Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants

• Published in: The Lancet
• Main Authors: Di Cesare, Mariachiara, Bentham, James, Stevens, Gretchen A., Zhou, Bin, Danaei, Goodarz, Lu, Yuan, Bixby, Honor, Cowan, Melanie J., Riley, Leanne M., Hajifathalian, Kaveh, Fortunato, Lea, Taddei, Cristina, Bennett, James E., Ikeda, Nayu, Khang, Young-Ho, Kyobutungi, Catherine, Laxmaiah, Avula, Li, Yanping, Lin, Hsien-Ho, Miranda, J. Jaime, Mostafa, Aya, Turley, Maria L., Paciorek, Christopher J., Gunter, Marc, Ezzati, Majid, Abdeen, Ziad A., Hamid, Zargar Abdul, Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert, Aekplakorn, Wichai, Aguilar-Salinas, Carlos A., Ahmadvand, Alireza, Ahrens, Wolfgang, Ali, Mohamed M., Alkerwi, Ala'a, Alvarez-Pedrerol, Mar, Aly, Eman, Amouyel, Philippe, Amuzu, Antoinette, Andersen, Lars Bo, Anderssen, Sigmund A., Andrade, Dolores S., Anjana, Ranjit Mohan, Aounallah-Skhiri, Hajer, Ariansen, Inger, Aris, Tahir, Arlappa, Nimmathota, Arveiler, Dominique, Assah, Felix K., Avdicova, Maria, Azizi, Fereidoun, Babu, Bontha V., Balakrishna, Nagalla, Bandosz, Piotr, Banegas, Jose R., Barbagallo, Carlo M., Barcelo, Alberto, Barkat, Amina, Barros, Mauro V., Bata, Iqbal, Batieha, Anwar M., Batista, Rosangela L., Baur, Louise A., Beaglehole, Robert, Ben Romdhane, Habiba, Benet, Mikhail, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloisa, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K., Bhatti, Zaid, Bhutta, Zulfiqar A., Bi, HongSheng, Bi, Yufang, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B., Bjorkelund, Cecilia, Blake, Margaret, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boddy, Lynne M., Boehm, Bernhard O., Boeing, Heiner, Boissonnet, Carlos P., Bongard, Vanina, Bovet, Pascal, Braeckman, Lutgart, Bragt, Marjolijn C. E., Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M., Brian, Garry R., Bruno, Graziella, Mesquita, Bruno de Buen, Bugge, Anna, Burns, Con, Cabrera de Leon, Antonio, Cacciottolo, Joseph, Cama, Tilema, Cameron, Christine, Camolas, Jose, Can, Gunay, Candido, Ana Paula C., Capuano, Vincenzo, Cardoso, Viviane C., Carvalho, Maria J., Casanueva, Felipe F., Casas, Juan-Pablo, Caserta, Carmelo A., Castetbon, Katia, Chamukuttan, Snehalatha, Chan, Angelique W., Chan, Queenie, Chaturvedi, Himanshu K., Chaturvedi, Nishi, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Chetrit, Angela, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Cho, Yumi, Christensen, Kaare, Chudek, Jerzy, Cifkova, Renata, Claessens, Frank, Clays, Els, Concin, Hans, Cooper, Cyrus, Cooper, Rachel, Coppinger, Tara C., Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L., Crujeiras, Ana B., D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Damasceno, Albertino, Damsgaard, Camilla T., Dankner, Rachel, Dauchet, Luc, De Backer, Guy, De Bacquer, Dirk, de Gaetano, Giovanni, De Henauw, Stefaan, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D., Dehghan, Abbas, Delisle, Helene, Delpeuch, Francis, Dhana, Klodian, Di