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Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults

Majid Ezzati, James Bentham, Mariachiara Di Cesare, Ver Bilano, Honor Bixby, Bin Zhou, Gretchen A. Stevens, Leanne M. Riley, Cristina Taddei, Kaveh Hajifathalian, et al. (2017) LANCET. 390(10113). p.2627-2642
abstract
Background: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods: We pooled 2416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 years and older, including 31.5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0.01 kg/m (2) per decade; 95% credible interval -0.42 to 0.39, posterior probability [PP] of the observed decrease being a true decrease= 0.5098) in eastern Europe to an increase of 1.00 kg/m(2) per decade (0.69-1.35, PP> 0.9999) in central Latin America and an increase of 0.95 kg/m (2) per decade (0.64-1.25, PP> 0.9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0.09 kg/m(2) per decade (-0.33 to 0.49, PP= 0.6926) in eastern Europe to an increase of 0.77 kg/m (2) per decade (0.50-1.06, PP> 0.9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0.7% (0.4-1.2) in 1975 to 5.6% (4.8-6.5) in 2016 in girls, and from 0.9% (0.5-1.3) in 1975 to 7.8% (6.7-9.1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9.2% (6.0-12.9) in 1975 to 8.4% (6.8-10.1) in 2016 in girls and from 14.8% (10.4-19.5) in 1975 to 12.4% (10.3-14.5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22.7% (16.7-29.6) among girls and 30.7% (23.5-38.0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. Interpretation: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.
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author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MILLION PARTICIPANTS, CHILDHOOD OBESITY, PREVENTION PROGRAMS, HEALTH, FOOD, PREVALENCE, WEIGHT, RISK, MORTALITY, COUNTRIES
journal title
LANCET
Lancet
volume
390
issue
10113
pages
2627 - 2642
Web of Science type
Article
Web of Science id
000418101000024
ISSN
0140-6736
1474-547X
DOI
10.1016/S0140-6736(17)32129-3
language
English
UGent publication?
yes
classification
A1
copyright statement
Creative Commons Attribution 4.0 International Public License (CC-BY 4.0)
id
8543503
handle
http://hdl.handle.net/1854/LU-8543503
date created
2018-01-03 15:03:43
date last changed
2018-01-12 14:58:53
@article{8543503,
  abstract     = {Background: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. 
Methods: We pooled 2416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 years and older, including 31.5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). 
Findings: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0.01 kg/m (2) per decade; 95\% credible interval -0.42 to 0.39, posterior probability [PP] of the observed decrease being a true decrease= 0.5098) in eastern Europe to an increase of 1.00 kg/m(2) per decade (0.69-1.35, PP{\textrangle} 0.9999) in central Latin America and an increase of 0.95 kg/m (2) per decade (0.64-1.25, PP{\textrangle} 0.9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0.09 kg/m(2) per decade (-0.33 to 0.49, PP= 0.6926) in eastern Europe to an increase of 0.77 kg/m (2) per decade (0.50-1.06, PP{\textrangle} 0.9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0.7\% (0.4-1.2) in 1975 to 5.6\% (4.8-6.5) in 2016 in girls, and from 0.9\% (0.5-1.3) in 1975 to 7.8\% (6.7-9.1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9.2\% (6.0-12.9) in 1975 to 8.4\% (6.8-10.1) in 2016 in girls and from 14.8\% (10.4-19.5) in 1975 to 12.4\% (10.3-14.5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22.7\% (16.7-29.6) among girls and 30.7\% (23.5-38.0) among boys. Prevalence of obesity was more than 30\% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20\% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. 
