Trends in obesity and associations with education and urban or rural residence in Thailand

Objective: To measure trends in the prevalence of overweight and obesity and the relationship with urban or rural residence and education in Thailand. Research Methods and Procedures: Data were from two nationally representative surveys of 38,323 individuals ≥18 years old (19,156 were 18 to 59 years old) in 2004 and 3375 individuals 18 to 59 years old in 1997. Overweight and obesity were defined using the World Health Organization's Asian criteria. Results: Among those ≥18 years old in 2004, 17.8% of men (95% confidence interval, 16.6% to 19.0%) were overweight, 18.4% (17.3% to 19.5%) had Class I obesity, 4.8% (4.1% to 5.5%) had Class II obesity, and 15.9% (14.6% to 17.1%) had abdominal obesity. In women, 18.2% (17.1% to 19.2%) were overweight, 26.1% (24.9% to 27.3%) had Class I obesity, 9.3% (8.6% to 10.0%) had Class II obesity, and 37.3% (35.3% to 39.2%) had abdominal obesity. In those 18 to 59 years old, the prevalence of Class I obesity in men and all four categories in women significantly increased between 1997 and 2004. There was an inverse relationship in women but a positive relationship in men between education and the odds of being overweight or obese. In 2004, there were significantly lower odds of being overweight or obese in rural compared with urban men but similar odds between urban and rural women. Discussion: The prevalence of overweight and obesity in Thailand is high and increasing. Although the transition of overweight and obesity to those of lower socioeconomic status is not complete, it is well on the way.     

Trends of overweight and obesity among white and american indian school children in south dakota, 1998–2010

Objective:

To investigate the prevalence of overweight and obesity among white and American Indian children in a predominantly rural state.

Design and Methods:

Using a repeated, cross‐sectional design of school children's height and weight, the study sample included 361,352 measures of children who were 5.0–19.9 years, attending school across 13 academic calendar years. Trained staff measured height, weight, and recorded gender, age, and race. Data were voluntarily reported to the State Department of Health.

Results:

American Indian children consistently had higher rates of overweight and obesity compared to white children. Across the years, 16.3% of white students were overweight, whereas 19.3% of American Indian students were overweight. In addition, 14.5% of white children were obese and 25.9% of American Indian children were obese. Examining by rural versus urban schools, prevalence of overweight had been increasing among white male and female students and American Indian female students living in rural areas. Obesity is also increasing among rural white females and male and female American Indian children.

Conclusions:

The findings here suggest that although American Indian children are at higher risk, in general, compared to white children, rural populations in general are experiencing increases in childhood overweight and obesity. Targeted rural interventions beginning at an early age are necessary to improve the health of rural children, especially in American Indian communities.     

Secular Trends in Prevalence of Overweight and Obesity among Adults in Rural Tianjin,China from 1991 to 2011: A Population-Based Study

Objectives

Obesity is associated with cardiovascular diseases and has become the main public health issue in western countries and urban China. However, the prevalence and secular trends of obesity in rural China are currently unknown. The aim of this study was to investigate secular trends in the prevalence of overweight and obesity among rural adults in northern China between 1991 and 2011.

Method

The prevalence of overweight and obesity was assessed in adults aged 35–74 years living in a rural area in northern China by comparing two surveys that were conducted in 1991 and 2011, respectively.

Result

The age-adjusted prevalence of overweight increased from 24.5% in 1991 to 42.0% in 2011, and the prevalence of obesity increased from 5.7% in 1991 to 19.6% in 2011. Over the 21-year period, there were significant increases in the prevalence of overweight and obesity for both men and women in all age groups; however, the greatest increase was observed in men aged 35–44 years, with an 10.3-fold increase in obesity prevalence. The prevalence of obesity increased significantly in all risk factors categories, including education levels, blood pressure categories, diabetes previous history, current smoking situation and alcohol drinking situation over the past 21 years overall (p<0.05). The greatest increase in obesity prevalence appeared among those who consumed alcohol (increased by 8.0-fold). Next, there was a 5.3-fold increase in the prevalence of obesity in illiterate residents.