Castelnuovo, Augusto F., Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Djalalinia, Shirin, Do, Ha T. P., Dobson, Annette J., Donfrancesco, Chiara, Doering, Angela, Doua, Kouamelan, Drygas, Wojciech, Egbagbe, Eruke E., Eggertsen, Robert, Ekelund, Ulf, El Ati, Jalila, Elliott, Paul, Engle-Stone, Reina, Erasmus, Rajiv T., Erem, Cihangir, Eriksen, Louise, Escobedo-de la Pena, Jorge, Evans, Alun, Faeh, David, Fall, Caroline H., Farzadfar, Farshad, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernandez-Berges, Daniel, Ferrante, Daniel, Ferrari, Marika, Ferreccio, Catterina, Ferrieres, Jean, Finn, Joseph D., Fischer, Krista, Monterubio Flores, Eric, Foeger, Bernhard, Foo, Leng Huat, Forslund, Ann-Sofie, Fortmann, Stephen P., Fouad, Heba M., Francis, Damian K., Franco, Maria do Carmo, Franco, Oscar H., Frontera, Guillermo, Fuchs, Flavio D., Fuchs, Sandra C., Fujita, Yuki, Furusawa, Takuro, Gaciong, Zbigniew, Gafencu, Mihai, Gareta, Dickman, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gates, Louise, Geleijnse, Johanna M., Ghasemian, Anoosheh, Giampaoli, Simona, Gianfagna, Francesco, Giovannelli, Jonathan, Giwercman, Aleksander, Goldsmith, Rebecca A., Gonzalez Gross, Marcela, Gonzalez Rivas, Juan P., Bonet Gorbea, Mariano, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dusan, Grajda, Aneta, Grammatikopoulou, Maria G., Gregor, Ronald D., Grodzicki, Tomasz, Grontved, Anders, Gruden, Grabriella, Grujic, Vera, Gu, Dongfeng, Guan, Ong Peng, Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gulliford, Martin C., Gunnlaugsdottir, Johanna, Guo, Xiu H., Guo, Yin, Gupta, Prakash C., Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Halkjaer, Jytte, Hardy, Rebecca, Kumar, Rachakulla Hari, Hayes, Alison J., He, Jiang, Hendriks, Marleen Elisabeth, Hernandez Cadena, Leticia, Heshmat, Ramin, Hihtaniemi, Ilpo Tapani, Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Hofman, Albert, Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Hussieni, Abdullatif S., Chinh Nguyen Huu, Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, M. Mohsen, Ikram, M. Arfan, Irazola, Vilma E., Islam, Muhammad, Iwasaki, Masanori, Jackson, Rod T., Jacobs, Jeremy M., Jafar, Tazeen, Jamil, Kazi M., Jamrozik, Konrad, Jasienska, Grazyna, Jiang, Chao Qiang, Joffres, Michel, Johansson, Mattias, Jonas, Jost B., Jorgensen, Torben, Joshi, Pradeep, Juolevi, Anne, Jurak, Gregor, Juresa, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kalter-Leibovici, Ofra, Kapantais, Efthymios, Kasaeian, Amir, Katz, Joanne, Kaur, Prabhdeep, Kavousi, Maryam, Keil, Ulrich, Boker, Lital Keinan, Kelishadi, Roya, Kemper, Han H. C. G., Kengne, Andre P., Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee H., Khouw, Ilse M. S. L., Kiechl, Stefan, Killewo, Japhet, Kim, Jeongseon, Kiyohara, Yutaka, Klimont, Jeannette, Kolle, Elin, Kolsteren, Patrick, Korrovits, Paul, Koskinen, Seppo, Kouda, Katsuyasu, Koziel, Slawomir, Kratzer, Wolfgang, Krokstad, Steinar, Kromhout, Daan, Kruger, Herculina