Interpretation: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.},
  author       = {Ezzati, Majid and Bentham, James and Di Cesare, Mariachiara and Bilano, Ver and Bixby, Honor and Zhou, Bin and Stevens, Gretchen A. and Riley, Leanne M. and Taddei, Cristina and Hajifathalian, Kaveh and Lu, Yuan and Savin, Stefan and Cowan, Melanie J. and Paciore, Christopher J. and Chiritaemandi, Adela and Hayes, Alison J. and Katz, Joanne and Kelishadi, Roya and Kengne, Andre Pascal and Khang, Young-Ho and Laxmaiah, Avula and Li, Yanping and Ma, Jun and Miranda, J. Jaime and Mostafa, Aya and Neovius, Martin and Padez, Cristina and Rampal, Lekhraj and Zhu, Aubrianna and Bennet, James E. and Danaei, Goodarz and Bhutta, Zulfiqar A. and Ezzati, Majid and Abarca-Gomez, Leandra and Abdeen, Ziad A. and Hamid, Zargar Abdul and Abu-Rmeileh, Niveen M. and Acosta-Cazares, Benjamin and Acuin, Cecilia and Adams, Robert J. and Aekplakorn, Wichai and Afsana, Kaosar and Aguilar-Salinas, Carlos A. and Agyemng, Charles and Ahmadvand, Alireza and Ahrens, Wolfgang and Ajlouni, Kamel and Akhtaeva, Nazgul and Al-Hazzaa, Hazzaa M. and Al-Othman, Amani Rashed and Al-Raddadi, Rajaa and AlBuhairan, Fadia and AlDhukai, Shahla and Ali, Mohamed M. and Ali, Osman and Alkerwi, Ala'a and Alvarez-Pedrerol, Mar and Aly, Eman and Amarapurkar, Deepak N. and Amouyel, Philippe and Amuzu, Antoinette and Andersen, Lars Bo and Anderssen, Sigmund A. and Andrade, Dolores S. and Angquist, Lars H. and Anjana, Ranjit Mohan and Aounallah-Skhiri, Hajer and Araujo, Joana and Arianse, Inger and Aris, Tahir and Arlappa, Nimmathota and Arveiler, Dominique and Aryal, Krishna K. and Aspelund, Thor and Assah, Felix K. and Assuncao, Maria Cecilia F. and Aung, May Soe and Avdicova, Maria and Azevedo, Ana and Azizi, Fereidoun and Babu, Bontha V. and Bahijri, Suhad and Baker, Jennifer L. and Balakrishna, Nagalla and Bamoshmoosh, Mohamed and Banach, Maciej and Bandosz, Piotr and Banegas, Jose R. and Barbagallo, Carlo M. and Barcelo, Alberto and Barkat, Amina and Barros, Aluisio J. D. and Barros, Mauro V. G. and Bata, Iqbal and Batieha, Anwar M. and Batista, Rosangela L. and Batyrbek, Assembekov and Baur, Louise A. and Beaglehole, Robert and Ben Romdhane, Habiba and Benedics, Judith and Benet, Mikhail and Bennet, James E. and Bernabe, Antonio and Bernotiene, Gailute and Bettiol, Heloisa and Bhagyalaxmi, Aroor and Bharadwaj, Sumit and Bhargava, Santosh K. and Bhatti, Zaid and Bhutta, Zulfiqar A. and Bi, Hongsheng and Bi, Yufang and Biehl, Anna and Bikbov, Mukharram and Bista, Bihungum and Bjelica, Dusko J. and Bjerregaard, Peter and Bjertnes, Espen and Bjness, Marius B. and Bjorkelund, Cecilia and Blokstra, Anneke and Bo, Simona and Bobak, Martin and Boddy, Lynne M. and Boehm, Bernhard O. and Boeing, Heiner and Boggia, Jose G. and Boissonnet, Carlos P. and Bonaccio, Marialaura and Bongard, Vanina and Bovet, Pascal and Braeckevelt, Lien and Braeckman, Lutgart and Bragt, Marjolijn C. E. and Brajkovich, Imperia and Branca, Francesco and Breckenkamp, Juergen and Breda, Joao and Brenner, Hermann and Brewster, Lizzy M. and Brian, Garry R. and Brinduse, Lacramioara and Bruno, Graziella and Bueno-de-Mesquita, H. B. and Bugge, Anna and Buoncristiano, Marta and Burazeri, Genc and Burns, Con and Cabrera de Leon, Antonio and Cacciottolo, Joseph and Cai, Hui and Cama, Tilema