Background In 2010, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost, and 3.8% of DALYs globally. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparative, up-to-date information on levels and trends is essential both to quantify population health effects and to prompt decision-makers to prioritize action. Methods We systematically identified surveys, reports, and published studies (n = 1,769) that included information on height and weight, both through physical measurements and self-reports. Mixed effects linear regression was used to correct for the bias in self-reports. Age-sex-country-year observations (n = 19,244) on prevalence of obesity and overweight were synthesized using a spatio-temporal Gaussian Process Regression model to estimate prevalence with 95% uncertainty intervals. Findings Globally, the proportion of adults with a body mass index (BMI) of 25 or greater increased from 28.8% (95% UI: 28.4-29.3) in 1980 to 36.9% (36.3-37.4) in 2013 for men and from 29.8% (29.3-30.2) to 38.0% (37.5-38.5) for women. Increases were observed in both developed and developing countries. There have been substantial increases in prevalence among children and adolescents in developed countries, with 23.8% (22.9-24.7) of boys and 22.6% (21.7-23.6) of girls being either overweight or obese in 2013. The prevalence of overweight and obesity is also rising among children and adolescents in developing countries as well, rising from 8.1% (7.7-8.6) to 12.9% (12.3-13.5) in 2013 for boys and from 8.4% (8.1-8.8) to 13.4% (13.0-13.9) in girls. Among adults, estimated prevalence of obesity exceeds 50% among men in Tonga and women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has stabilized. Interpretation Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Contrary to other major global risks, there is little evidence of successful population-level intervention strategies to reduce exposure. Not only is obesity increasing, but there are no national success stories over the past 33 years. Urgent global action and leadership is required to assist countries to more effectively intervene.

In most populations studied, birth weight was inversely related to type 2 diabetes risk.

Accumulating research suggests that racism may be a major determinant of health. Here we report associations between self-reported experience of racial discrimination and health in New Zealand. Data from the 2002/2003 New Zealand Health Survey, a cross-sectional survey involving face-to-face interviews with 12,500 people, were analysed. Five items were included to capture racial discrimination in two dimensions: experience of ethnically motivated attack (physical or verbal), or unfair treatment because of ethnicity (by a health professional, in work or when gaining housing). Ethnicity was classified using self-identification to one of four ethnic groups: Māori, Pacific, Asian and European/Other peoples. Logistic regression, accounting for the survey design, age, sex, ethnicity and deprivation, was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Māori reported the highest prevalence of "ever" experiencing any of the forms of racial discrimination (34%), followed by similar levels among Asian (28%) and Pacific peoples (25%). Māori were almost 10 times more likely to experience multiple types of discrimination compared to European/Others (4.5% vs. 0.5%). Reported experience of racial discrimination was associated with each of the measures of health examined. Experience of any one of the five types of discrimination was significantly associated with poor or fair self-rated health; lower physical functioning; lower mental health; smoking; and cardiovascular disease. There was strong evidence of a dose-response relationship between the number of reported types of discrimination and each health measure. These results highlight the need for racism to be considered in efforts to eliminate ethnic inequalities in health.

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Although some evidence was found to support the relation between tooth loss and CVD mortality, causal mechanisms underlying this association remain uncertain.

We explored the contribution of stage at diagnosis to ethnic disparities in cancer survival in New Zealand. We linked 115811 adult patients with invasive cancer registered on the cancer registry (1994 to 2002) to mortality data. Age-standardized, 5-year relative survival rates were lowest for Maori, intermediate for Pacific people (otherwise known as Pacific Islanders), and highest for non-Maori/non-Pacific people for many cancers. Stage at diagnosis accounted for only part of these differences. Possible factors responsible for ethnic inequalities might include access to specialized cancer services and the quality of care received.

BACKGROUND:The aim of this study was to investigate the associations between body mass index (BMI) in early and midadulthood, and BMI change between these ages, and mortality. 3.0 kg/m 2 ) in mid-adulthood. All-cause mortality was associated with being overweight (BMIZ25 kg/m 2 ) at age 22 but not at age 38, adjusted hazard ratio (HR): 1.85 (95% confidence interval (CI) 1.09-3.13) and 1.05 (95% CI: 0.73-1.52), respectively. BMI at age 22 y was more strongly associated with CVD mortality than was BMI at age 38 y, adjusted HR 22 y : 2.41 (95% CI: 1.26-4.60) and HR 38 y : 1.33 (95% CI: 0.82-2.16). There was no clear relationship between cancer mortality and BMI at either age: HR 22 y : 0.68 (95% CI: 0.16-2.91), HR 38 y : 0.90 (95% CI: 0.44-1.84), although relatively few men died of cancer in the follow-up period. Similar patterns were seen for obesity (BMIZ30 kg/m 2 ) as for being overweight. Analyses of weight patterns indicated particularly detrimental effects of overweight persisting from early to mid-adulthood. CONCLUSIONS: BMI in early adulthood is positively related to CVD mortality in later life in men. The risk associated with early adulthood adiposity appeared to be greater than that in mid-adulthood. We did not demonstrate an association between weight gain and later mortality. These results reinforce the need to stem the obesity epidemic in children and young adults.

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