Publications
81 results found
Di Cesare M, Soric M, Bovet P, et al., 2019, The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action, BMC MEDICINE, Vol: 17, ISSN: 1741-7015
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- Citations: 416
Di Cesare M, 2019, Global trends of chronic non-communicable diseases risk factors, Publisher: OXFORD UNIV PRESS, Pages: 77-77, ISSN: 1101-1262
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- Citations: 6
Bixby H, Bentham J, Zhou B, et al., 2019, Rising rural body-mass index is the main driver of the global obesity epidemic, Nature, Vol: 569, Pages: 260-264, ISSN: 0028-0836
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
Teplitski M, Irani T, Krediet CJ, et al., 2018, Student-Generated Pre-Exam Questions is an Effective Tool for Participatory Learning: A Case Study from Ecology of Waterborne Pathogens Course, JOURNAL OF FOOD SCIENCE EDUCATION, Vol: 17, Pages: 76-84, ISSN: 1541-4329
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- Citations: 7
Ezzati M, Di Cesare M, Bentham J, 2018, Determining the worldwide prevalence of obesity reply, LANCET, Vol: 391, Pages: 1774-1774, ISSN: 0140-6736
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- Citations: 5
NCD Risk Factor Collaboration NCD-RisC, 2017, Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults., Lancet, Vol: 390, Pages: 2627-2642, ISSN: 0140-6736
BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m(2) per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m(2) per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m(2) per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m(2) per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m(2) per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Tre
Kenge AP, Bentham J, Zhou B, et al., 2017, Trends in obesity and diabetes across regions in Africa from 1980 to 2014: an analysis of pooled population-based studies., International Journal of Epidemiology, Vol: 46, Pages: 1421-1432, ISSN: 1464-3685
Background: The 2016 Dar Es Salaam Call to Action on Diabetes and other NCDs advocates national multi-sectoral NCD strategies and action plans based on available data and information from countries of sub-Saharan Africa and beyond. We estimated trends, from 1980 to 2014, in age-standardised mean body mass index (BMI) and diabetes prevalence in these countries in order to assess the co-progression and assist policy formulation.Methods: We pooled data from African and world-wide population-based studies which measured height, weight, and biomarkers to assess diabetes status in adults aged >18 years. A Bayesian hierarchical model was used to estimate trends, by sex, for 200 countries and territories including 53 countries across five African regions, (central, eastern, northern, southern and western) in mean BMI and diabetes prevalence (defined as either fasting plasma glucose of >7.0 mmol/L, history of diabetes diagnosis, or use of insulin or oral glucose control agents). ResultsAfrican data came from 245 population-based surveys (1.2 million participants) for BMI and 76 surveys (182 000 participants) for diabetes prevalence estimates. Countries with the highest number of data sources for BMI were South Africa (n=17), Nigeria (n=15) and Egypt (n=13); and for diabetes estimates, Tanzania (n=8), Tunisia (n=7), Cameroon, Egypt and South Africa (all n=6). The age-standardised mean BMI increased from 21.0 kg/m2 (95% credible interval: 20.3-21.7) to 23.0 kg/m2 (22.7-23.3) in men, and from 21.9 kg/m2 (21.3-22.5) to 24.9 kg/m2 (24.6-25.1) in women. The age-standardised prevalence of diabetes increased from 3.4% (1.5-6.3) to 8.5% (6.5-10.8) in men, and from 4.1% (2.0-7.5) to 8.9 % (6.9-11.2) in women. Estimates in northern and southern regions were mostly higher than the global average; those in central, eastern and western regions were lower than global averages. A positive association (correlation coefficient ≃0.9) was observed between mean BMI and diabetes prevalence
Ueda P, Woodward M, Lu Y, et al., 2017, Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries: a pooled analysis of prospective cohorts and health surveys., Lancet Diabetes and Endocrinology, Vol: 5, Pages: 196-213, ISSN: 2213-8595
BACKGROUND: Worldwide implementation of risk-based cardiovascular disease (CVD) prevention requires risk prediction tools that are contemporarily recalibrated for the target country and can be used where laboratory measurements are unavailable. We present two cardiovascular risk scores, with and without laboratory-based measurements, and the corresponding risk charts for 182 countries to predict 10-year risk of fatal and non-fatal CVD in adults aged 40-74 years. METHODS: Based on our previous laboratory-based prediction model (Globorisk), we used data from eight prospective studies to estimate coefficients of the risk equations using proportional hazard regressions. The laboratory-based risk score included age, sex, smoking, blood pressure, diabetes, and total cholesterol; in the non-laboratory (office-based) risk score, we replaced diabetes and total cholesterol with BMI. We recalibrated risk scores for each sex and age group in each country using country-specific mean risk factor levels and CVD rates. We used recalibrated risk scores and data from national surveys (using data from adults aged 40-64 years) to estimate the proportion of the population at different levels of CVD risk for ten countries from different world regions as examples of the information the risk scores provide; we applied a risk threshold for high risk of at least 10% for high-income countries (HICs) and at least 20% for low-income and middle-income countries (LMICs) on the basis of national and international guidelines for CVD prevention. We estimated the proportion of men and women who were similarly categorised as high risk or low risk by the two risk scores. FINDINGS: Predicted risks for the same risk factor profile were generally lower in HICs than in LMICs, with the highest risks in countries in central and southeast Asia and eastern Europe, including China and Russia. In HICs, the proportion of people aged 40-64 years at high risk of CVD ranged from 1% for South Korean women to 42% for