Conclusion

The prevalence of overweight and obesity has increased rapidly among rural adults in Tianjin over the past 21 years, with the most dramatic increase observed in young men. Therefore, the burden of obesity should serve as a call for action.     

Prevalence and risk factors of overweight and obesity in China

Objective: To examine the prevalence and risk factors of overweight and obesity in China. Research Methods and Procedures: A cross‐sectional survey was conducted in a nationally representative sample of 15,540 Chinese adults in 2000–2001. Body weight, height, and waist circumference were measured by trained observers. Overweight and obesity were defined according to the World Health Organization classification. Central obesity was defined according to guidelines of the International Diabetes Federation. Results: Mean BMI and waist circumference were 23.1 kg/m² and 79.6 cm, respectively, for men and 23.5 kg/m² and 77.2 cm, respectively, for women. The prevalences of overweight and obesity were 24.1% and 2.8% in men and 26.1% and 5.0% in women, respectively. The prevalence of central obesity was 16.1% in men and 37.6% in women. The prevalences of overweight, obesity, and central obesity were higher among residents in northern China compared with their counterparts in southern China and among those in urban areas compared with those in rural areas. Lifestyle factors were the most important risk factors to explain the differences in overweight and central obesity between northern and southern residents. Among women, lifestyle and diet were the most important risk factors to explain the differences between urban and rural residents, whereas socioeconomic status, lifestyle, and diet were all important among men. Discussion: Our study indicates that overweight and obesity have become important public health problems in China. Environmental risk factors may be the main reason for regional differences in the prevalence of overweight and obesity in China.     

Prevalence of overweight and obesity in 2- to 6-year-old Italian children

Objective: To assess the prevalence of overweight and obesity in 2‐ to 6‐year‐old Italian children and to compare the prevalence between the north and the south of the country. Research Methods and Procedures: This was a cross‐sectional study of 2150 subjects (M/F: 1137/1013), 5.36 ± 0.83 years of age. The sampling areas were Verona (north Italy) and Messina (south Italy). We used definitions of overweight and obesity using BMI values, with cut‐off values proposed by the International Obesity Task Force. Results: The prevalence of overweight was 16.6% (males: 13.9%, females: 19.6%), and it was higher in the south (males: 17.8%, females: 22.4%) than in the north (males: 11.3%, females: 17.9%). The prevalence of obesity was 8.0% (males: 8.3%, females: 7.7%), and it was higher in the south (males: 12.3%, females: 10.7%) than in the north (males: 5.7%, females: 5.8%). Using the Centers for Disease Control reference charts, the prevalence of overweight and obesity of Italian children was close to that reported in children living in the United States (32% vs. 32.7%, respectively). Discussion: The prevalence of overweight and obesity in young Italian children is very high, and it is rapidly growing. In the south of the country, the prevalence is higher than in the north.     

Trends in Overweight and Obesity among Children and Adolescents in China from 1981 to 2010: A Meta-Analysis

Background

Overweight/obesity is a serious public health problem that affects a large part of the world population across all age and racial/ethnic groups. However, there has not been a meta-analysis of the prevalence of childhood and adolescent overweight/obesity in China during the past 30 years.

Methods

The China National Knowledge Infrastructure and Wanfang DATA, MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature were searched for relevant studies published between January 1970 and June 2012. The prevalence of overweight/obesity over time was pooled using Stata/SE, version 9. Summary statistics (odds ratios, ORs) were used to compare sex-specific and urban-rural preponderance of overweight/obesity using Review Manager.

