More than one billion people in the world now living with obesity, finds new research
The total number of children, adolescents and adults worldwide living with obesity has surpassed one billion, according to a global analysis published in The Lancet. These trends, together with the declining prevalence of people who are underweight since 1990, make obesity the most common form of malnutrition in most countries.
The analysis of global data estimates that among the world's children and adolescents, the rate of obesity in 2022 was four times the rate in 1990. Among adults, the obesity rate more than doubled in women and nearly tripled in men. In total, 159 million children and adolescents and 879 million adults were living with obesity in 2022.
Obesity and underweight are both forms of malnutrition and are detrimental to people's health in many ways. This latest study provides a highly detailed picture of global trends in both forms of malnutrition over the last 33 years.
Senior author Professor Majid Ezzati, of Imperial College London, said: ‘It is very concerning that the epidemic of obesity that was evident among adults in much of the world in 1990 is now mirrored in school-aged children and adolescents. At the same time, hundreds of millions are still affected by undernutrition, particularly in some of the poorest parts of the world. To successfully tackle both forms of malnutrition it is vital we significantly improve the availability and affordability of healthy, nutritious foods.’ The study was conducted by the NCD Risk Factor Collaboration and the World Health Organization. Researchers analysed weight and height measurements from over 220 million people aged 5 years or older (63 million people aged 5 to 19 years, and 158 million aged 20 years or older), representing more than 190 countries.
More than 1500 researchers contributed to the study, which looked at body mass index (BMI) to understand how obesity and underweight have changed worldwide from 1990 to 2022.
Among school-aged children (5–9 years) and adolescents (aged 10–19 years), the BMI used to define obesity and underweight depended on age and sex as there is significant increase in height and weight during childhood and adolescence.
From 1990 to 2022, global obesity rates more than quadrupled in girls (1.7% to 6.9%) and boys (2.1% to 9.3%), with increases seen in almost all countries. The proportion of girls who were underweight fell from 10.3% in 1990 to 8.2% in 2022, and for boys it fell from 16.7% to 10.8%. Among girls, a decrease in the rates of underweight was detected in 44 countries, whilst among boys, a decrease was noted in 80 countries.
The total number of children and adolescents who were affected by obesity in 2022 was nearly 160 million (65 million girls and 94 million boys), compared to 31 million in 1990. A total of 77 million girls and 108 million boys were underweight in 2022, decreasing from 81 million for girls and 138 million for boys in 1990.
Child health outcomes ‘influenced by climate change’
A new review published in Science of The Total Environment has sought to identify which climate-health relationships pose the greatest threats to children across the world.
The researchers reviewed epidemiologic studies to analyse various child health outcomes due to climate change and identify the relationships with the largest effect size. They also provided recommendations for future research.
A total of 721 unique studies were identified after removing duplicates, and after exclusion, 163 unique studies were retained, measuring a change in a particular climate variable within a population and presenting a measured health outcome.
Forty-nine studies explored the impacts of climate changes on various perinatal outcomes, of which 39 examined temperature changes, and 10 examined air pollutants.
The main health outcome measured was preterm birth, followed by changes in birth weight and pregnancy loss. Of the 39 studies examining the impact of temperature changes in perinatal outcomes, preterm birth (births occurring up to week 37 of gestation) was the most common health outcome (29 studies), followed by low birth weight, gestational age changes, premature rupture of membranes, and pregnancy loss.
While highly variable among studies, exposure to >95th percentile of average daily temperature increased the odds ratio of paediatric hospital admission from 1.17 to 1.27. The authors found clear evidence for many relationships between various climate change variables and different measures of child health, despite considerable variation and inconsistences among the studies assessed. After standardisation, the effects of temperature changes on preterm birth were strongest, followed by respiratory outcomes, and then mortality/morbidity. The effects of different air pollutants on health outcomes were considerably smaller compared to temperature effects, but with most (16/20=80%) pollutant studies indicating at least a weak effect. The following factors were protective of climate-related child-health threats: economic stability and strength; access to quality healthcare; adequate infrastructure; and food security. Threats to these services vary by local geographical, climate and socio-economic conditions.
The authors conclude that children will have increased prevalence of disease due to anthropogenic climate change.
Extra funding announced for early support hubs in England
More children and young people will receive earlier access to mental health interventions at 24 hubs in local communities, the government has announced.
The drop-in centres offer mental health support and advice to young people without a referral by a doctor or school. Services provided include group work, counselling, psychological therapies, specialist advice and signposting to information and other services.
The government announced in October 2023 that £4.92 million would be available for 10 early support hubs. It is now providing an additional £3 million to expand the number of hubs to 24 across England. The government says the £8 million overall package will improve access for children and young people to vital mental health support, offering early interventions to improve wellbeing before their condition escalates further, which will also reduce pressure on NHS services.
Mental Health Minister Maria Caulfield said: ‘This government is taking the long-term decisions needed to make our healthcare system faster, simpler and fairer. Mental health support for our young people is a key part of that.
‘No child or young person should suffer alone, and this additional funding for 24 mental health hubs will improve access and bring in more staff and experts who can help those who need it the most.
‘This will build on the brilliant work they already do, and supports our ongoing work to make sure every person has access the highest quality mental health services’.
A network of around 70 early support hubs exist across the country. They are run by a range of local services including volunteer organisations, NHS trusts and local authorities.