S., Kula, Krzysztof, Kulaga, Zbigniew, Kumar, R. Krishna, Kusuma, Yadlapalli S., Kuulasmaa, Kari, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Laugsand, Lars E., Khanh Le Nguyen Bao, Le, Tuyen D., Leclercq, Catherine, Lee, Jeannette, Lee, Jeonghee, Lehtimaki, Terho, Lekhraj, Rampal, Leon-Munoz, Luz M., Lim, Wei-Yen, Fernanda Lima-Costa, M., Lin, Xu, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Jing, Lorbeer, Roberto, Lotufo, Paulo A., Eugenio Lozano, Jose, Luksiene, Dalia, Lundqvist, Annamari, Lunet, Nuno, Lytsy, Per, Ma, Guansheng, Machi, Suka, Maggi, Stefania, Magliano, Dianna J., Makdisse, Marcia, Malekzadeh, Reza, Malhotra, Rahul, Rao, Kodavanti Mallikharjuna, Manios, Yannis, Mann, Jim I., Manzato, Enzo, Margozzini, Paula, Markey, Oonagh, Marques-Vidal, Pedro, Marrugat, Jaume, Martin-Prevel, Yves, Martorell, Reynaldo, Masoodi, Shariq R., Matsha, Tandi E., Mazur, Artur, Mbanya, Jean Claude N., McFarlane, Shelly R., McGarvey, Stephen T., McKee, Martin, McLachlan, Stela, McLean, Rachael M., McNulty, Breige A., Yusof, Safiah Md, Mediene-Benchekor, Sounnia, Meirhaeghe, Aline, Meisinger, Christa, Mendes, Larissa L., Menezes, Ana Maria B., Mensink, Gert B. M., Meshram, Indrapal I., Metspalu, Andres, Mi, Jie, Michaelsen, Kim F., Mikkel, Kairit, Miller, Jody C., Francisco Miquel, Juan, Jaime Miranda, J., Misigoj-Durakovic, Marjeta, Mohamed, Mostafa K., Mohammad, Kazem, Mohammadifard, Noushin, Mohan, Viswanathan, Yusoff, Muhammad Fadhli Mohd, Molbo, Drude, Moller, Niels C., Molnar, Denes, Mondo, Charles K., Monterrubio, Eric A., Monyeki, Kotsedi Daniel K., Moreira, Leila B., Morejon, Alain, Moreno, Luis A., Morgan, Karen, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Mu, Thet Thet, Muiesan, Maria Lorenza, Mueller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M., Musa, Kamarul Imran, Musil, Vera, Nagel, Gabriele, Nakamura, Harunobu, Namesna, Jana, Nang, Ei Ei K., Nangia, Vinay B., Nankap, Martin, Narake, Sameer, Maria Navarrete-Munoz, Eva, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Neuhauser, Hannelore K., Nguyen, Nguyen D., Quang Ngoc Nguyen, Nieto-Martinez, Ramfis E., Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Norat, Teresa, Noto, Davide, Al Nsour, Mohannad, O'Reilly, Dermot, Ochoa-Aviles, Angelica M., Oh, Kyungwon, Olayan, Iman H., Anselmo Olinto, Maria Teresa, Oltarzewski, Maciej, Omar, Mohd A., Onat, Altan, Ordunez, Pedro, Ortiz, Ana P., Osler, Merete, Osmond, Clive, Ostojic, Sergej M., Otero, Johanna A., Overvad, Kim, Paccaud, Fred Michel, Padez, Cristina, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Panda-Jonas, Songhomitra, Panza, Francesco, Parnell, Winsome R., Parsaeian, Mahboubeh, Pednekar, Mangesh S., Peeters, Petra H., Peixoto, Sergio Viana, Pereira, Alexandre C., Perez, Cynthia M., Peters, Annette, Peykari, Niloofar, Son Thai Pham, Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Piwonski, Jerzy, Plans-Rubio, Pedro, Poh, Bee Koon, Porta, Miquel, Portegies, Marileen