Results

After screening 1326 papers, we included 35 papers (41 studies), most of medium quality. The prevalence of overweight/obesity increased from 1.8% (95% confidence interval [CI], 0.4%–3.1%) and 0.4% (95% CI, −0.1% to −0.8%) respectively in 1981–1985 to 13.1% (95% CI, 11.2%–15.0%) and 7.5% (95% CI, 6.6%–8.4%) respectively in 2006–2010. The average annual increase was 8.3% and 12.4% respectively. Boys were more likely to be overweight/obese than girls (OR, 1.36; 95% CI, 1.24–1.49 and OR, 1.68; 95% CI, 1.52–1.86 respectively). The prevalence of overweight/obesity was higher in urban areas than in rural areas (OR, 1.66; 95% CI, 1.54–1.79 and OR, 1.97; 95% CI, 1.68–2.30 respectively). For age-specific subgroup analyses, both overweight and obesity increased more rapidly in the toddler stage than in other developmental stages. Sensitivity analyses showed that sample-size differences, study quality, overweight/obesity criteria and geographical distribution affected overweight/obesity prevalence.

Conclusions

Toddlers and urban boys were at particularly high risk; the prevalence in these groups increased more rapidly than in their counterparts. Public health prevention strategies are urgently needed to modify health behaviors of children and adolescents and control overweight/obesity in China.     

Area-Level Socioeconomic Gradients in Overweight and Obesity in a Community-Derived Cohort of Health Service Users – A Cross-Sectional Study

Background

Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities.

Materials and Methods

The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable.

Results

The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males.

Conclusion

It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.     

Relationship between overweight, obesity and socioeconomic factors of adolescents in Vojvodina, Serbia

Obesity is a very important issue in developed societies and depends on many factors. The aim of this paper was to determine a possible relationship between overweight, obesity and socioeconomic factors among adolescents in Vojvodina. A cross-sectional anthropometric study was carried out from 2001 to 2004 in towns of Vojvodina, northern Serbia. The research included height and body weight measurements as well as body mass index (BMI) of 1236 schoolboys and 1414 schoolgirls aged 15–18 years. The socioeconomic factors (SES) included parents’ level of education and monthly income per family member. The overweight prevalence of about 10% (85 < P < 95) and the prevalence of obesity of 5% (P > 95) were recorded in both male and female adolescents. A significant correlation (p < 0.01) between all socioeconomic factors was observed in male subjects, although there were no significant differences in the prevalence of overweight and obesity when different categories of subjects set by SES were compared. In females lower rates of the prevalence of overweight and obesity were detected in the subjects whose parents had a university education, but the difference was not significant. Regarding the prevalence of obesity, a significant difference was recorded between females with high and low incomes, those with a high income showing significantly greater prevalence of obesity than females coming from low income families. The results of the research indicate that in Vojvodina the family income is the only factor that significantly correlates with female obesity.     

Overweight and obesity prevalence in urban Sardinian children

The aim of this study is to evaluate the prevalence of overweight and obesity in children (6-10 years) of the city of Cagliari (Sardinia, Italy) with different socioeconomic status. The sample is composed by 1000 children, 500 males and 500 females, 6 to 10 years old, attending primary schools in Cagliari during 2003. For uniformity with similar Italian studies, in this study overweight and obesity were defined as calculated from the charts published by Tanner et al. (1966). In the Cagliari children, the prevalence of obesity is 22.70%. The percentages of overweight and obese children increase with age: respectively from 11.5% and 14.0% at 6 years to 15.4% and 22.7% at 10 years. There are higher numbers of overweight and obese boys than girls in all the age classes. Both males and females show an increasing percentage of overweight and obesity as the socioeconomic level decreases. Males present higher percentages of overweight and obesity than females of the same social level, i.e. in the lowest social category overweight is 18.68% in males and 13.60% in females and obesity 26.46% in males and 23.62% in females. The standard multivariate regression analysis with the indicator of overweight and obesity as dependent variable showed that the sex (male), socio-economic status, maternal schooling and sums of the limb and trunk skinfolds have the greatest influence on overweight and obesity. The results suggest that overweight and obesity are becoming serious social and health problems in Sardinia.     

