Mixed
In low- and middle-income countries, obesity trends are characterized by a disproportionate increase in BMI at the upper end of the distribution (rightward shift) and an increase in waist circumference at any given BMI level, leading to higher cardiometabolic risk than BMI alone suggests.
If you live in or are analyzing data from a low- or middle-income country, standard BMI metrics may underestimate health risks. Focus on waist circumference as a key indicator of cardiometabolic risk, as visceral fat accumulation is increasing even among those with stable BMI. This shift suggests a growing burden of metabolic disease that current BMI-based estimates may miss.
In sum, this paper indicates growing potential for increased cardiometabolic problems linked with a large rightward shift in the BMI distribution and increased waist circumference at each BMI level.
Why this rating
Large sample size (n=815,609) and use of nationally representative surveys, but observational cross-sectional data limits causal inference.
Source
New dynamics in global obesity facing low‐ and middle‐income countries
Barry M. Popkin et al. · Obesity Reviews · 2013
DOI 10.1111/obr.12102
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