and Cameron, Christine and Camola, Jose and Can, Gunay and Candido, Ana P. C. C. and Capanzana, Mario and Capuano, Vincenzo and Cardoso, Viviane C. and Carlsson, Axel C. and Carvalho, Maria J. and Casanueva, Felipe F. and Casas, Juan Pablo and Caserta, Carmelo A. and Chamukuttan, Snehalatha and Chan, Angelique W. and Chan, Queenie and Chaturvedi, Himanshu K. and Chaturvedi, Nishi and Chen, Chien-Jen and Chen, Fangfang and Chen, Huashuai and Chen, Shuohua and Chen, Zhengming and Cheng, Ching-Yu and Chetrit, Angela and Chikova-Iscener, Ekaterina and Chiolero, Arnaud and Chiou, Shu-Ti and Chirita-Emandi, Adela and Chirlaque, Maria-Dolores and Cho, Belong and Cho, Yumi and Christensen, Kaare and Christofaro, Diego G. and Chudek, Jerzy and Cifkova, Renata and Cinteza, Eliza and Claessens, Frank and Clays, Els and Concin, Hans and Confortin, Susana C. and Cooper, Cyrus and Cooper, Rachel and Coppinger, Tara C. and Costanzo, Simona and Cottel, Dominique and Cowell, Chris and Craig, Cora L. and Crujeiras, Ana B. and Cucu, Alexandra and D'Arrigo, Graziella and d'Orsi, Eleonora and Dallongeville, Jean and Damasceno, Albertino and Damsgaard, Camilla T. and Danae, Goodarz and Dankner, Rachel and Dantoft, Thomas M. and Dastgiri, Saeed and Dauchet, Luc and Davletov, Kairat and De Backer, Gui and De Bacquer, Dirk and De Curtis, Amalia and de Gaetano, Giovanni and De Henauw, Stefaan and de Oliveira, Paula Duarte and De Ridder, Karin and De Smedt, Delphine and Deepa, Mohan and Deev, Alexander D. and Dehghan, Abbas and Delisle, Helene and Delpeuch, Francis and Deschamps, Valerie and Dhana, Klodian and Di Castelnuovo, Augusto F. and Dias-da-Costa, Juvenal Soares and Diaz, Alejandro and Dika, Zivka and Djalalinia, Shirin and Do, Ha T. P. and Dobson, Annette J. and Donati, Maria Benedetta and Donfrancesco, Chiara and Donoso, Silvana P. and Doering, Angela and Dorobantu, Maria and Dorosty, Ahmad Reza and Doua, Kouamelan and Drygas, Wojciech and Duan, Jia Li and Duante, Charmaine and Duleva, Vesselka and Dulskiene, Virginija and Dzerve, Vilnis and Dziankowska-Zaborszczyk, Elzbieta and Egbagbe, Eruke E. and Eggertsen, Robert and Eiben, Gabriele and Ekelund, Ulf and El Ati, Jalila and Elliott, Paul and Engle-Stone, Reina and Erasmus, Rajiv T. and Erem, Cihangir and Eriksen, Louise and Eriksson, Johan G. and Escobedo, Jorge and Evans, Alun and Faeh, David and Fall, Caroline H. and Sant'Angelo, Victoria Farrugia and Farzadfar, Farshad and Felix-Redondo, Francisco J. and Ferguson, Trevor S. and Fernandes, Romulo A. and Fernandez-Berges, Daniel and Ferrante, Daniel and Ferrari, Marika and Ferreccio, Catterina and Ferrieres, Jean and Finn, Joseph D. and Fischer, Krista and Monterubio Flores, Eric and Foeger, Bernhard and Foo, Leng Huat and Forslund, Ann-Sofie and Forsner, Maria and Fouad, Heba M. and Francis, Damian K. and Franco, Maria do Carmo and Franco, Oscar H. and Frontera, Guillermo and Fuchs, Flavio D. and Fuch, Sandra C. and Fujita, Yuki and Furusawa, Takuro and Gaciong, Zbigniew and Gafencu, Mihai and Galeone, Daniela and Galvano, Fabio and Garcia-de-la-Hera, Manoli and Gareta, Dickman and Garnett, Sarah P. and Gaspoz, Jean-Michel and Gasull, Magda and Gates, Louise and Geiger, Harald and Geleijnse, Johanna M. and Ghasemian, Anoosheh and Giampaoli, Simona and Gianfagna, Francesco and Gill, Tiffany K. and