Food marketing, policies, pricing behind tenfold rise in childhood, adolescent obesity in four decades

The number of obese children and adolescents (aged five to 19 years) worldwide has risen tenfold in the past four decades. If current trends continue, more children and adolescents will be obese than moderately or severely underweight by 2022, according to a new study led by Imperial College London and the World Health Organisation (WHO).

The study was published in The Lancet ahead of World Obesity Day (11 October). It analysed weight and height measurements from nearly 130 million people aged over five years (31.5 million people aged five to 19, and 97.4 million aged 20 and older), making it the largest ever number of participants involved in an epidemiological study. More than 1000 contributors participated in the study, which looked at body mass index (BMI) and how obesity has changed worldwide from 1975 to 2016.

Obesity rates in the world’s children and adolescents increased from less than one per cent (equivalent to five million girls and six million boys) in 1975 to nearly six per cent in girls (50 million) and nearly eight per cent in boys (74 million) in 2016. Combined, the number of obese five to 19 year olds rose more than tenfold globally, from 11 million in 1975 to 124 million in 2016. An additional 213 million were overweight in 2016 but fell below the threshold for obesity.

Meanwhile, the Director-General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, has announced the establishment of a new High-level global Commission on Noncommunicable Diseases (NCDs). The announcement came at the 64th Session of WHO’s Regional Committee for the Eastern Mediterranean being held in Islamabad, October 9-12.

The commission’s aim is to identify innovative ways to curb the world’s biggest causes of death and extend life expectancy for millions of people.

The commission will support ongoing political efforts to accelerate action on cardiovascular disease, cancers, diabetes and respiratory disease, as well as reducing suffering from mental health issues and the impacts of violence and injuries.

The High-level global Commission will be chaired by Dr. Sania Nishtar, a prominent global advocate for action against NCDs, former Federal Minister of the government of Pakistan and civil society leader.Nishtar has also previously served as co-chair of the WHO Commission on Ending Childhood Obesity.

Lead author Professor Majid Ezzati, of Imperial’s School of Public Health, says: “Over the past four decades, obesity rates in children and adolescents have soared globally, and continue to do so in low- and middle-income countries. More recently, they have plateaued in higher income countries, although obesity levels remain unacceptably high.”

Ezzati adds: “These worrying trends reflect the impact of food marketing and policies across the globe, with healthy nutritious foods too expensive for poor families and communities. The trend predicts a generation of children and adolescents growing up obese and at greater risk of diseases, like diabetes. We need ways to make healthy, nutritious food more available at home and school, especially in poor families and communities, and regulations and taxes to protect children from unhealthy foods.”

The authors say that if post-2000 trends continue, global levels of child and adolescent obesity will surpass those for moderately and severely underweight youth from the same age group by 2022. In 2016, the global number of moderately or severely underweight girls and boys was 75 million and 117 million respectively.

Nevertheless, the large number of moderately or severely underweight children and adolescents in 2016 (75 million girls and 117 million boys) still represents a major public health challenge, especially in the poorest parts of the world. This reflects the threat posed by malnutrition in all its forms, with there being underweight and overweight young people living in the same communities.

Children and adolescents have rapidly transitioned from mostly underweight to mostly overweight in many middle-income countries, including in East Asia, Latin America and the Caribbean. The authors say this could reflect an increase in the consumption of energy-dense foods, especially highly processed carbohydrates, which lead to weight gain and poor lifelong health outcomes.

NCDs kill approximately 40 million people globally each year, accounting for 70 per cent of all deaths. About 15 million of those deaths are in people between the ages of 30 and 69. Low- and middle-income countries are particularly affected by NCDs with more than 80 per cent of all deaths from NCDs occurring in these countries. Violence and injuries take an overwhelming toll on young people, particularly boys.

In 2015, world leaders committed to reduce premature deaths from NCDs by one third by 2030 as part of the Sustainable Development Goals. Recent WHO reports indicate that the world will struggle to meet that target.

Later this month ministers and other health leaders from around the world will review progress in Montevideo, Uruguay at the WHO Global Conference on Noncommunicable Diseases, co-hosted by WHO and the President of Uruguay. Governments and other stakeholders will meet again at the third United Nations High-level meeting on NCDs in 2018.