They aim to offer advice on wider issues which may affect a young person's mental health, including sexual health, exam worries, jobs, drugs, alcohol and financial worries.
RCN Head of Nursing Practice and Professional Lead for Mental Health Stephen Jones said:
‘The RCN has repeatedly pushed the government to invest in early mental health intervention and we're pleased to see these calls recognised with additional funding for early support hubs.
‘But as demand continues to rise, this must be one step of many. Across England's NHS mental health services, there are over 13 000 unfilled nursing posts, accounting for nearly 1 in 3 of all nurse vacancies.
‘Shortages like this have real-world consequences, leaving staff unable to meet the needs of all patients suffering a mental health crisis.
‘More funding, like that announced today, should help improve mental health services. However, ministers are urged not to become complacent and invest in the nursing workforce which delivers these vital interventions.’
Evidence links ultra-processed food to ‘over 30 health outcomes’
Consistent evidence shows that higher exposure to ultra-processed foods is associated with an increased risk of 32 damaging health outcomes, including cancer, major heart and lung conditions, mental health disorders, and early death.
The findings, published by The BMJ, show that diets high in ultra-processed food may be harmful to many body systems and highlight the need for urgent measures that target and aim to reduce dietary exposure to these products and better understand the mechanisms linking them to poor health, say the authors.
Ultra-processed foods, including packaged baked goods and snacks, fizzy drinks, sugary cereals, and ready-to-eat or heat products, undergo multiple industrial processes and often contain colours, emulsifiers, flavours, and other additives. These products also tend to be high in added sugar, fat, and/or salt, but are low in vitamins and fibre. They can account for up to 58% of total daily energy intake in some high income countries, and have rapidly increased in many low and middle income nations in recent decades.
Many previous studies and meta-analyses have linked highly processed food to poor health, but no comprehensive review has yet provided a broad assessment of the evidence in this area. Convincing evidence showed that higher ultra-processed food intake was associated with around a 50% increased risk of cardiovascular disease related death, a 48–53% higher risk of anxiety and common mental disorders, and a 12% greater risk of type 2 diabetes.
Highly suggestive evidence also indicated that higher ultra-processed food intake was associated with a 21% greater risk of death from any cause, a 40–66% increased risk of heart disease related death, obesity, type 2 diabetes, and sleep problems, and a 22% increased risk of depression. Evidence for the associations of ultra-processed food exposure with asthma, gastrointestinal health, some cancers and cardiometabolic risk factors, such as high blood fats and low levels of ‘good’ cholesterol, remains limited, add the authors.
They acknowledge that umbrella reviews can only provide high-level overviews and they cannot rule out the possibility that other unmeasured factors and variations in assessing ultra-processed food intake may have influenced their results.
However, their use of rigorous and prespecified systematic methods to evaluate the credibility and quality of the analyses suggests that the results withstand scrutiny. As such, they conclude: ‘These findings support urgent mechanistic research and public health actions that seek to target and minimise ultra-processed food consumption for improved population health.’
Empathetic communication ‘can help overcome vaccine hesitancy’
A study has shown how empathetic correction of misinformation among vaccine-hesitant patients may ‘significantly improve attitudes towards vaccination’ – and potentially boost vaccine uptake.
The research, led by the University of Bristol, found this new style of communication could help build and maintain a positive relationship with health professionals, increasing trust and public confidence.
The findings, published in the journal Health Psychology, found more than two-thirds (around 69%) of vaccine-hesitant study participants who received empathetic engagement from a health professional preferred this compared with a group who were just told the facts.
Lead author Dr Dawn Holford, Senior Research Associate in Psychology, said: ‘Although we expected people to generally respond more positively to an empathetic approach, it was surprising how much greater the preference for this style of communication was among those who expressed concerns about vaccination. The study highlights how the way misinformation is tackled, especially with vaccine averse groups, can play a vital role in changing perceptions which can be hard to shift.’
The study involved more than 2500 participants in the UK and US, and compared their responses to direct, factual communication with a novel dialogue-based technique empathising with their views, while also addressing false or misleading anti-vaccination arguments. The results showed participants overall preferred the new approach, known as empathetic refutational interviewing – and this response was strongest for the vaccine-hesitant, who found it more compelling than being presented purely with facts. The majority of participants (around 64%) who experienced the empathetic refutational interview also indicated they were more open to continuing the conversation with a health professional, and around 12% became more willing to be vaccinated compared to those participants who received the factual approach.
The interview technique comprises a four-step process. First, the patient is invited to share their thoughts and concerns about vaccination so that health professionals can understand their motivations and reservations. Next, understanding and trust is built by affirming the patient's feelings and concerns. Third, a tailored explanation is provided to challenge misconceptions, offering a truthful alternative to any misinformed beliefs. Finally, relevant facts about vaccination are provided, such as how they can benefit the individual by guarding against disease as well as collectively protecting others by reducing the spread and building vaccine-induced herd immunity.
Dr Dawn Holford said: ‘The findings actively demonstrate the power of communication, which healthcare professionals can use in their daily roles. Our study shows it is possible to gain trust and change minds if we take people's concerns seriously and tailor our approach to help them make informed decisions about their health. This is hugely encouraging, especially with the growing influence of misinformation and fake news worldwide.’
The research is now being developed into training tools and programmes to support healthcare professionals in the UK, France, Germany, and Romania.