Giovannelli, Jonathan and Giwerman, Aleksander and Godos, Justyna and Gogen, Sibel and Goldsmith, Rebecca A. and Goltzman, David and Goncalves, Helen and Gonzalez-Leon, Margot and Gonzalez-Rivas, Juan P. and Gonzalez-Gross, Marcela and Gottrand, Frederic and Graca, Antonio Pedro and Graff-Iversen, Sidsel and Grafnetter, Dusan and Grajda, Aneta and Grammatikopoulou, Maria G. and Gregor, Ronald D. and Grodzicki, Tomasz and Grontved, Anders and Grosso, Giuseppe and Gruden, Gabriella and Grujic, Vera and Gu, Dongfeng and Gualdi-Russo, Emanuela and Guallar-Castillon, Pilar and Guan, Ong Peng and Gudmundsson, Elias F. and Gudnason, Vilmundur and Guerrero, Ramiro and Guessous, Idris and Guimaraes, Andre L. and Gulliford, Martin C. and Gunnlaugsdottir, Johanna and Gunter, Marc and Guo, Xiuhua and Guo, Yin and Gupta, Prakash C. and Gupta, Rajeev and Gureje, Oye and Gurzkowska, Beata and Gutierrez, Laura and Gutzwiller, Felix and Hadaegh, Farzad and Hadjigeorgiou, Charalambos A. and Si-Ramlee, Khairil and Halkjaer, Jytte and Hambleton, Ian R. and Hardy, Rebecca and Kumar, Rachakulla Hari and Hassapidou, Maria and Hata, Jun and Hayes, Alison J. and He, Jiang and Heidinger-Felso, Regina and Heinen, Mirjam and Hendriks, Marleen Elisabeth and Henriques, Ana and Cadena, Leticia Hernandez and Herrala, Sauli and Herrera, Victor M. and Herter-Aeberli, Isabelle and Heshmat, Ramin and Hihtaniemi, Ilpo Tapani and Ho, Sai Yin and Ho, Suzanne C. and Hobbs, Michael and Hofman, Albert and Hopman, Wilma M. and Horimoto, Andrea R. V. R. and Hormiga, Claudia M. and Horta, Bernardo L. and Houti, Leila and Howitt, Christina and Htay, Thein Thein and Htet, Aung Soe and Htike, Maung Maung Than and Hu, Yonghua and Huerta, Jose Maria and Petrescu, Constanta Huidumac and Huisman, Martijn and Husseini, Abdullatif and Chinh Nguyen Huu, Chinh Nguyen Huu and Huybrechts, Inge and Hwalla, Nahla and Hyska, Jolanda and Iacoviello, Licia and Iannone, Anna G. and Ibarluzea, Jesus M. and Ibrahim, Mohsen M. and Ikeda, Nayu and Ikram, M. Arfan and Irazola, Vilma E. and Islam, Muhammad and Ismail, Aziz al-Safi and Ivkovic, Vanja and Iwasaki, Masanori and Jackson, Rod T. and Jacobs, Jeremy M. and Jaddou, Hashem and Jafar, Tazeen and Jamil, Kazi M. and Jamrozik, Konrad and Janszky, Imre and Jarani, Juel and Jasienska, Grazyna and Jelakovic, Ana and Jelakovic, Bojan and Jennings, Garry and Jeong, Seung-Lyeal and Jiang, Chao Qiang and Magaly Jimenez-Acosta, Santa and Joffres, Michel and Johansson, Mattias and Jonas, Jost B. and Jorgensen, Torben and Joshi, Pradeep and Jovic, Dragana P. and Jozwiak, Jacek and Juolevi, Anne and Jurak, Gregor and Juresa, Vesna and Kaaks, Rudolf and Kafatos, Anthony and Kajantie, Eero O. and Kalter-Leibovici, Ofra and Kamaruddin, Nor Azmi and Kapantais, Efthymios and Karki, Khem B. and Kasaeian, Amir and Katz, Joanne and Kauhanen, Jussi and Kaur, Prabhdeep and Kavousi, Maryam and Kazakbaeva, Gyulli and Keil, Ulrich and Boker, Lital Keinan and Keinanen-Kiukaanniemi, Sirkka and Kelishadi, Roya and Kelleher, Cecily and Kemper, Han C. G. and Kengne, Andre P. and Kerimkulova, Alina and Kersting, Mathilde and Key, Timothy and Khader, Ousef Saleh and Khalili, Davood and Khang, Young-Ho and Khateeb, Mohammad and Khaw, Kay-Tee and Khouw, Ilse M. S. L. and Kiechl-Kohlendorfer, Ursula and Kiech, Stefan and Killewo, Japhet and