Navegando por Palavras-chave "Morbidity"

Agora exibindo 1 - 16 de 16
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Age and regional differences in clinical presentation and risk of hospitalization for dengue in brazil, 2000-2014
    (Hindawi Ltd, 2016) Burattini, Marcelo N. [UNIFESP]; Lopez, Luis F.; Coutinho, Francisco A. B.; Siqueira-, Joao B., Jr.; Homsani, Sheila; Sarti, Elsa; Massad, Eduardo
    OBJECTIVES: Dengue cases range from asymptomatic to severe, eventually leading to hospitalization and death. Timely and appropriate management is critical to reduce morbidity. Since 1980, dengue has spread throughout Brazil, affecting an increasing number of individuals. This paper describes age and regional differences in dengue's clinical presentation and associated risk of hospitalization based on more than 5 million cases reported to the Brazilian Ministry of Health from 2000-2014. METHODS: We performed a retrospective analysis of similar to 5,450,000 dengue cases, relating clinical manifestations and the risk of hospitalization to age, gender, previous infection by dengue, dengue virus serotype, years of formal education, delay to first attendance and the occurrence of dengue during outbreaks and in different Brazilian regions. RESULTS: Complicated forms of dengue occurred more frequently among those younger than 10 years (3.12% vs 1.92%) and those with dengue virus 2 infection (7.65% vs 2.42%), with a delay to first attendance >2 days (3.18% vs 0.82%) and with <= 4 years of formal education (2.02% vs 1.46%). The risk of hospitalization was higher among those aged 6-10 years old (OR 4.57
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Análise perioperatória de morbimortalidade em neurocirurgia pediátrica
    (Universidade Federal de São Paulo (UNIFESP), 2011-03-30) Mekitarian Filho, Eduardo [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction. The increasing complexity and improving care assistance and monitoring of children undergoing neurosurgical procedures has been remarkable in recent years. However, there are few publications about the main characteristics of perioperative morbidity and risk factors associated with worse outcomes from them. Objectives. To study, retrospectively, the main determinants of morbidity and mortality in children undergoing neurosurgical procedures hospitalized in the Hospital Santa Catarina’s Pediatric Intensive Care Unit and characterize them in to know the profile of the service studied. Methods. A retrospective cohort study was conducted using medical records review between 2005 to 2009 of all patients undergoing neurosurgical procedures, from 1 month to 16 years, and the main data regarding the diagnosis and surgical postoperative outcome and main complications and outcome of patients during hospitalization were reviewed. Results. We studied data from 198 patients during the study period. The most common diagnoses were craniosynostosis (31.3%), supratentorial tumors (19.7%), ventriculoperitoneal shunts (16.7%), spinal cord tumors (9.1%) and infratentorial tumors (8.6%) . Altogether, 57.6% of patients were male with a mean age of 50 months, mean ICU stay of 3.4 days and hospital stay of 7.2 days with an average time of mechanical ventilation of 6.6 hours. The most frequent complications were bleeding (48.5%), fever (30.3%), hypothermia (16.2%) and post-extubation laryngitis (15.2%). In the multivariate analysis, the risk factors associated with longer ICU lenght-of-stay were fever (p = 0.001), laryngitis (p = 0.001) and infection (p = 0.003); with greater hospital stay, fever (p = 0.001) and infection (p = 0.003) and with greater duration of mechanical ventilation, fever (p = 0.015), bleeding (p = 0.04), laryngitis (p = 0.007), coagulation disorders (p <0.001) and use of corticosteroids (p <0.001). There were two deaths in this population due to intracranial hypertension. Conclusions. It’s very important to study the major complications associated with poor prognosis in pediatric neurosurgery. Fever and bleeding were very frequent, impacting on almost all outcomes studied. Case series with the largest number of patients are needed to better establish the risk factors.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Cancer incidence in eighteen cities of the State of São Paulo, Brazil
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2001-08-01) Andreoni, Gisela I; Veneziano, Donaldo B; Giannotti Filho, Osvaldo [UNIFESP]; Marigo, Carlos; Mirra, Antonio Pedro; Fonseca, Luiz Augusto M; Instituto Brasileiro de Controle do Câncer; Fundação Oncocentro de São Paulo; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Catarina Serviço de Anatomia Patológica; Universidade de São Paulo (USP)