Lauby-Secretan B, Scoccianti C, Loomis D, et al., 2016, Body Fatness and Cancer - Viewpoint of the IARC Working Group, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 375, Pages: 794-798, ISSN: 0028-4793
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- Citations: 1780
Bentham J, Di Cesare M, Stevens GA, et al., 2016, A century of trends in adult human height, eLife, Vol: 5, ISSN: 2050-084X
Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
Zhou B, Lu Y, Hajifathalian K, et al., 2016, Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants, Lancet, Vol: 387, Pages: 1513-1530, ISSN: 1474-547X
BackgroundOne of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.MethodsWe pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.FindingsWe used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalenc
Di Cesare M, Bentham J, Stevens GA, et al., 2016, 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, Lancet, Vol: 387, Pages: 1377-1396, ISSN: 1474-547X
BackgroundUnderweight 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.MethodsWe 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/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [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.FindingsWe 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/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of un
Sabates R, Di Cesare M, Reilly B, 2016, DOES EDUCATIONAL EXCLUSION EXPLAIN HEALTH DIFFERENTIALS AMONG CHILDREN? An empirical analysis of children in Ethiopia using Young Lives data, ROUTLEDGE HANDBOOK OF INTERNATIONAL EDUCATION AND DEVELOPMENT, Editors: McGrath, Gu, Publisher: ROUTLEDGE, Pages: 182-195, ISBN: 978-0-415-74754-7
Ezzati M, Danaei G, Fahimi S, et al., 2015, Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants, The Lancet Diabetes & Endocrinology, Vol: 3, Pages: 624-637, ISSN: 2213-8587
Background: Over time, diabetes has been defined based on different biomarkers, includingfasting plasma glucose (FPG) or 2-hour plasma glucose in an oral glucose tolerance test (2hOGTT) and,more recently, haemoglobin A1c (HbA1c). We examined the influence of diagnostic definitions on boththe population prevalence of diabetes and the classification of previously-undiagnosed individuals aswith vs. without diabetes in a pooled analysis of data from population-based health examinationsurveys in different world regions.
Hajifathalian K, Ueda P, Lu Y, et al., 2015, A novel risk score to predict cardiovascular disease risk in national populations (Globorisk): a pooled analysis of prospective cohorts and health examination surveys, The Lancet Diabetes & Endocrinology, Vol: 3, Pages: 339-355, ISSN: 2213-8587
BackgroundTreatment of cardiovascular risk factors based on disease risk depends on valid risk prediction equations. We aimed to develop, and apply in example countries, a risk prediction equation for cardiovascular disease (consisting here of coronary heart disease and stroke) that can be recalibrated and updated for application in different countries with routinely available information.MethodsWe used data from eight prospective cohort studies to estimate coefficients of the risk equation with proportional hazard regressions. The risk prediction equation included smoking, blood pressure, diabetes, and total cholesterol, and allowed the effects of sex and age on cardiovascular disease to vary between cohorts or countries. We developed risk equations for fatal cardiovascular disease and for fatal plus non-fatal cardiovascular disease. We validated the risk equations internally and also using data from three cohorts that were not used to create the equations. We then used the risk prediction equation and data from recent (2006 or later) national health surveys to estimate the proportion of the population at different levels of cardiovascular disease risk in 11 countries from different world regions (China, Czech Republic, Denmark, England, Iran, Japan, Malawi, Mexico, South Korea, Spain, and USA).FindingsThe risk score discriminated well in internal and external validations, with C statistics generally 70% or more. At any age and risk factor level, the estimated 10 year fatal cardiovascular disease risk varied substantially between countries. The prevalence of people at high risk of fatal cardiovascular disease was lowest in South Korea, Spain, and Denmark, where only 5–10% of men and women had more than a 10% risk, and 62–76% of men and 79–82% of women had less than a 3% risk. Conversely, the proportion of people at high risk of fatal cardiovascular disease was largest in China and Mexico. In China, 33% of men and 28% of women had a 10-year risk of
Di Cesare M, Bhatti Z, Soofi SB, et al., 2015, Geographical and socioeconomic inequalities in women and children's nutritional status in Pakistan in 2011: an analysis of data from a nationally representative survey., The Lancet Global Health, Vol: 3, Pages: e229-e239, ISSN: 2214-109X
Pakistan has one of the highest levels of child and maternal undernutrition worldwide, but little information about geographical and socioeconomic inequalities is available. We aimed to analyse anthropometric indicators for childhood and maternal nutrition at a district level in Pakistan and assess the association of nutritional status with food security and maternal and household socioeconomic factors.