Kim, Jeongseon and Kim, Yeon-Yong and Klimont, Jeannette and Klumbiene, Jurate and Knoflach, Michael and Koirala, Bhawesh and Kolle, Elin and Kolsteren, Patrick and Korrovits, Paul and Kos, Jelena and Koskinen, Seppo and Kouda, Katsuyasu and Kovacs, Viktoria A. and Kowlessur, Sudhir and Koziel, Slawomir and Kratzer, Wolfgang and Kriemler, Susi and Kristensen, Peter Lund and Krokstad, Steinar and Kromhout, Daan and Kruger, Herculina S. and Kubinova, Ruzena and Kuciene, Renata and Kuh, Diana and Kujala, Urho M. and Kulaga, Zbigniew and Kumar, R. Krishna and Kunesova, Marie and Kurjata, Pawel and Kusuma, Yadlapalli S. and Kuulasmaa, Kari and Kyobutungi, Catherine and Quang Ngoc La, Quang Ngoc La and Laamiri, Fatima Zahra and Laatikainen, Tina and Lachat, Carl and Laid, Youcef and Lam, Tai Hing and Landrove, Orlando and Lanska, Vera and Lappas, Georg and Larijani, Bagher and Laugsand, Lars E. and Lauria, Laura and Laxmaiah, Avula and Khanh Le Nguyen Bao, Khanh Le Nguyen Bao and Tuyen D Le, Tuyen D Le and Lebanan, May Antonnette O. and Leclercq, Catherine and Lee, Jeannette and Lee, Jeonghee and Lehtimaki, Terho and Leon-Munoz, Luz M. and Levitt, Naomi S. and Li, Yanping and Lilly, Christa L. and Lim, Wei-Yen and Fernanda Lima-Costa, M. and Lin, Hsien-Ho and Lin, Xu and Lind, Lars and Linneberg, Allan and Lissner, Lauren and Litwin, Mieczyslaw and Liu, Jing and Loit, Helle-Mai and Lopes, Luis and Lorbeer, Roberto and Lotufo, Paulo A. and Eugenio Lozano, Jose and Luksiene, Dalia and Lundqvist, Annamari and Lunet, Nuno and Lytsy, Per and Ma, Guansheng and Ma, Jun and Machado-Coelho, George L. L. and Machado-Rodrigues, Aristides M. and Machi, Suka and Maggi, Stefania and Magliano, Dianna J. and Magriplis, Emmanuella and Mahaletchumy, Alagappan and Maire, Bernard and Majer, Marjeta and Makdisse, Marcia and Malekzadeh, Reza and Malhotra, Rahul and Rao, Kodavanti Mallikharjuna and Malyutina, Sofia and Manios, Yannis and Mann, Jim I. and Manzato, Enzo and Margozzini, Paula and Markaki, Anastasia and Markey, Oonagh and Marques, Larissa P. and Marques-Vidal, Pedro and Marrugat, Jaume and Martin-Prevel, Yves and Martin, Rosemarie and Martorell, Reynaldo and Martos, Eva and Marventano, Stefano and Masoodi, Shariq R. and Mathiesen, Ellisiv B. and Matijasevich, Alicia and Matsha, Tandi E. and Mazur, Artur and Mbanya, Jean Claude N. and McFarlane, Shelly R. and McGarvey, Stephen T. and McKee, Martin and McLac, Stela and McLean, Rachael M. and McLean, Scott B. and McNulty, Breige A. and Yusof, Safiah Md and Mediene-Benchekor, Sounnia and Medzioniene, Jurate and Meirhaeghe, Aline and Meisfjord, Jorgen and Meisinger, Christa and Menezes, Ana Maria B. and Menon, Geetha R. and Mensink, Gert B. M. and Meshram, Indrapal I. and Metspalu, Andres and Meyer, Haakon E. and Mi, Jie and Michaelsen, Kim F. and Michels, Nathalie and Mikkel, Kairit and Miller, Jody C. and Minderico, Claudia S. and Miquel, Juan Francisco and Miranda, J. Jaime and Mirkopoulou, Daphne and Mirrakhimov, Erkin and Misigoj-Durakovic, Marjeta and Mistretta, Antonio and Mocanu, Veronica and Modesti, Pietro A. and Mohamed, Mostafa K. and Mohammad, Kazem and Mohammadifard, Noushin and Mohan, Viswanathan and Mohanna, Salim and Yusoff, Muhammad Fadhli Mohd and Molbo, Drude and Mollehave, Line T. and Moller, Niels C. and Molnar, Denes and Momenan, Amirabbas and