L. P., Poulimeneas, Dimitrios, Pradeepa, Rajendra, Prashant, Mathur, Price, Jacqueline F., Puiu, Maria, Punab, Margus, Qasrawi, Radwan F., Qorbani, Mostafa, Tran Quoc Bao, Radic, Ivana, Radisauskas, Ricardas, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Rafel, Rampal, Sanjay, Rasmussen, Finn, Redon, Josep, Reganit, Paul Ferdinand M., Ribeiro, Robespierre, Riboli, Elio, Rigo, Fernando, de Wit, Tobias Floris Rinke, Ritti-Dias, Raphael M., Rivera, Juan A., Robinson, Sian M., Robitaille, Cynthia, Rodriguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, Maria, Rodriguez-Villamizar, Laura A., Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Ronkainen, Kimmo, Rosengren, Annika, Rouse, Ian, Rubinstein, Adolfo, Ruehli, Frank J., Rui, Ornelas, Sandra Ruiz-Betancourt, Blanca, Russo Horimoto, Andrea R. V., Rutkowski, Marcin, Sabanayagam, Charumathi, Sachdev, Harshpal S., Saidi, Olfa, Salanave, Benoit, Salazar Martinez, Eduardo, Salomaa, Veikko, Salonen, Jukka T., Salvetti, Massimo, Sanchez-Abanto, Jose, Sandjaja, Sans, Susana, Santos, Diana A., Santos, Osvaldo, dos Santos, Renata Nunes, Santos, Rute, Sardinha, Luis B., Sarrafzadegan, Nizal, Saum, Kai-Uwe, Savva, Savvas C., Scazufca, Marcia, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schmidt, Ida Maria, Schneider, Ione J., Schultsz, Constance, Schutte, Aletta E., Sein, Aye Aye, Senbanjo, Idowu O., Sepanlou, Sadaf G., Shalnova, Svetlana A., Shaw, Jonathan E., Shibuya, Kenji, Shin, Youchan, Shiri, Rahman, Siantar, Rosalynn, Sibai, Abla M., Silva, Antonio M., Santos Silva, Diego Augusto, Simon, Mary, Simons, Judith, Simons, Leon A., Sjostrom, Michael, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, Smith, Margaret C., Snijder, Marieke B., So, Hung-Kwan, Sobngwi, Eugene, Soderberg, Stefan, Soekatri, Moesijanti Y. E., Solfrizzi, Vincenzo, Sonestedt, Emily, Sorensen, Thorkild I. A., Soric, Maroje, Jerome, Charles Sossa, Soumare, Aicha, Staessen, Jan A., Starc, Gregor, Stathopoulou, Maria G., Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D., Stergiou, George S., Stessman, Jochanan, Stieber, Jutta, Stoeckl, Doris, Stocks, Tanja, Stokwiszewski, Jakub, Stratton, Gareth, Strufaldi, Maria Wany, Sun, Chien-An, Sundstrom, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A., Sy, Rody G., Szponar, Lucjan, Tai, E. Shyong, Tammesoo, Mari-Liis, Tamosiunas, Abdonas, Tang, Line, Tang, Xun, Tanser, Frank, Tao, Yong, Tarp, Jakob, Tarqui-Mamani, Carolina B., Taylor, Anne, Tchibindat, Felicite, Thijs, Lutgarde, Thuesen, Betina H., Tjonneland, Anne, Tolonen, Hanna K., Tolstrup, Janne S., Topbas, Murat, Topor-Madry, Roman, Torrent, Maties, Traissac, Pierre, Trichopoulou, Antonia, Trichopoulos, Dimitrios, Trinh, Oanh T. H., Trivedi, Atul, Tshepo, Lechaba, Tulloch-Reid, Marshall K., Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Tynelius, Per, Tzotzas, Themistoklis, Tzourio, Christophe, Ueda, Peter, Ukoli, Flora A. M., Ulmer, Hanno, Unal, Belgin, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van der Schouw, Yvonne T., Van Herck, Koen, Hoang