    OBJECTIVE: As in Brazil cancer registries are mostly based on large cities, there are no estimates per state or per region and information on the disease incidence in the vast in-land areas is very scarce. An incidence survey was conducted in 18 major cities of the state of São Paulo, excluding the capital, aiming to collect information about cancer incidence in the state of São Paulo. METHODS: Of the 18 cities in state of São Paulo included in the survey, all had available resources for cancer management. Data from the year of 1991 were collected by the personnel of the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Statistics), who were especially trained by the study coordinators at the Fundação Oncocentro de São Paulo (Cancer Center of São Paulo). The collected data were processed and analyzed at the Oncocentro. Data collection, processing, and analyses were performed according to the recommendations of the International Agency for Research on Cancer. RESULTS: Although some discrepancies were observed in cancer incidence rates between the cities, results obtained for all 18 cities combined were remarkably close to those recently found for the city of São Paulo in the year 1993. One remarkable finding was the relatively high cancer incidence rates in both sexes in the city of Santos. CONCLUSIONS: The very similar all-sites cancer incidence rates found in the year 1991, when compared to those for the city of São Paulo in the year 1993, are suggestive that all regions have common cancer-related factors. Nevertheless, other explanations, such as the inclusion in the study of prevalent cases, as well as of non-residents, may have occurred in both studies, biasing the results. There is a need of further studies to confirm the high cancer incidence in Santos.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Co-morbidade e mortalidade de pacientes em início de diálise
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2006-09-01) Barbosa, Dulce Aparecida [UNIFESP]; Gunji, Clara Kimiyo [UNIFESP]; Bittencourt, Ana Rita De Cássia [UNIFESP]; Belasco, Angélica Gonçalves Silva [UNIFESP]; Diccini, Solange [UNIFESP]; Vattimo, Fátima; Vianna, Lucila Amaral Carneiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    OBJECTIVES: to identify to the co-morbity and causes of mortality of the patients in beginning of dialysis and to analyze if the personal variables, the co-morbity, the laboratory results, the number of days of internment and number of dialysis sessions are factors of risk for mortality. METHODS: was included in this study 102 patients who had initiated dialysis treatment in a university hospital. The prospective record was realized to collect personals data, laboratory data, morbity and mortality. RESULTS: the arterial hypertension and the infection was more frequent causes of co-morbity (58,8%). The infection locality more frequent was the blood circulation in 30 (50%). CONCLUSION: the majority of the patients who had arrived at the service was in dialysis urgency; the morbity most prevalent was the arterial hypertension and the infection; the infection locality more frequent was the blood circulation related to the use of the central venous catheter; and that the male sex, the white race, the uremia, and the morbity arterial hypertension and infection, had been the ones that more contributed for the increase of the mortality risk.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Displasia broncopulmonar: incidência e fatores de risco neonatais para recém-nascidos prematuros de muito baixo peso nascidos em hospital universitários de Maceió-2009
    (Universidade Federal de São Paulo (UNIFESP), 2010-09-29) Moura, Katharina Vidal de Negreiros [UNIFESP]; Solé, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To determine the incidence of bronchopulmonary dysplasia in the period of one year (from March 2009 to February 2010) and analyze the associated neonatal risk factors to the development of the disease in Public Services in two references of high risk newborn in Maceió, the “Hospital Universitário Alberto Antunes” and the “Maternidade Escola Santa Mônica”. Methods: All very low birth weight preterm infants who were admitted in the both institutions were recorded during one year. The diagnosis was established in those preterm infants who needed oxygen at 28 days of life. The incidence was calculated by dividing the number of cases by the total number of preterm births in both hospitals during the study period. The associated variables were analysed with the “Chi-square” test and the T test of Student or Mann-Whitney. Logistic regression analysis was performed to predict the value of those variables. Results: 244 RNMBP were admitted in both institutions. The incidence was 22.1%. 