Mondo, Charles K. and Monterrubio, Eric A. and Monyeki, Kotsedi Daniel K. and Moon, Jin Soo and Moreira, Leila B. and Morejo, Alain and Moreno, Luis A. and Morgan, Karen and Mortensen, Erik Lykke and Moschonis, George and Mossakowska, Malgorzata and Mostafa, Aya and Mota, Jorge and Mota-Pinto, Anabela and Motlag, Mohammad Esmaeel and Motta, Jorge and Mu, Thet Thet and Muc, Magdalena and Muiesan, Maria Lorenza and Mueller-Nurasyid, Martina and Murphy, Neil and Mursu, Jaakko and Murtagh, Elaine M. and Musil, Vera and Nabipour, Iraj and Nagel, Gabriele and Naidu, Balkish M. and Nakamura, Harunobu and Namesna, Jana and Nang, Ei Ei K. and Nangia, Vinay B. and Nankap, Martin and Narake, Sameer and Nardone, Paola and Navarrete-Munoz, Eva Maria and Neal, William A. and Nenko, Ilona and Neovius, Martin and Nervi, Flavio and Nguyen, Chung T. and Nguyen, Nguyen D. and Quang Ngoc Nguye, Quang Ngoc Nguye and Nieto-Martinez, Ramfis E. and Ning, Guang and Ninomiya, Toshiharu and Nishtar, Sania and Noale, Marianna and Noboa, Oscar A. and Norat, Teresa and Norie, Sawada and Noto, Davide and Al Nsour, Mohannad and O'Reilly, Dermot and Obreja, Galina and Oda, Eiji and Oehlers, Glenn and Oh, Kyungwon and Ohara, Kumiko and Olafsson, Orn and Anselmo Olinto, Maria Teresa and Oliveira, Isabel O. and Oltarzewski, Maciej and Omar, Mohd Azahadi and Onat, Altan and Ong, Sok King and Ono, Lariane M. and Ordunez, Pedro and Ornelas, Rui and Ortiz, Ana P. and Osler, Merete and Osmond, Clive and Ostojic, Sergej M. and Ostovar, Afshin and Otero, Johanna A. and Overvad, Kim and Owusu-Dabo, Ellis and Paccaud, Fred Michel and Padez, Cristina and Pahomova, Elena and Pajak, Andrzej and Palli, Domenico and Palloni, Alberto and Palmieri, Luigi and Pan, Wen-Harn and Panda-Jonas, Songhomitra and Pandey, Arvind and Panza, Francesco and Papandreou, Dimitrios and Park, Soon-Woo and Parnell, Winsome R. and Parsaeian, Mahboubeh and Pascanu, Ionela M. and Patel, Nikhil D. and Pecin, Ivan and Pednekar, Mangesh S. and Peer, Nasheeta and Peeters, Petra H. and Peixoto, Sergio Viana and Peltonen, Markku and Pereira, Alexandre C. and Perez-Farinos, Napoleon and Perez, Cynthia M. and Peters, Annette and Petkeviciene, Janina and Petrauskiene, Ausra and Peykari, Niloofar and Son Thai Pham, Son Thai Pham and Pierannunzio, Daniela and Pigeo, Iris and Pikhart, Hynek and Pilav, Aida and Pilotto, Lorenza and Pistelli, Francesco and Pitakaka, Freda and Piwonska, Aleksandra and Plans-Rubio, Pedro and Poh, Bee Koon and Pohlabeln, Hermann and Pop, Raluca M. and Popovic, Stevo R. and Porta, Miquel and Portegies, Marileen L. P. and Posch, Georg and Poulimeneas, Dimitrios and Pouraram, Hamed and Pourshams, Akram and Poustchi, Hossein and Pradeepa, Rajendra and Prashant, Mathur and Price, Jacqueline F. and Puder, Jardena J. and Pudule, Iveta and Puiu, Maria and Punab, Margus and Qasrawi, Radwan F. and Qorbani, Mostafa and Tran Quoc Bao, Tran Quoc Bao and Radic, Ivana and Radisauskas, Ricardas and Rahman, Mahfuzar and Rahman, Mahmudur and Raitakari, Olli and Raj, Manu and Rao, Sudha Ramachandra and Ramachandran, Ambady and Ramke, Jacqueline and Ramos, Elisabete and Ramos, Rafel and Rampal, Lekhraj and Rampal, Sanjay and Rascon-Pacheco, Ramon A. and Redon, Josep and Reganit, Paul Ferdinand M. and Ribas-Barba, Lourdes and Ribeiro, Robespierre and Riboli, Elio and