Van Minh, van Valkengoed, Irene G. M., Vanderschueren, Dirk, Vanuzzo, Diego, Vatten, Lars, Vega, Tomas, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Verschuren, W. M. Monique, Viegi, Giovanni, Viet, Lucie, Viikari-Juntura, Eira, Vineis, Paolo, Vioque, Jesus, Virtanen, Jyrki K., Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vollenweider, Peter, Voutilainen, Sari, Vrijheid, Martine, Wade, Alisha N., Wagner, Aline, Walton, Janette, Mohamud, Wan Nazaimoon Wan, Wang, Ming-Dong, Wang, Qian, Wang, Ya Xing, Wannamethee, S. Goya, Wareham, Nicholas, Weerasekera, Deepa, Whincup, Peter H., Widhalm, Kurt, Widyahening, Indah S., Wiecek, Andrzej, Wilks, Rainford J., Willeit, Johann, Wojtyniak, Bogdan, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C., Wu, JianFeng, Wu, Shou Ling, Xu, Haiquan, Xu, Liang, Yamborisut, Uruwan, Yan, Weili, Yang, Xiaoguang, Yardim, Nazan, Ye, Xingwang, Yiallouros, Panayiotis K., Yoshihara, Akihiro, You, Qi Sheng, Younger-Coleman, Novie O., Yusoff, Ahmad F., Zainuddin, Ahmad A., Zambon, Sabina, Zdrojewski, Tomasz, Zeng, Yi, Zhao, Dong, Zhao, Wenhua, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Dan, Zimmermann, Esther, Zuniga Cisneros, Julio
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier Science Inc 2016
• Subjects: Argentina; Baja; Brisbane; Canada; Hernandez; Indian; Keller; Lulea; Mara; New Zealand; Norway; Orleans; Palermo; Pasteur; Queensland; Rene; Rua; San Juan; Sida; Tonga; Iceland
• Online Access: https://repositorio.unifesp.br/handle/11600/56063; https://doi.org/10.1016/S0140-6736(16)30054-X

Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18.5 kg/m(2) [underweight], 18.5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), = 40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19.2 million adult participants (9.9 million men and 9.3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21.7 kg/m(2) (95% credible interval 21.3-22.1) in 1975 to 24.2 kg/m(2) (24.0-24.4) in 2014 in men, and from 22.1 kg/m(2) (21.7-22.5) in 1975 to 24.4 kg/m(2) (24.2-24.6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21.4 kg/m(2) in central Africa and south Asia to 29.2 kg/m(2) (28.6-29.8) in Polynesia and Micronesia for women the range was from 21.8 kg/m(2) (21.4-22.3) in south Asia to 32.2 kg/m(2) (31.5-32.8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13.8% (10.5-17.4) to 8.8% (7.4-10.3) in men and from 14.6% (11.6-17.9) to 9.7% (8.3-11.1) in women. South Asia had the highest prevalence of underweight in 2014, 23.4% (17.8-29.2) in men and 24.0% (18.9-29.3) in women. Age-standardised prevalence of obesity increased from 3.2% (2.4-4.1) in 1975 to 10.8% (9.7-12.0) in 2014 in men, and from 6.4% (5.1-7.8) to 14.9% (13.6-16.1) in women. 2.3% (2.0-2.7) of the world's men and 5.0% (4.4-5.6) of women were severely obese (ie, have BMI = 35 kg/m(2)). Globally, prevalence of morbid obesity was 0.64% (0.46-0.86) in men and 1.6% (1.3-1.9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY. 