54 evolved with bronchopulmonary dysplasia and 94 without. There were differences regarding the average weight of the groups (1050g with and 1275g without dysplasia)) and also as to the gestational age (30 weeks with BPD and 32 weeks without the disease). 94% of the prematures with and 45,8% without the disease made use of mechanical ventilation, with p<0,01. There were association with surfactant in the group with bronchopulmonay dysplasia (98% with and 71,7% without displasia, com p<0,01). The logistic regression model was predictive in 70% of mechanical ventilation at birth (RR=2,04 IC 95% 1,62-2,55) and weight lower than 1000g (RR=1,89 IC 95% 1,19-3,00).Conclusions: The incidence of DBP was similar to the literature. There were association with low weight in born, with low gestational age, use of surfactant and mechanical ventilation. Mechanical ventilation and weight lower than 1000g were predictive for the disease.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Efeito da pneumonia hospitalar sobre a letalidade e o tempo de hospitalização em adultos internados em unidade de terapia intensiva
    (Universidade Federal de São Paulo (UNIFESP), 1991) Medeiros, Eduardo Alexandrino Servolo de [UNIFESP]; Wey, Sergio Barsanti [UNIFESP]; Wey, Sergio Barsanti [UNIFESP]
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Health outcomes associated with crack-cocaine use: Systematic review and meta-analyses
    (Elsevier Ireland Ltd, 2017) Butler, Ainslie J.; Rehm, Juergen; Fischer, Benedikt [UNIFESP]
    Background: Crack-cocaine use is prevalent largely in socio-economically marginalized populations in the Americas. Its use has been associated with diverse health outcomes, yet no recent or systematic reviews of these exist. Methods: A systematic review of health outcomes associated with crack-cocaine use was performed, using MEDLINE, Scopus, Web of Science, CINAHL, PsycINFO, and LILACS up to October 2016. Search terms included crack-cocaine and health outcome-related keywords, targeting peer-reviewed studies on quantified health outcomes associated with crack-cocaine use. Random effects meta-analyses produced pooled odds ratios. Levels of evidence for major results were assessed using the GRADE approach. A review protocol was registered with PROSPERO (CRD42016035486). Results: Of 4700 articles returned, 302 met eligibility criteria, reporting on health outcomes for 14 of 22 ICD-10 chapters. Conclusive evidence and meta -analyses showed positive associations between crack-cocaine use and blood/sexually transmitted diseases (HIV and hepatitis C virus, others); moderate evidence and meta -analyses supported associations with neonatal health, and violence. There were mixed associations for mental and other health outcomes, yet insufficient evidence to perform meta -analyses for many categories (e.g., mortality). Most underlying research was of limited or poor quality, with crack-cocaine commonly assessed as a secondary covariate. Conclusions: Crack-cocaine use was associated with a range of health outcomes, although it was unclear if there was direct causal impact, interactions between risk factors, or external drivers of both crack-cocaine use and outcomes. Rigorous epidemiological studies are needed to systematically assess health outcomes of crack-cocaine use and underlying pathways, also to inform evidence-based interventions.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Hiperglicemia e morbimortalidade em crianças graves: análise crítica baseada em revisão sistemática
    (Associação Médica Brasileira, 2009-01-01) Mekitarian Filho, Eduardo [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Troster, Eduardo Juan; Hospital Santa Catarina; Pronto Socorro Infantil Sabará; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Hospital Israelita Albert Einstein