Di Cesare M, 2014, Women, marginalization, and vulnerability, Genus: journal of population studies, Vol: 70, ISSN: 2035-5556
Di Cesare M, 2014, GENUS thematic issue: Women, marginalization, and vulnerability (part 1), Genus, Vol: 70, ISSN: 0016-6987
Di Cesare M, 2014, Women, marginalization, and vulnerability: Introduction, Genus, Vol: 70, Pages: 1-6, ISSN: 0016-6987
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Di Cesare M, Sabates R, Lewin KM, 2013, A double prevention: How maternal education can affect maternal mental health, child health and child cognitive development, Longitudinal and Life Course Studies, Vol: 4, Pages: 166-179
This study uses the longitudinal data of Young Lives for Peru to investigate the protective role that maternal education has for children whose mothers suffer from mental health problems. Our first set of findings confirms previous research in this area by showing that maternal education is associated with reduced risk of mental health problems for mothers and with improved nutrition and cognitive development for their children. We further find that maternal education reduces the burden of maternal mental health problems on child development. This is particularly the case for children of mothers with high levels of education. Unfortunately, for children of mothers with low levels of education maternal mental health problems continues to predict poor nutritional status and poor cognitive development for children. These results suggest that monitoring and support may be especially important for mothers with lower levels of education if inequalities across generations are to be reduced.
Di Cesare M, Bennett JE, Best N, et al., 2013, The contributions of risk factor trends to cardiometabolic mortality decline in 26 industrialized countries, INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Vol: 42, Pages: 838-848, ISSN: 0300-5771
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- Citations: 54
Di Cesare M, Sabates R, 2013, Access to antenatal care and children's cognitive development: a comparative analysis in Ethiopia, Peru, Vietnam and India, INTERNATIONAL JOURNAL OF PUBLIC HEALTH, Vol: 58, Pages: 459-467, ISSN: 1661-8556
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- Citations: 8
Giombini A, Dragoni S, Di Cesare A, et al., 2013, Asymptomatic Achilles, patellar, and quadriceps tendinopathy: A longitudinal clinical and ultrasonographic study in elite fencers, SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS, Vol: 23, Pages: 311-316, ISSN: 0905-7188
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- Citations: 58
Di Cesare M, Khang Y-H, Asaria P, et al., 2013, Inequalities in non-communicable diseases and effective responses, LANCET, Vol: 381, Pages: 585-597, ISSN: 0140-6736
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- Citations: 421
Di Cesare M, Murphy M, 2012, Historical trends of mortality and its implications for health policies in England and. Wales: the cause-of-death approach, The Lse Companion to Health Policy, Editors: McGuire, Costa-font, Pages: 283-296, ISBN: 9781781004234
16. . Mariachiara Di Cesare and Michael Murphy 3. ALZHEIMERHistorical. trends. of. mortality. and. its. implications. for. health. policies. in. England. and. Wales: the. cause-of-death. approach9;S AND DEMENTIA: A PROBLEMATIC CAUSE OF ...
Murphy M, Di Cesare M, 2012, Use of an age-period-cohort model to reveal the impact of cigarette smoking on trends in Twentieth-century adult cohort mortality in England and Wales, POPULATION STUDIES-A JOURNAL OF DEMOGRAPHY, Vol: 66, Pages: 259-277, ISSN: 0032-4728
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- Citations: 20
Giombini A, Di Cesare A, Di Cesare M, et al., 2011, Localized hyperthermia induced by microwave diathermy in osteoarthritis of the knee: a randomized placebo-controlled double-blind clinical trial, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 19, Pages: 980-987, ISSN: 0942-2056
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- Citations: 21
Di Cesare M, 2011, El perfil epidemiológico de América Latina y el Caribe: desafíos, límites y acciones, Documento de proyecto, Santiago, Chile, LC/W.395
Panni AS, Cerciello S, Maffulli N, et al., 2011, Patellar shape can be a predisposing factor in patellar instability, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 19, Pages: 663-670, ISSN: 0942-2056
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- Citations: 94
Di Cesare A, Giombini A, Di Cesare M, et al., 2011, Comparison between the effects of trigger point mesotherapy versus acupuncture points mesotherapy in the treatment of chronic low back pain: A short term randomized controlled trial, COMPLEMENTARY THERAPIES IN MEDICINE, Vol: 19, Pages: 19-26, ISSN: 0965-2299
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- Citations: 20
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