Clinical research study
Increasing Trends in Incidence of Overweight and Obesity over 5 Decades

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Abstract

Purpose

We evaluated trends in the incidence of overweight and obesity over the past 50 years.

Methods

We evaluated trends in the incidence of overweight (25  body mass index [BMI] <30 kg/m2), obesity (BMI ≥30 kg/m2) and stage 2 obesity (BMI ≥35 kg/m2) from 1950 to 2000 in Framingham Study participants (n = 6798, 54% women). Individuals aged 40-55 years who attended 2 examinations 8 years apart in each decade were eligible.

Results

The incidences of overweight, obesity, and stage 2 obesity increased across the decades in both sexes (P for trend <.001). For men, the incidence of overweight rose from 21.8% (95% confidence interval [CI], 17.6-26.5) in the 1950s to 35.2% (95% CI, 28.6-42.5) in the 1990s; of obesity from 5.8% (95% CI, 4.4-7.6) to 14.8% (95% CI, 12.2-17.9); and of stage 2 obesity from 0.2% (95% CI, 0.1-0.9) to 5.4% (95% CI, 4.0-7.2). For women, incidence rates of overweight increased from 15.0% (95% CI, 12.3-18.1) to 33.1% (95% CI, 29.0-37.4); of obesity from 3.9% (95% CI, 2.9-5.3) to 14% (95% CI, 11.6-16.7); and of stage 2 obesity from 1.7% (95% CI, 1.1-2.6) to 4.4% (95% CI, 3.2-6.0). Overall, incidence rates of overweight increased 2-fold and that of obesity more than 3-fold over 5 decades, findings that remained robust upon additional adjustment for baseline BMI in each decade.

Conclusions

The incidence of overweight and obesity increased progressively over the last 5 decades, suggesting that the rising trend in prevalence is not a recent phenomenon.

Section snippets

Sample

The Framingham Heart Study, a community-based prospective cohort study, began in 1948, with enrollment of 5209 participants (original cohort).12, 13 In 1971, 5124 individuals who were children of the original cohort (and their spouses) were enrolled into the Framingham Offspring Study. Participants in the original cohort are examined biennially, whereas the offspring cohort is evaluated quadriennially.14, 15

For the present investigation, we chose 2 examinations within each calendar decade from

Baseline Characteristics

In our sample, the prevalence of obesity, stage 2 obesity, mean values of height, and weight increased across the decades from the 1950s to 2000 in both sexes (Table 1; P for trend <.001). Over this period, mean BMI increased by about 2.7 kg/m2in men and 1.5 kg/m2 in women. Smoking rates decreased in men more substiantially than in women (P for trend <.001).

Table 2 displays the baseline characteristics of study participants eligible for analyses in each decade. Among eligible individuals from

Discussion

It is estimated that the lifetime risk of being overweight exceeds 70% and that for obesity it exceeds 35%.23 In the present investigation we assessed if the rising prevalence of overweight and obesity in national cross-sectional surveys was a recent trend or a gradual phenomenon accruing over decades. Our principal findings are 3-fold. First, incidence rates of overweight and obesity increased 2- to more than 3-fold over the last 5 decades in our community-based sample. Second, the incidence

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    Supported by a National Institutes of Health/National Heart, Lung, and Blood Institute, contract N01-HC-25195, and research grants 2K24HL04334 (R.S.V.), and K23HL074077 (T.J.W.). The funding sources had no role in the design/conduct of the study, management, analysis, and interpretation of data, or the preparation of the manuscript. The National Heart Lung Blood Institute funded the collection of data on height and weight (NO1-HC-25195) used in this investigation, and approved the manuscript. Dr. Vasan had full access to all of the data in the study and takes responsibility for the integrity of and the accuracy of the data analysis.

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