    OBJECTIVE: This article focused on verifying if hyperglycemia in critically ill pediatric patients is a risk factor for increased morbidity and mortality and carried out a critical analysis of the articles in pediatrics and neonatology. METHODS: A systematic review of literature was performed using Medline, Cochrane, Lilacs and Embase databases and references of articles. Articles written in Portuguese, English and Spanish were selected and the terms used in the search were hyperglycemia, intensive care units (pediatrics), hospitals, pediatrics and pediatric intensive care. Cohort studies, retrospective and prospective, were selected for analysis. The outcomes evaluated were mortality during pediatric intensive care unit (PICU) stay, mortality during hospital stay, length-of-stay in the PICU, mortality due to specific diseases, and risk of infection and time of mechanical ventilation. RESULTS: During the study period 79 articles related to hyperglycemiain criticallyillpediatric patients were selected; 15 (19%) were cohort studies (2 prospective and 13 retrospective) that were analyzed separately. CONCLUSION: Analysis of these cohort studies supported the conclusion that hyperglycemia, isolated or persistent during stay in PICU, increases morbidity, mortality and length-of-stay in PICU of critically ill children. However, these studies disclosed methodological issues such as lack of protocols for glucose measurement, design (most of them retrospective cohorts) and many articles did not confirm hyperglycemia as a single predictor of morbidity and mortality in pediatrics; therefore further prospective studies are necessary.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Idosos e o uso de medicamentos
    (Universidade Federal de São Paulo (UNIFESP), 2010-01-27) Silva, Carla Silvana de Oliveira e [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Disease and drugs are present in the daily life of elderly as a form for absorption and alternatives for managing especial conditions. This dissertation aims to provide the profile of the elderly registered at the PSF in Montes Claros/MG, Brazil, and identify the major morbidities, used medications, and difficulties reported by them on medication use. It is a cross-sectional field-based study, using a quantitative and descriptive method. Semi-structured questionnaires were applied to 211 elderly. The results show predominance of female respondents with low family income and schooling; they live with relatives, and have no difficulties in medication use. The study reveals important aspects regarding the profile of the elderly, pattern of morbidity/medication use, and association between medication use and morbidity. It may support planning and management of public policies regarding this population, and may support the implementation of new and more comprehensive studies on the subject.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Impacto do estudo urodinâmico em mulheres com incontinência urinária
    (Associação Médica Brasileira, 2007-04-01) Araujo, Maita Poli de [UNIFESP]; Oliveira, Emerson de [UNIFESP]; Queiroz, Gabriela Cabral [UNIFESP]; Pimentel, Silvia Helena Caires de Oliveira [UNIFESP]; Takano, Cláudia Cristina [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: The purpose was to evaluate tolerance of patients with urinary incontinence undergoing an urodynamic study. METHODS: Forty nine patients with lower urinary tract symptoms submitted to an urodynamic study were evaluated... Prior to and immediately after the procedure each patient completed a self-administered questionnaire about several emotional variables, including anxiety, pain and shame. Answers about pain were given on a visual analog scale. Mean values of continuous variables were compared using a paired t-test, whereas categorical variables were compared using the chi-square test. RESULTS: The mean age was 49.5 (23-84) years. Pain score pre-procedure was 4.29 ± 3 and after procedure was 2.7 ± 2.9 (p=0.001). CONCLUSION: The urodynamic study is well tolerated by female patients and a low morbidity was found. Previous orientation can decrease anxiety.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Morbidade da biópsia da próstata transretal guiada por ultrassonografia
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2013-04-01) Solha, Raphael Sandes [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; De Nicola, Harley [UNIFESP]; Shigueoka, David Carlos [UNIFESP]; Castro, Hugo Alexandre Sócrates de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the incidence of postprocedural complications in patients submitted to transrectal ultrasound-guided prostate biopsy at the Unit of Intervention, Department of Imaging Diagnosis of Escola Paulista de Medicina - Universidade Federal de São Paulo (UNIFESP). MATERIALS AND METHODS: Telephone interviews were conducted with 132 patients who had undergone transrectal ultrasound-guided prostate biopsy in the period from April 2011 to June 2011, according to the institution's protocol. RESULTS: Post-biopsy complications were categorized into two groups - minor and major complications, according to their need for further clinical evaluation. Complications were reported by 59 patients (61.8%), most of them (86.4%) with mild and self-limited symptoms, classified as minor complications. Eight patients (8.2%) had major complications, one of which required in-hospital treatment. Urinary retention was the major and most common complication. CONCLUSION: The present study has demonstrated a low prevalence of major complications after transrectal prostate biopsy.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Morbidade hospitalar decorrente de lesões traumáticas: análise dos fatores de risco relacionados às complicações
    (Universidade Federal de São Paulo (UNIFESP), 2014-10-29) Aguiar Junior, Wagner de [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; http://lattes.cnpq.br/4954772252354513; Universidade Federal de São Paulo (UNIFESP)
    Complications that arise during treatment of traumatic injuries are major causes of morbidity and mortality. Objective: To identify the complications and risk factors related to complications in trauma patients during hospitalization. Method: Retrospective observational study based on secondary data, conducted in a university hospital in São Paulo. The sample consisted of trauma patients treated in the emergency room and hospitalized in 2011, whose medical records were available for consultation. In the data analysis the complications were considered as the dependent variable and using the chi-square or Fisher's exact, Student t test or Mann-Whitney test, Mantel-Haenszel and logistic regression were applied. Results: The sample consisted of 407 patients and 194 (47.66%) had records of 500 complications, the most frequent infectious (41.80%), renal and metabolic (12.20%) and lung (10,00%). The occurrence of complications was statistically significant with increasing age (p = 0.037) in patients with burns (p <0.001) and those who died (p <0.001), and when two or more operations were performed (p <0.001). Patients with complications remained hospitalized twice the time and the higher the severity of the trauma greater number of patients with complications (p <0.001). The final model of logistic regression indicated age (OR = 1.02), length of hospital stay (OR = 1.02), burns (OR = 3.91) and falls (OR = 3.09) with scores < 8 on the Glasgow Coma Scale (OR = 4.25) and ISS scores between 25 and 40 (OR 8.58) and between 16 and 24 (OR = 2.46) as risk factors for posttraumatic complications factors during period of hospitalization. Conclusion: Infectious complications were the most frequent and before the identified risk factors, underscores the importance of surveillance and preventive measures in reducing complications in hospitalized trauma patients.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Perioperative Factors Associated with Prolonged Intensive Care Unit and Hospital Length of Stay after Pediatric Neurosurgery
    (Karger, 2011-01-01) Mekitarian Filho, Eduardo [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Cavalheiro, Sergio [UNIFESP]; Horigoshi, Nelson Kazunobu; Freddi, Norberto Antonio; Universidade de São Paulo (USP); Hosp Israelita Albert Einstein; Santa Catarina Hosp; Universidade Federal de São Paulo (UNIFESP)
    Objectives: This study aims to describe the association between different postoperative complications and the length of hospital stay among children undergoing neurosurgical procedures. Methods: A retrospective cohort study was carried out between May 2004 and May 2009 in a tertiary community hospital. All postoperative complications following neurosurgical procedures and their association with the main outcomes [length of intensive care unit (ICU) and hospital stay] were investigated in a univariate and multivariate analysis. Results: the medical records of 198 patients treated during the study period were reviewed. the most frequently performed surgeries were ventriculoperitoneal shunting (16.7%), correction of craniosynostosis (30%) and brain tumor resections (28.3%). of the 198 patients eligible for this analysis, 79 (39.9%) suffered from at least one complication. the most frequent complications were fever (30.3%), hypothermia (16%), postextubation laryngitis (15.1%) and postoperative bleeding (7%). Factors independently associated with a longer pediatric ICU stay were fever (odds ratio 1.39, 95% confidence interval 