Rigo, Fernando and de Wit, Tobias F. Rinke and Rito, Ana and Ritti-Dias, Raphael M. and Rivera, Juan A. and Robinson, Sian M. and Robitaille, Cynthia and Rodrigues, Daniela and Rodriguez-Artalejo, Fernando and del Cristo Rodriguez-Perez, Maria and Rodriguez-Villamizar, Laura A. and Rojas-Martinez, Rosalba and Rojroongwasinkul, Nipa and Romaguera, Dora and Ronkainen, Kimmo and Rosengren, Annika and Rouse, Ian and Roy, Joel G. R. and Rubinstein, Adolfo and Ruhli, Frank J. and Ruiz-Betancourt, Blanca Sandra and Russo, Paola and Rutkowski, Marcin and Sabanayagam, Charumathi and Sachdev, Harshpal S. and Saidi, Olfa and Salanave, Benoit and Martinez, Eduardo Salazar and Salmeron, Diego and Salomaa, Veikko and Salonen, Jukka T. and Salvetti, Massimo and Sanchez-Abanto, Jose and Sandjaja, Sandjaja and Sans, Susana and Marina, Loreto Santa and Santos, Diana A. and Santos, Ina S. and Santos, Osvaldo and dos Santos, Renata Nunes and Santos, Rute and Saramies, Jouko L. and Sardinha, Luis B. and Sarrafzadegan, Nizal and Saum, Kai-Uwe and Savva, Savvas and Savy, Mathilde and Scazufca, Marcia and Rosario, Angelika Schaffrath and Schargrodsky, Herman and Schienkiewitz, Anja and Schipf, Sabine and Schmidt, Carsten O. and Schmidt, Ida Maria and Schultsz, Constance and Schutte, Aletta E. and Sein, Aye Aye and Sen, Abhijit and Senbanjo, Idowu O. and Sepanlou, Sadaf G. and Serra-Majem, Luis and Shalnova, Svetlana A. and Sharma, Sanjib K. and Shaw, Jonathan E. and Shibuya, Kenji and Shin, Dong Wook and Shin, Youchan and Shiri, Rahman and Siani, Alfonso and Siantar, Rosalynn and Sibai, Abla M. and Silva, Antonio M. and Santos Silva, Diego Augusto and Simon, Mary and Simons, Judith and Simons, Leon A. and Sjoberg, Agneta and Sjostrom, Michael and Skovbjerg, Sine and Slowikowska-Hilczer, Jolanta and Slusarczyk, Przemyslaw and Smeeth, Liam and Smith, Margaret C. and Snijder, Marieke B. and So, Hung-Kwan and Sobngwi, Eugene and Soderberg, Stefan and Soekatri, Moesijanti Y. 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Shyong and Tammesoo, Mari-Liis and Tamosiunas, Abdonas and Tan, Eng Joo and Tang, Xun and Tanser, Frank and Tao, Yong and Tarawneh, Mohammed Rasoul and Tarp, Jakob and Tarqui-Mamani, Carolina B. and Tautu, Oana-Florentina and Braunerova, Radka Taxova and Taylor, Anne and Tchibindat, Felicite and Theobald, Holger and Theodoridis, Xenophon and Thijs, Lutgarde and Thuesen, Betina H. and Tjonneland, Anne and Tolonen, Hanna K. and Tolstrup, Janne S. and Topbas, Murat and Topor-Madry, Roman and Tormo, Maria Jose and Tornaritis, Michael J. and Torrent, Maties and Toselli, Stefania and Traissac, Pierre and Trichopoulos, Dimitrios and Trichopoulou, Antonia and Trinh, Oanh T. H. and Trivedi, Atul and Tshepo, Lechaba and Tsigga, Maria and Tsugane, Shoichiro and Tulloch-Reid, Marshall K. and Tullu, Fikru and Tuomainen, Tomi-Pekka and Tuomilehto, Jaakko and Turley, Maria L. and Tynelius, Per and Tzotzas, Themistoklis and Tzourio, Christophe and Ueda, Peter and Ugel, Eunice E. and Ukoli, Flora A. M. and Ulmer, Hanno and Unal, Belgin and Uusitalo, Hannu M. T. and Valdivia, Gonzalo and Vale, Susana and Valvi, Damaskini and van der Schouw, Yvonne T. and Van Herck, Koen and Hoang Van Minh, Hoang Van Minh and van Rossem, Lenie and Van Schoor, Natasja M. and van Valkengoed, Irene G. M. and Vanderschueren, Dirk and