Prevalence of obesity and correlations with lifestyle and dietary factors in Chinese men

Objective: To estimate the age‐adjusted prevalence of general and centralized obesity among Chinese men living in urban Shanghai. Methods and Procedures: A cross‐sectional study was conducted in 61,582 Chinese men aged 40–75. BMI (kg/m²) was used to measure overweight (23 ≤ BMI < 27.4) and obesity (BMI ≥ 27.5) based on the World Health Organization (WHO) recommended criteria for Asians. Waist‐to‐hip ratio (WHR) was used to measure moderate (75th ≤ WHR < 90th percentile) and severe (WHR ≥ 90th percentile) centralized obesity. Results: The average BMI and WHR were 23.7 kg/m² and 0.90, respectively. The prevalence of overweight was 48.6% and obesity was 10.5%. The prevalence of general and centralized obesity was higher in men with high income or who were retired, tea drinkers, or nonusers of ginseng than their counterparts. Men with high education had a higher prevalence of overweight and centralized obesity, but had a lower prevalence of obesity and severe centralized obesity compared to those with less education. Current smokers or alcohol drinkers had a lower prevalence of general obesity but higher prevalence of centralized obesity than nonsmokers or nondrinkers of alcohol. Ex‐smokers and ex‐alcohol drinkers had a higher prevalence of general and centralized obesity compared to nonsmokers and nondrinkers of alcohol. Prevalence of obesity was associated with high energy intake and less daily physical activity. Discussion: The prevalence of obesity among Chinese men in urban Shanghai was lower than that observed in Western countries but higher than that in other Asian countries, and the prevalence of general and centralized obesity differed by demographic, lifestyle, and dietary factors.     

Secular trends in prevalence of overweight and obesity from 2006 to 2009 in urban asian Indian adolescents aged 14-17 years

The present study examines the secular trends in prevalence of overweight and obesity among urban Asian Indian adolescents in New Delhi (North India). The data were derived from cross-sectional sampling of children, 3493 in year 2006 and 4908 in year 2009, aged 14-17 years studying in privately-funded and government-funded schools. Age, gender and Asian Indian-specific cut offs of body mass index (BMI) were used to define overweight and obesity. The prevalence of obesity increased significantly from 9.8% in 2006 to 11.7% in 2009 (p<0.01), whereas underweight decreased from 11.3% to 3.9% (p<0.001). There was a significantly higher risk of being overweight (OR 1.28; 95% CI, 1.15-1.42) and obese (OR 1.44; 95% CI, 1.24-1.66) in year 2009 than 2006, after adjusting for age, gender and type of school. Males and privately-funded school children had significantly higher increase in prevalence and risk of being overweight and obese over the three years. In conclusion, this study showed an increasing trend in prevalence of overweight and obesity in urban Asian Indian adolescents. More specifically, the study showed the association of this increasing trend of overweight and obesity prevalence with male gender and high socio-economic status, calling for an urgent need for immediate and targeted preventive measures.     

Overweight and obesity doubled over a 6-year period in young women living in poverty in Mexico

Objective: To document the changes in BMI and the prevalence of overweight and obesity in young women living in poverty in a semi‐urban community in Mexico. Methods and Procedures: Women who had previously participated in a longitudinal research study (1997–2000) were re‐assessed in 2005. Anthropometric measurements were obtained using standard procedures, and socio‐demographic questionnaires were administered. Total and annual rate of change in BMI and change in the prevalence of overweight and obesity (BMI ≥ 25.0 and ≥30.0) were estimated. Results: Mean age in 2005 was 30.0 ± 5.7 years (n = 683) and time between recruitment and follow‐up was 6.4 ± 1.0 years. Mean change in BMI was +3.6 ± 2.7 (range ?8.2 to +14.6). In 2005, 500 (73.2%) women were overweight, up from 263 (38.5%) in the original assessment. The prevalence of obesity tripled over the follow‐up period (from 9.8% to 30.3%). The mean annual rate of change in BMI was +0.6 (±0.4). After adjustment for age and parity at baseline, an annual rate of change of BMI above the sample median (>0.5) was associated with lower levels of formal education. Discussion: The annual increase in the prevalence of overweight and obesity in this sample is double that which was reported at a national level in Mexico. An understanding of the determinants of this rapid increase among the women living in poverty in Mexico is urgently needed.     