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Lausanne, Switzerland Univ Ghent, B-9000 Ghent, Belgium FrieslandCampina, Singapore, Singapore Cent Univ Venezuela, Caracas, Venezuela Univ Bielefeld, Bielefeld, Germany German Canc Res Ctr, Berlin, Germany Univ Amsterdam, NL-1012 WX Amsterdam, Netherlands Fred Hollows Fdn New Zealand, Auckland, New Zealand Cork Inst Technol, Cork, Ireland Univ La Laguna, E-38207 San Cristobal la Laguna, Spain Univ Malta, Msida, Malta Minist Hlth, Nukualofa, Tonga Canadian Fitness & Lifestyle Res Inst, Toronto, ON, Canada Hosp Santa Maria, CHLN, Lisbon, Portugal Istanbul Univ, Istanbul, Turkey Univ Fed Juiz de Fora, Juiz De Fora, Brazil Cardiol Mercato S Severino, Mercato San Severino, Italy Univ Porto, Rua Campo Alegre 823, P-4100 Oporto, Portugal Univ Santiago de Compostela, Santiago De Compostela, Spain Assoc Calabrese Epatol, Rome, Italy French Inst Hlth Surveillance, Lyon, France India Diabet Res Fdn, New Delhi, India Duke NUS Grad Med Sch, Singapore, Singapore Natl Inst Med Stat, New Delhi, India Acad Sinica, Taipei, Taiwan Capital Inst Pediat, Beijing, Peoples R China Duke Univ, Durham, NC 27706 USA Kailuan Gen Hosp, Beijing, Peoples R China Univ Oxford, Oxford OX1 2JD, England Gertner Inst Epidemiol & Hlth Policy Res, Tel Aviv, Israel Univ Lausanne Hosp, Lausanne, Switzerland Minist Hlth & Welf, Taipei, Taiwan Victor Babes Univ Med & Pharm, Timisoara, Romania Korea Ctr Dis Control & Prevent, Seoul, South Korea Med Univ Silesia, Katowice, Poland Charles Univ Prague, Prague, Czech Republic Katholieke Univ Leuven, Louvain, Belgium Agcy Prevent & Social Med, Vienna, Austria Univ Southampton, Southampton SO9 5NH, Hants, England IRCCS Ist Neurol Mediterraneo Neuromed, Rome, Italy Inst Pasteur, Lille, France Westmead Univ Sydney, Sydney, NSW, Australia CIBEROBN, Madrid, Spain CNR, Rome, Italy Univ Fed Santa Catarina, BR-88040900 Florianopolis, SC, Brazil Eduardo Mondlane Univ, Maputo, Mozambique Univ Copenhagen, DK-1168 Copenhagen, Denmark Lille Univ Hosp, Lille, France Natl Res Ctr Prevent Med, Moscow, Russia Erasmus MC, Rotterdam, Netherlands Univ Montreal, Montreal, PQ H3C 3J7, Canada Inst Rech Dev, Montpellier, France Univ Vale Rio dos Sinos, Sao Leopoldo, RS, Brazil Natl Council Sci & Tech Res, Buenos Aires, DF, Argentina Natl Inst Nutr, Hanoi, Vietnam Univ Queensland, Brisbane, Qld 4072, Australia Ist Super Sanita, Rome, Italy Helmholtz Zentrum mUNCHEN, Munich, Germany Minist Sante & Lutte Sida, Yamoussoukro, Cote Ivoire Cardinal Wyszynski Inst Cardiol, Warsaw, Poland Univ Benin, Coll Med Sci, Benin, Nigeria Natl Inst Nutr & Food Technol, Tunis, Tunisia Univ Calif Davis, Davis, CA USA Univ Stellenbosch, ZA-7600 Stellenbosch, South Africa Karadeniz Tech Univ, Trabzon, Turkey Queens Univ Belfast, Belfast BT7 1NN, Antrim, North Ireland Univ Zurich, CH-8006 Zurich, Switzerland Univ Tehran Med Sci, Tehran, Iran Univ W Indies, Kingston, Jamaica Minist Hlth, Buenos Aires, DF, Argentina Council Agr Res & Econ, Rome, Italy Univ Manchester, Manchester M13 9PL, Lancs, England Univ Tartu, Tartu, Estonia Inst Nacl Salud Publ, Mexico City, DF, Mexico Univ Sains Malaysia, Shah Alam, Malaysia Univ Lulea, S-97187 Lulea, Sweden Stanford Univ, Stanford, CA 94305 USA Univ Fed Sao Paulo, Sao Paulo, Brazil Univ Fed Rio Grande do Sul, BR-90046900 Porto Alegre, RS, Brazil Kinki Univ, Fac Med, Higashiosaka, Osaka 577, Japan Kyoto Univ, Kyoto 6068501, Japan Med Univ Warsaw, Warsaw, Poland Univ Hosp Geneva, Geneva, Switzerland Wageningen Univ, NL-6700 AP Wageningen, Netherlands Univ Insubria, Varese, Italy Lund Univ, S-22100 Lund, Sweden Univ Politecn Madrid, E-28040 Madrid, Spain Andes Clin Cardiometab Studies, Caracas, Venezuela Natl Inst Hyg Epidemiol & Microbiol, Havana, Cuba Univ Lille 2, F-59800 Lille, France Inst Clin & Expt Med, Prague, Czech Republic Childrens Mem Hlth Inst, Warsaw, Poland Alexander Technol Educ Inst, Athens, Greece Jagiellonian Univ, Coll Med, PL-31007 Krakow, Poland Inst Publ Hlth Vojvodina, Belgrade, Serbia Natl Ctr Cardiovasc Dis, Beijing, Peoples R China Singapore Eye Res Inst, Singapore, Singapore Iceland Heart Assoc, Kopavogur, Iceland Univ Icesi, Cali, Colombia Univ Hosp Geneva, Geneva, Switzerland Kings Coll London, London WC2R 2LS, England Capital Med Univ, Beijing, Peoples R China Healis Sekhsaria Inst Publ Hlth, New Delhi, India Univ Ibadan, Ibadan, Nigeria Childrens Mem Hlth Inst, Warsaw, Poland Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina Univ Zurich, CH-8006 Zurich, Switzerland Danish Canc Soc Res Ctr, Lyngby, Denmark Tulane Univ, New Orleans, LA 70118 USA Univ Amsterdam, Acad Med Ctr, NL-1012 WX Amsterdam, Netherlands Natl Inst Publ Hlth, Mexicali, Baja California, Mexico Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Univ Western Australia, Nedlands, WA 6009, Australia Univ Fed Pelotas, Pelotas, Brazil Univ Oran 1, Oran, Algeria Minist Hlth, Naypyidaw, Myanmar Peking Univ, Hlth Sci Ctr, Beijing, Peoples R 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Chinese Acad Sci, Beijing, Peoples R China Res Ctr Prevent & Hlth, Aalborg, Denmark Childrens Mem Hlth Inst, Lodz, Poland Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China Univ Med Greifswald, Greifswald, Germany Consejeria Sanidad Junta Castilla & Leon, Leon, Spain Natl Inst Hlth & Welf, Tampere, Finland Univ Porto, Sch Med, Rua Campo Alegre 823, P-4100 Oporto, Portugal Uppsala Univ, S-75105 Uppsala, Sweden Peking Univ, Beijing 100871, Peoples R China Jikei Univ, Sch Med, Tokyo, Japan CNR, Pisa, Italy Baker IDI Heart & Diabet Inst, Melbourne, Vic, Australia Hosp Israelita Albert Einstein, Sao Paulo, Brazil Univ Tehran Med Sci, Tehran, Iran Harokopio Univ Athens, Athens, Greece Univ Otago, Otaru, Hokkaido, Japan Univ Padua, I-35100 Padua, Italy Pontificia Univ Catolica Chile, Santiago, Chile Univ Reading, Reading RG6 2AH, Berks, England Emory Univ, Atlanta, GA 30322 USA Sherikashmir Inst Med Sci, Jammu, India Cape Peninsula Univ Technol, Cape Town, South Africa Univ Rzeszow, Rzeszow, Poland