The burden of non-communicable diseases attributable to high BMI in Brazil, 1990–2017: findings from the Global Burden of Disease Study

Abstract

Background The prevalence and burden of disease resulting from obesity have increased worldwide. In Brazil, more than half of the population is now overweight. However, the impact of this growing risk factor on disease burden remains inexact. Using the 2017 Global Burden of Disease (GBD) results, this study sought to estimate mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) in both sexes and across age categories. This study also aimed to describe the prevalence of overweight and obesity throughout the states of Brazil. Methods Age-standardized prevalence of overweight and obesity were estimated between 1990 and 2017. A comparative risk assessment was applied to estimate DALYs and deaths for non-communicable diseases and for all causes linked to high BMI. Results The prevalence of overweight and obesity increased during the period of analysis. Overall, age-standardized prevalence of obesity in Brazil was higher in females (29.8%) than in males (24.6%) in 2017; however, since 1990, males have presented greater rise in obesity (244.1%) than females (165.7%). Increases in prevalence burden were greatest in states from the North and Northeast regions of Brazil. Overall, burden due to high BMI also increased from 1990 to 2017. In 2017, high BMI was responsible for 12.3% (8.8–16.1%) of all deaths and 8.4% (6.3–10.7%) of total DALYs lost to non-communicable diseases, up from 7.2% (4.1–10.8%), and 4.6% (2.4-6.0%) in 1990, respectively. Change due to risk exposure is the leading contributor to the growth of BMI burden in Brazil. In 2017, high BMI was responsible for 165,954 deaths and 5,095,125 DALYs. Cardiovascular disease and diabetes have proven to be the most prevalent causes of deaths, along with DALYs caused by high BMI, regardless of sex or state. Conclusions This study demonstrates increasing age-standardized prevalence of obesity in all Brazilian states. High BMI plays an important role in disease burdens in terms of cardiovascular diseases, diabetes, and all causes of mortality. Assessing levels and trends in exposures to high BMI and the resulting disease burden highlights the current priority for primary prevention and public health action initiatives focused on obesity.

Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil

“…The extent of the burden we document highlights the importance of engaging society and government in the task of type 2 diabetes prevention and the need to include social determinants and health disparities in actions. Given the current lack of success [ 37 - 39 ] in implementing preventive strategies in Brazil, health care resources spent on diabetes are currently almost exclusively for its treatment. The prevention strategy of frequent diagnostic screening to identify individuals at high risk for type 2 diabetes followed by coaching to improve lifestyle has been shown to be effective [ 40 ] and could be implemented to a greater extent in Brazil.…”

Coronary heart disease and stroke mortality trends in Brazil 2000–2018

“…Mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) was observed in 2017. High BMI was responsible for 12.3% of all deaths and 8.4% of total DALYs lost to non-communicable diseases [ 44 ].…”

Secular Trends of Underweight, Overweight, and Obesity in Children and Adolescents from Ukraine

“…High BMI plays an important role in the disease burden of cardiovascular disease, diabetes, and all causes of mortality. Assessment of levels and trends in exposure to high BMI and the resulting burden of disease underlines the current priority of primary prevention and public health measures focused on obesity [38].…”