부산대학교 도서관

Background: In Mexico, obesity prevalence among adults increased from 23% in 2000 to 36% in 2018, approximately. Mexico has not defined short- or long-term obesity goals, obscuring the level of effort required to achieve a relevant impact. We aimed to explore potential obesity goals for 2030 and 2040 in Mexico and to estimate the required caloric reductions to achieve them. Methods and findings: We obtained anthropometric and demographic information on the Mexican adult population (age ≥20 years) from the Health and Nutrition Surveys conducted in 2000, 2006, 2012, 2016, and 2018 (n = 137,907). Each survey wave is cross-sectional, multistage, and representative of the Mexican population at the national, regional, and urban/rural levels. Obesity prevalence was projected for 2030 and 2040 by combining population projections of energy intake by socioeconomic status (SES) with a weight-change microsimulation model taking into account individual-level information on sex, age, physical activity, and initial body weight and height. If current trends continue, Mexico's obesity prevalence is expected to increase from 36% (95% CI 35% to 37%) in 2018 to 45% (uncertainty interval [UI] 41% to 48%) in 2030 and to 48% (UI 41% to 55%) in 2040. Based on expert opinion, we identified 3 obesity goals scenarios: (1) plausible (38% in 2030 and 36% in 2040); (2) intermediate (33% in 2030 and 29% in 2040); and (3) ideal based on the average prevalence of Organization for Economic Co-operation and Development countries (OECD; 19%). We estimated the caloric reductions needed to achieve the goal scenarios using the microsimulation model. Obesity was projected to increase more rapidly in the low SES (around 34% in 2018 to 48% (UI 41% to 55%) in 2040), than in the middle (around 38% to 52% (UI 45% to 56%)), or high SES group (around 36% to 45% (UI 36% to 54%)). Caloric reductions of 40 (UI 13 to 60), 75 (UI 49 to 95), and 190 (UI 163 to 215) kcal/person/day would be needed to reach the plausible, intermediate, and the ideal (OECD) average scenarios for 2030, respectively. To reach the 2040 goals, caloric reductions of 74 (UI 28 to 114), 124 (UI 78 to 169), and 209 (UI 163 to 254) kcal/person/day would be required, respectively. Study limitations include assuming a constant and sedentary physical activity level, not considering cohort-specific differences that could occur in the future, and assuming the same caloric trends under no intervention and the obesity goal scenarios. Conclusions: To reach the 3 obesity goals in 2040, caloric reductions between 74 and 209 kcal/day/person would be needed in Mexico. A package of new and stronger interventions should be added to existing efforts such as food taxes and warning labels on non-nutritious food. Tonatiuh Barrientos-Gutiérrez and co-workers model anticipated changes in calories consumed per person needed to achieve population obesity goals in Mexico. Author summary: Why was this study done?: Mexico has one of the highest obesity prevalences worldwide. Efforts have been made to improve dietary habits, such as implementing taxes and warning labels on non-nutritious food and beverages. However, obesity prevalence in Mexico is still increasing. Mexico has not defined obesity goals to help track country-level advances and assess the effectiveness of public health policies. What did the researchers do and find?: We projected the obesity prevalence in Mexico to 2030 and 2040. These predictions were estimated using a microsimulation model of body weight, informed by projections of energy intake by socioeconomic. We defined 3 obesity goals based on expert opinion and the average obesity prevalence from the Organization for Economic Co-operation and Development countries (OECD): plausible (38% in 2030 and 36% in 2040), intermediate (33% in 2030 and 29% in 2040), and ideal (19%). We estimated the caloric reductions needed to attain these goals. Obesity prevalence is expected to increase from 36% (95% CI 35% to 37%) in 2018 to 48% (uncertainty interval [UI] 41% to 55%) in 2040. To reach the obesity goals for 2040, caloric reductions of 74 kcal/person/day (UI 28 to 114), 124 kcal/person/day (UI 78 to 169), and 209 kcal/person/day (UI 163 to 254) would be needed for the plausible, intermediate, and ideal scenarios, respectively. These goals would require higher caloric reductions for people of low socioeconomic position than people of other socioeconomic levels. What do these findings mean?: Defining obesity goals and estimating the required caloric reductions to achieve them are needed to assess the required impact of interventions and attain meaningful population health advances. The obesity challenge in Mexico is substantial and requires a comprehensive package of interventions to achieve obesity goals, addressing the mechanisms affecting poor diets and weight gain. [ABSTRACT FROM AUTHOR]