study.


Journal

The Lancet. Global health
ISSN: 2214-109X
Titre abrégé: Lancet Glob Health
Pays: England
ID NLM: 101613665

Informations de publication

Date de publication:
12 2019
Historique:
received: 12 04 2019
revised: 12 09 2019
accepted: 19 09 2019
entrez: 12 11 2019
pubmed: 12 11 2019
medline: 28 5 2020
Statut: ppublish

Résumé

The burden of obesity differs by socioeconomic status. We aimed to characterise the prevalence of obesity among adult men and women in Latin America and the Caribbean by socioeconomic measures and the shifting obesity burden over time. We did a cross-sectional series analysis of obesity prevalence by socioeconomic status by use of national health surveys done between 1998 and 2017 in 13 countries in Latin America and the Caribbean. We generated equiplots to display inequalities in, the primary outcome, obesity by wealth, education, and residence area. We measured obesity gaps as the difference in percentage points between the highest and lowest obesity prevalence within each socioeconomic measure, and described trends as well as changing patterns of the obesity burden over time. 479 809 adult men and women were included in the analysis. Obesity prevalence across countries has increased over time, with distinct patterns emerging by wealth and education indices. In the most recent available surveys, obesity was most prevalent among women in Mexico in 2016, and the least prevalent among women in Haiti in 2016. The largest gap between the highest and lowest obesity estimates by wealth was observed in Honduras among women (21·6 percentage point gap), and in Peru among men (22·4 percentage point gap), compared with a 3·7 percentage point gap among women in Brazil and 3·3 percentage points among men in Argentina. Urban residents consistently had a larger burden than their rural counterparts in most countries, with obesity gaps ranging from 0·1 percentage points among women in Paraguay to 15·8 percentage points among men in Peru. The trend analysis done in five countries suggests a shifting of the obesity burden across socioeconomic groups and different patterns by gender. Obesity gaps by education in Mexico have reduced over time among women, but increased among men, whereas the gap has increased among women but remains relatively constant among men in Argentina. The increase in obesity prevalence in the Latin American and Caribbean region has been paralleled with an unequal distribution and a shifting burden across socioeconomic groups. Anticipation of the establishment of obesity among low socioeconomic groups could provide opportunities for societal gains in primordial prevention. None.

Sections du résumé

BACKGROUND
The burden of obesity differs by socioeconomic status. We aimed to characterise the prevalence of obesity among adult men and women in Latin America and the Caribbean by socioeconomic measures and the shifting obesity burden over time.
METHODS
We did a cross-sectional series analysis of obesity prevalence by socioeconomic status by use of national health surveys done between 1998 and 2017 in 13 countries in Latin America and the Caribbean. We generated equiplots to display inequalities in, the primary outcome, obesity by wealth, education, and residence area. We measured obesity gaps as the difference in percentage points between the highest and lowest obesity prevalence within each socioeconomic measure, and described trends as well as changing patterns of the obesity burden over time.
FINDINGS
479 809 adult men and women were included in the analysis. Obesity prevalence across countries has increased over time, with distinct patterns emerging by wealth and education indices. In the most recent available surveys, obesity was most prevalent among women in Mexico in 2016, and the least prevalent among women in Haiti in 2016. The largest gap between the highest and lowest obesity estimates by wealth was observed in Honduras among women (21·6 percentage point gap), and in Peru among men (22·4 percentage point gap), compared with a 3·7 percentage point gap among women in Brazil and 3·3 percentage points among men in Argentina. Urban residents consistently had a larger burden than their rural counterparts in most countries, with obesity gaps ranging from 0·1 percentage points among women in Paraguay to 15·8 percentage points among men in Peru. The trend analysis done in five countries suggests a shifting of the obesity burden across socioeconomic groups and different patterns by gender. Obesity gaps by education in Mexico have reduced over time among women, but increased among men, whereas the gap has increased among women but remains relatively constant among men in Argentina.
INTERPRETATION
The increase in obesity prevalence in the Latin American and Caribbean region has been paralleled with an unequal distribution and a shifting burden across socioeconomic groups. Anticipation of the establishment of obesity among low socioeconomic groups could provide opportunities for societal gains in primordial prevention.
FUNDING
None.

Identifiants

pubmed: 31708145
pii: S2214-109X(19)30421-8
doi: 10.1016/S2214-109X(19)30421-8
pmc: PMC7613084
mid: EMS150063
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1644-e1654

Subventions

Organisme : NCI NIH HHS
ID : P20 CA217231
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268200900033C
Pays : United States
Organisme : Wellcome Trust
ID : 103994
Pays : United Kingdom
Organisme : NIMH NIH HHS
ID : U19 MH098780
Pays : United States
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : FIC NIH HHS
ID : D71 TW010877
Pays : United States
Organisme : Medical Research Council
ID : MR/M007405/1
Pays : United Kingdom
Organisme : FIC NIH HHS
ID : R21 TW009982
Pays : United States
Organisme : Wellcome Trust
ID : 074833
Pays : United Kingdom
Organisme : NHLBI NIH HHS
ID : U01 HL114180
Pays : United States
Organisme : Wellcome Trust
ID : 214185
Pays : United Kingdom
Organisme : NHLBI NIH HHS
ID : UM1 HL134590
Pays : United States
Organisme : Wellcome Trust
ID : 205177
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn
Type : ErratumIn

Informations de copyright

Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

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Auteurs

Safia S Jiwani (SS)

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: sjiwani1@jhu.edu.

Rodrigo M Carrillo-Larco (RM)

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.

Akram Hernández-Vásquez (A)

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.

Tonatiuh Barrientos-Gutiérrez (T)

Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.

Ana Basto-Abreu (A)

Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.

Laura Gutierrez (L)

South American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.

Vilma Irazola (V)

South American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.

Ramfis Nieto-Martínez (R)

South Florida Veterans Affairs Foundation for Research and Education and Geriatric Research, Education and Clinical Center, Miami VA Healthcare System, Miami, FL, USA; Foundation for Clinical, Public Health, and Epidemiology Research in Venezuela, Caracas, Venezuela.

Bruno P Nunes (BP)

Postgraduate Program of Nursing, Federal University of Pelotas, Rio Grande do Sul, Brazil.

Diana C Parra (DC)

Program of Physical Therapy and Department of Surgery, Institute for Public Health, Washington University in St Louis School of Medicine, St Louis, MO, USA.

J Jaime Miranda (JJ)

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.

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Classifications MeSH