Overweight and obesity in 7 to 10-year-old Hungarian boys. Short communication

Increasing prevalence of overweight and obesity is a serious social and health problem both in the economically developed and developing countries. Despite this fact the nation-wide growth studies completed in Hungary during the past 30 years had not categorised the children either by body fat content or nutritional status. The aim of the study was to estimate the prevalence of overweight and obese boys in the country at the beginning of the new millennium. Height, body mass and four skinfold thicknesses were measured in 7173 volunteer boys aged between 7 and 10 and living in various urban and rural settlements of Hungary between 2003 and 2005. Nutritional status was qualified by the BMI and relative body fat content. The significantly increasing prevalence with age of overweight and obesity ranged between 10.3 and 23.4%. The results showed the joint effects of a secular trend of growth and of a remarkably changed lifestyle. Of these the consequences of the lifestyle are the more important ones. The high and possibly further increasing prevalence of child-age overweight and obesity reminds one of the observations of Kopp and associates (5), namely that of the increased prevalence of chronic childhood diseases during the past 15 years. More intense habitual physical activity and dramatic changes in dietary habits still promise some solution. No one should reckon, however, with the efficiency of physical education at the schools with its very few classes.     

Prevalence and associated factors of overweight and obesity in a Chinese rural population

Background: Overweight and obesity are now considered as a serious health problem, and a very important risk factor for many diseases. Objective: This study was designed to investigate the epidemiologic features of overweight and obesity among rural adults in China. Method and Procedures: A cross‐sectional survey was conducted during 2004–2005, using a multistage cluster sampling method to select a representative sample in Fuxin county, Liaoning province, China. A total of 29,970 adults, aged ≥35 years, were examined. At baseline, lifestyle and other factors were obtained. Overweight and obesity were defined according to the classification by the World Health Organization. Results: Overall, the prevalence of overweight was 18.6%; 15.1% in men and 22.1% in women. The prevalence of obesity was 1.7%; 1.2% in men and 2.2% in women. Multivariable logistic regression revealed certain risk factors of obesity that included being a women, Mongolian nationality and education status of over junior high school level. Moderate physical activity alone was shown as protective factor. Discussion: Although the prevalence of obesity was low, overweight was relatively high in the Chinese rural population, especially in adult women. Gender, diet, physical activity, education levels, and ethnicity were associated with the prevalence of these health conditions.     

Trends in overweight and obesity in Chinese adults: between 1991 and 1999-2000

Objective: The aim of this study was to evaluate trends in BMI and the prevalence of overweight (BMI ≥ 25 kg/m²) and obesity (BMI ≥ 30 kg/m²) between 1991 and 1999–2000 among Chinese adults. Methods and Procedures: In this study, two population‐based samples of Chinese adults aged between 45 and 79 years (n = 7,858 during each period), and comparable in the distributions of age, gender, degree of urbanization, and region (North/South) were used. Height and weight were measured using identical procedures at each period, and BMI was calculated as weight (in kilogram) divided by height (in square meter). Results: From 1991 to 1999–2000, the mean BMI increased from 21.8 to 23.4 kg/m² among men and from 21.8 to 23.5 kg/m² among women (each P < 0.001). Among men, the prevalence of overweight and obesity increased from 9.6 and 0.6%, respectively, in 1991 to 20.0 and 3.0%, respectively, in 1999–2000 (each P < 0.001). Among women, the prevalence of overweight and obesity increased from 14.5 and 1.8%, respectively, in 1991 to 26.5 and 5.2%, respectively, in 1999–2000 (each P < 0.001). The prevalence of overweight and obesity increased in all age groups, in rural and urban areas, and in North and South China, with greater relative increases in obesity among older age groups, South China, and rural areas (P interaction < 0.05). Discussion: Overweight and obesity increased tremendously during the 1990s in China. These data underscore the need for national programs in weight maintenance and reduction, to prevent obesity‐related outcomes in China.     

Prevalence and Trends in Obesity among China’s Children and Adolescents, 1985–2010

Objectives

We examined the prevalence of and trends in obesity among children and adolescents in China (1985–2010).