Vanuzzo, Diego and Vatten, Lars and Vega, Tomas and Veidebaum, Toomas and Velasquez-Melendez, Gustavo and Velika, Biruta and Veronesi, Giovanni and Verschuren, W. M. Monique and Victora, Cesar G. and Viegi, Giovanni and Viet, Lucie and Viikari-Juntura, Eira and Vineis, Paolo and Vioque, Jesus and Virtanen, Jyrki K. and Visvikis-Siest, Sophie and Viswanathan, Bharathi and Vlasoff, Tiina and Vollenweider, Peter and Voelzke, Henry and Voutilainen, Sari and Vrijheid, Martine and Wade, Alisha N. and Wagner, Aline and Waldhor, Thomas and Walton, Janette and Bebakar, Wan Mohamad Wan and Mohamud, Wan Nazaimoon Wan and Wanderley, Rildo S., Jr. and Wang, Ming-Dong and Wan, Qian and Wang, Ya Xing and Wannamethee, S. Goya and Wareham, Nicholas and Weber, Adelheid and Wedderkopp, Niels and Weerasekera, Deepa and Whincup, Peter H. and Widhalm, Kurt and Widyahening, Indah S. and Wiecek, Andrzej and Wijga, Alet H. and Wilks, Rainford J. and Willeit, Johann and Willeit, Peter and Wilsgaard, Tom and Wojtyniak, Bogdan and Wong-McClure, Roy A. and Wong, Justin Y. Y. and Wong, Jyh Eiin and Wong, Tien Yin and Woo, Jean and Woodward, Mark and Wu, Frederick C. and Wu, Jianfeng and Wu, Shouling and Xu, Haiquan and Xu, Liang and Yamborisut, Uruwan and Yan, Weili and Yang, Xiaoguang and Yardim, Nazan and Ye, Xingwang and Yiallouros, Panayiotis K. and Yngve, Agneta and Yoshihara, Akihiro and You, Qi Sheng and Younger-Coleman, Novie O. and Yusoff, Faudzi and Yusoff, Muhammad Fadhli M. and Zaccagni, Luciana and Zafiropulos, Vassilis and Zainuddin, Ahmad A. and Zambon, Sabina and Zampelas, Antonis and Zamrazilova, Hana and Zdrojewski, Tomasz and Zeng, Yi and Zhao, Dong and Zhao, Wenhua and Zheng, Wei and Zheng, Yingfeng and Zholdin, Bekbolat and Zhou, Maigeng and Zhu, Dan and Zhussupov, Baurzhan and Zimmermann, Esther and Cisneros, Julio Zuniga},
  issn         = {0140-6736},
  journal      = {LANCET},
  keyword      = {MILLION PARTICIPANTS,CHILDHOOD OBESITY,PREVENTION PROGRAMS,HEALTH,FOOD,PREVALENCE,WEIGHT,RISK,MORTALITY,COUNTRIES},
  language     = {eng},
  number       = {10113},
  pages        = {2627--2642},
  title        = {Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults},
  url          = {http://dx.doi.org/10.1016/S0140-6736(17)32129-3},
  volume       = {390},
  year         = {2017},
}

Chicago
Ezzati, Majid, James Bentham, Mariachiara Di Cesare, Ver Bilano, Honor Bixby, Bin Zhou, Gretchen A. Stevens, et al. 2017. “Worldwide Trends in Body-mass Index, Underweight, Overweight, and Obesity from 1975 to 2016 : a Pooled Analysis of 2416 Population-based Measurement Studies in 128.9 Million Children, Adolescents, and Adults.” Lancet 390 (10113): 2627–2642.
APA
Ezzati, M., Bentham, J., Di Cesare, M., Bilano, V., Bixby, H., Zhou, B., Stevens, G. A., et al. (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. LANCET, 390(10113), 2627–2642.
Vancouver
1.
Ezzati M, Bentham J, Di Cesare M, Bilano V, Bixby H, Zhou B, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. LANCET. 2017;390(10113):2627–42.
MLA
Ezzati, Majid, James Bentham, Mariachiara Di Cesare, et al. “Worldwide Trends in Body-mass Index, Underweight, Overweight, and Obesity from 1975 to 2016 : a Pooled Analysis of 2416 Population-based Measurement Studies in 128.9 Million Children, Adolescents, and Adults.” LANCET 390.10113 (2017): 2627–2642. Print.