The Global Spread of Severe Obesity in Toddlers, Children, and Adolescents: A Systematic Review and Meta-Analysis

Abstract

Introduction: Severe obesity among children and adolescents has emerged as a public health concern in multiple places around the world. Methods: We searched the Medline database for articles on severe obesity rates in children published between January 1960 and January 2020. For studies with available prevalence rates for an early and a more recent time period, the relative increase in prevalence was imputed. Results: In total, 874 publications were identified, of which 38 contained relevant epidemiological data. Rates of severe obesity varied significantly according to age, gender, geographic area, and the definition of severe obesity. The highest rates of class II and III obesity in the US according to the Centers of Disease Control cutoff were 9.5% and 4.5%, respectively. Seventeen studies reported prevalence rates in at least two time periods. Data for 9,190,718 individuals showed a 1.71 (95%CI, 1.53-1.90) greater odds for severe obesity in 2006-2017 (N=5,029,584) vs. 1967-2007 (N=4,161,134). In an analysis limited to studies from 1980s’ with a minimum follow-up of 20 years, a 9.16(95%CI, 7.76-10.80) greater odds for severe obesity in recent vs. earlier time was found. An analysis limited to studies from 2000, with a follow-up of 5-15 years, a 1.09 (95%CI, 0.99-1.20) greater odds was noted when comparing (2011-2017; N=4,991,831) vs. (2000-2011; N=4,134,340). Conclusion: Severe pediatric obesity is escalating with a marked increase from the1980’s and a slower rate from 2000.

Iron Deficiency and Iron Deficiency Anemia in Women with and without Obesity: NHANES 2001–2006

“…The disproportionate rates of ID in children and women align with elevated rates of severe obesity in these populations. Severe pediatric obesity rates have escalated since the 1980s [ 19 ], and women with severe obesity (11.5%) currently outnumber men (6.9%) in the United States [ 20 ]. Given the rising levels of obesity in these groups, particularly severe obesity, and its impact on iron metabolism and status, studies that focus on providing how iron biomarkers and ID vary by BMI in large populations could be important for public health education and policy.…”

Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study

“…The negative effects of severe childhood obesity on health [36] and its rising prevalence in many HICs are alarming [37]. Although emergent scientific evidence is showing that severe obesity is in general associated with lower socioeconomic status [38], more in-depth analyses are needed to study its association with specific SES indicators [39]. Data from the WHO European Childhood Obesity Surveillance Initiative (COSI) found that in European countries, severe obesity was more common among children whose mothers had a lower educational level.…”

High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity

“…A substantial increase in the rates of severe obesity in children and adolescents has been demonstrated over the past decades, and this phenomenon appears to be nearly universal and not limited to a particular region [ 35 ]. The prevalence of severe obesity among subjects aged 2–19 years in United States, from the years 1971–1974 to the years 2017–2018, raised from 1.0% to 6.1% [ 36 ].…”