Methods

We used data from the 1985, 1991, 1995, 2000, 2005, and 2010 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). The CNSSCH is a national survey of physical fitness and health status in Chinese students that uses multistage stratified sampling of 31 provinces and municipalities. A subject was considered obese or overweight if weight-for-height exceeded the 20% or 10% of standard weight-for-height. The standard weight-for-height was the 80th percentile for sex- and age-specific growth charts.

Results

The age-adjusted prevalence of obesity and of overweight and obesity combined was 8.1% (95% CI, 8.0–8.3%) and 19.2% (95% CI, 19.1–19.4%) among children and adolescents 7–18 years in age. Obesity was more likely to be present among children or adolescents who were male (RR, 1.93; 95% CI, 1.90–1.97), urban (RR, 1.99; 95% CI, 1.95–2.02), or 10–12 years (RR, 1.43; 95% CI, 1.40–1.46). Trend analyses of the 25-year period revealed a significant increasing trend in males (RR, 1.59; 95% CI, 1.58–1.60) and in females (RR, 1.49; 95% CI, 1.48–1.50). The rate of increase in obese or overweight prevalence was highest in boys from rural areas (9% annual increase).

Conclusions

During 1985–2010, there was a significant and continuous increase in the prevalence of obesity in children and adolescents. Obesity is epidemic in China, but may be reduced with evidence-based interventions (e.g., school intervention programs).     

Dramatic Rise in Overweight and Obesity in Adult Filipino Women and Risk of Hypertension

Objective:To assess trends in BMI of adult Filipino women over a 16‐year period of rapid socioeconomic change; to identify factors associated with those trends; and to estimate the risk of hypertension associated with overweight, obesity, and high waist‐to‐hip ratio (WHR). Research Methods and Procedures:Women from randomly selected urban and rural communities of Metro Cebu, Philippines were recruited during a 1983 to 1984 index pregnancy, then followed prospectively for 16 years. Overweight and obesity were defined using BMI cut‐off points of 25 and 30, respectively. The analysis sample included women 15 to 45 years of age when measured 4 months postpartum. Weight change in subsequent intervals from 1985 to 1999 was modeled using linear regression. The relationship of BMI and WHR to risk of hypertension in the last survey was modeled using logistic regression. Results:The prevalence of overweight and obesity combined increased nearly 6‐fold from ～6% in 1983 to 1984 to 35% in 1998 to 1999. Weight gain was positively associated with urban residence, improved socioeconomic status, fewer pregnancies and months of lactation, and more away‐from‐home work hours. Risk of hypertension was independently elevated by high WHR and overweight/obesity. Discussion:The dramatic trend of increasing overweight and obesity in this sample of women represents a serious health concern, especially in light of the strong association of excess weight, particularly in the truncal region, to risk of hypertension.     

Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study

Background

Taxing sugar-sweetened beverages (SSBs) has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population.

Methods and Findings

Using consumption and price variations data from a nationally representative survey of 100,855 Indian households, we first calculated how changes in SSB price alter per capita consumption of SSBs and substitution with other beverages. We then incorporated SSB sales trends, body mass index (BMI), and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidence among Indian subpopulations facing a 20% SSB excise tax. The 20% SSB tax was anticipated to reduce overweight and obesity prevalence by 3.0% (95% CI 1.6%–5.9%) and type 2 diabetes incidence by 1.6% (95% CI 1.2%–1.9%) among various Indian subpopulations over the period 2014–2023, if SSB consumption continued to increase linearly in accordance with secular trends. However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity (95% CI 2.5–10.0%) and 2.5% (95% CI 1.0–2.8%) of incident type 2 diabetes from 2014–2023. Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation. Key limitations of this estimation approach include the assumption that consumer expenditure behavior from prior years, captured in price elasticities, will reflect future behavior among consumers, and potential underreporting of consumption in dietary recall data used to inform our calculations.

Conclusion

Sustained SSB taxation at a high tax rate could mitigate rising obesity and type 2 diabetes in India among both urban and rural subpopulations. Please see later in the article for the Editors'' Summary