Brown Univ, Providence, RI 02912 USA Univ Edinburgh, Edinburgh EH8 9YL, Midlothian, Scotland Univ Coll Dublin, Dublin, Ireland Univ Teknol MARA, Serdang, Malaysia Robert Koch Inst, Berlin, Germany Univ Tartu, Ulikooli 18, EE-50090 Tartu, Estonia Univ Zagreb, Zagreb 41000, Croatia Univ Tehran Med Sci, Tehran, Iran Isfahan Cardiovasc Res Ctr, Esfahan, Iran Univ Pecs, Pecs, Hungary Mulago Hosp, Kampala, Uganda Univ Limpopo, Limpopo, South Africa Univ Zaragoza, E-50009 Zaragoza, Spain RCSI Dublin, Dublin, Ireland Harokopio Univ Athens, Athens, Greece Univ Porto, Rua Campo Alegre 823, P-4100 Oporto, Portugal Ahvaz Jundishapur Univ Med Sci, Tehran, Iran Gorgas Mem Inst Publ Hlth, Panama City, Panama Univ Brescia, I-25121 Brescia, Italy Univ Eastern Finland, Joensuu, Finland Mary Immaculate Coll, Limerick, Ireland Univ Sains Malaysia, Kota Baharu, Malaysia Univ Zagreb, Zagreb 41000, Croatia Univ Ulm, D-89069 Ulm, Germany Suraj Eye Inst, Nagpur, Maharashtra, India Helen Keller Int, Yaounde, Cameroon Karolinska Inst, S-10401 Stockholm, Sweden Univ Pharm & Med Ho Chi Minh City, Ho Chi Minh City, Vietnam Hanoi Med Univ, Hanoi 100803, Vietnam Heartfile, Karachi, Pakistan Eastern Mediterranean Publ Hlth Network, Amman, Jordan Kuwait Inst Sci Res, Kuwait, Kuwait Univ Puerto Rico, San Juan, PR USA MRC Lifecourse Epidemiol Unit, Southampton, Hants, England Univ Novi Sad, Novi Sad 21000, Serbia Aarhus Univ, DK-8000 Aarhus C, Denmark Univ Coimbra, P-3000 Coimbra, Portugal Univ Madison Wisconsin, Madison, WI USA Univ Bari, I-70121 Bari, Italy Univ Med Ctr Utrecht, Utrecht, Netherlands Heart Inst InCor, Sao Paulo, Brazil Vietnam Natl Heart Inst, Hanoi, Vietnam Fed Minist Hlth, Sarajevo, Bosnia & Herceg Univ Hosp Pisa, Pisa, Italy Univ New S Wales, Sydney, NSW 2052, Australia Cardinal Wyszynski Inst Cardiol, Warsaw, Poland Publ Hlth Agcy Catalonia, Catalonia, Spain Alexander Technol Educ Inst, Athens, Greece Univ Edinburgh, Edinburgh EH8 9YL, Midlothian, Scotland Tartu Univ Clin, Tartu, Estonia Alborz Univ Med Sci, Golestan, Iran Inst Publ Hlth Vojvodina, Vojvodina, Serbia Inst Epidemiol Dis Control & Res, Dhaka, Bangladesh Turku Univ Hosp, FIN-20520 Turku, Finland Univ New S Wales, Sydney, NSW 2052, Australia Univ Malaya, Serdang, Malaysia Univ Valencia, E-46003 Valencia, Spain Univ Philippines, Quezon City 1101, Philippines Hlth Ctr San Agustin, Madrid, Spain PharmAccess Fdn, Groningen, Netherlands Publ Hlth Agcy Canada, Montreal, PQ, Canada Canarian Hlth Serv, Madrid, Spain Univ Ind Santander, Santander, Colombia Fiji Natl Univ, Nasinu, Fiji Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina Univ Zurich, CH-8006 Zurich, Switzerland Univ Madeira, Funchal, Portugal Singapore Eye Res Inst, Singapore, Singapore Sitaram Bhartia Inst Sci & Res, New Delhi, India Fac Med Tunis, Tunis, Tunisia Univ Helsinki, FIN-00014 Helsinki, Finland Univ Brescia, I-25121 Brescia, Italy Natl Inst Hlth, Lima, Peru Minist Hlth, Bandung, 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