Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ing this period. 8-10 Therefore, the association of obesity with CVD remains to be investigated, especially in terms of differences in the association by time period as well as how the association (if any) would be mediated by the established risk factors. 11 Also, there may be differences in the threshold of BMI where significant BMI would be observed, because significant differences exist in the prevalence of obesity by sex and ethnicity. Hence, we set 2 aims in this review. The first aim was to provide an overview of global trends of overweight and obesity according to the WHO regions and countries within each region by sex. The second aim was to provide upto-date information on cohort studies that have investigated the associations of BMI with coronary artery disease (CAD) and stroke in various parts of the world. Methods Overweight and Obesity TrendsThe review compiles the prevalence of overweight and obesity for every country in the WHO's 6 regions of the world (Africa, the Americas, Eastern Mediterranean, South-East Asia, Western Pacific, and Europe).besity is a state of excess fat accumulation that accompanies wide range of health disadvantages. The World Health Organization (WHO) defines a body mass index (BMI) of ≥25 kg/m 2 as overweight, and a BMI of ≥30 kg/m 2 as obesity. 1 The global prevalence of the overweight and obese is on the rise. 2 The Global Burden of Disease Study estimated that the proportion of overweight or obese adults in 2013 was 36% in men and 37% in women worldwide. 3 Globally, the epidemic has affected both developed and developing countries, men and women, and adults and children, although there are great variations in their prevalence and trends among regions or countries, and sexes.Because obesity is believed to cause a number of established risk factors for cardiovascular diseases (CVD) such as hypertension, dyslipidemia, and diabetes, 4 the growing prevalence of obesity is assumed to increase the global CVD burden. However, it is also known that other changes in diet and lifestyle have led to changes in the prevalence of these risk factors, and presumably in CVD incidence. 5, 6 An example of this would be a dramatic decrease in stroke mortality observed after World War 2 in Japan because of the decrease in severe hypertension, 7 although the average BMI also increased dur- Global Trend in Overweight and Obesity and Its Association With Cardiovascular Disease IncidenceHiroshi Yatsuya, MD, PhD; Yuanying Li, PhD; Esayas Haregot Hilawe, PhD; Atsuhiko Ota, MD, PhD; Chaochen Wang, BSc; Chifa Chiang, PhD; Yan Zhang, BSc; Mayu Uemura, BSc; Ayaka Osako, BSc; Yukio Ozaki, MD, PhD; Atsuko Aoyama, MD, PhDAlthough the global prevalence of both the overweight and obese is on the rise, there are variations among regions or countries, and sexes. Approximately half or more than half of the population are overweight/obese defined as body mass index ≥25 kg/m 2 in the Americas (61.1%), Europe (54.8%...

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There is some evidence that tuberculosis vaccine bacillus Calmette-Guérin (BCG) has non-specific beneficial effects against non-related infections. Here, we examined the possible association between BCG vaccination with prevalence and mortality by COVID-19 by using publicly available data of COVID-19 in 199 countries/regions and the BCG World Atlas. By using linear regression modeling, we found that the number of total cases and deaths per one million population were significantly associated with the country's policy concerning BCG vaccine administration. The amount of variance in cases and deaths explained by BCG vaccination policy ranged between 12.5% and 38%. Importantly, this effect remained significant after controlling for the country's life expectancy and the average temperature in February and March 2020, which themselves are significantly correlated with the cases and deaths indices, respectively. By contrast, the ratio between deaths and cases was weakly affected. This latter outcome suggested that BCG vaccination may have hindered the overall spread of the virus or progression of the disease rather than reducing mortality rates (i.e., deaths/cases ratio). Finally, by roughly dividing countries into three categories showing high, middle, or low growth rate of the cases, we found a highly significant difference between the slope categories among the BCG groups, suggesting that the time since the onset of the spread of the virus was not a major confounding factor.

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