1.1-3.2; p = 0.001), laryngitis (odds ratio 2.24, 95% confidence interval 1.8-5.2; p = 0.001), postoperative bleeding requiring reoperation (odds ratio 1.8, 95% confidence interval 1.4-3.9; p < 0.001) and infection (odds ratio 3.71, 95% confidence interval 1.8-12.4; p = 0.033). Fever (odds ratio 2.54, 95% confidence interval 2-7.4; p = 0.001) and infection (odds ratio 11.23, 95% confidence interval 4-22.4; p = 0.003) were related to the total length of the patient's hospital stay. Conclusions: in this study population, most elective neurosurgical procedures were not associated with significant complications, and morbidity and mortality were low. Some complications significantly influenced patients' outcomes and should be monitored for early diagnosis. This study may improve our understanding and identification of postoperative outcomes in pediatric neurosurgery. Copyright (C) 2012 S. Karger AG, Basel
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Qualidade de vida, morbidade psiquiátrica e eventos estres sores de pacientes portadores de litíase renal com historia de cólicas recorrentes: um estudo caso-controle
    (Universidade Federal de São Paulo (UNIFESP), 2006) Diniz, Denise Helena de Madureira Pará [UNIFESP]; Schor, Nestor [UNIFESP]
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Tradução e adaptação cultural das escalas Pediatric Cerebral Performance Category (PCPC) e Pediatric Overall Performance Category (POPC) para o português brasileiro
    (Universidade Federal de São Paulo, 2021-08-24) Chiarastelli, Talita de Castro [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Sá, Cristina dos Santos Cardoso de [UNIFESP]; http://lattes.cnpq.br/9259523998158401; http://lattes.cnpq.br/7980384093582831; http://lattes.cnpq.br/9099484336191286; Universidade Federal de São Paulo (UNIFESP)
    Objetivo: Traduzir e adaptar culturalmente para a população brasileira as escalas Pediatric Cerebral Performance Category (PCPC) e Pediatric Overall Performance Category (POPC). Métodos: Duas pessoas bilingues, com perfis distintos, traduziram as escalas originais para o português do Brasil, sendo as duas versões fundidas em um documento. Esse documento foi retrotraduzido para o inglês, por duas pessoas nativas da língua inglesa, gerando duas versões, as quais foram fundidas em um documento único que foi confrontado com a versão original. Em seguida, um comitê de especialistas verificou a validade do conteúdo gerando a versão final das escalas, que foi testada em 25 crianças por 25 profissionais de uma Unidade de Terapia Intensiva, a fim de verificar a tradução e adaptação cultural para o português do Brasil. Um processo de auditoria foi realizado para verificar a consistência do processo metodológico. Resultados: Não foi necessária a realização de mudanças importantes no conteúdo do instrumento, entretanto foi observada a necessidade da criação de um guia com instruções sobre a aplicação das escalas. Conclusão: As fases de tradução e adaptação cultural das escalas foram concluídas, resultando nas versões PCPC-BR e POPC-BR. Futuros estudos são necessários para os testes de validade e confiabilidade das escalas para garantir a acurácia da aplicação na população brasileira.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    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
    (Elsevier Sci Inc, 2017) Ezzati, Majid; Bentham, James; Di Cesare, Mariachiara; Bilano, Ver; Bixby, Honor; Zhou, Bin; Stevens, Gretchen A.; Riley, Leanne M.; Taddei, Cristina; Hajifathalian, Kaveh; Lu, Yuan; Savin, Stefan; Cowan, Melanie J.; Paciore, Christopher J.; Chirita-Emandi, Adela; Hayes, Alison J.; Katz, Joanne; Kelishadi, Roya; Kengne, Andre Pascal; Khang, Young-Ho; Laxmaiah, Avula; Li, Yanping; Ma, Jun; Miranda, J. Jaime; Mostafa, Aya; Neovius, Martin; Padez, Cristina; Rampal, Lekhraj; Zhu, Aubrianna; Bennet, James E.; Danaei, Goodarz; Bhutta, Zulfiqar A.; Ezzati, Majid; Abarca-Gomez, Leandra; Abdeen, Ziad A.; Hamid, Zargar Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Acuin, Cecilia; Adams, Robert J.; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A.; Agyemng, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Ajlouni, Kamel; Akhtaeva, Nazgul; Al-Hazzaa, Hazzaa M.; Al-Othman, Amani Rashed; Al-Raddadi, Rajaa; AlBuhairan, Fadia; AlDhukai, Shahla; Ali, Mohamed M.; Ali, Osman; Alkerwi, Ala'a; Alvarez-Pedrerol, Mar; Aly, Eman; Amarapurkar, Deepak N.; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Andrade, Dolores S.; Angquist, Lars H.; Anjana, Ranjit Mohan; Aounallah-Skhiri, Hajer; Araujo, Joana; Arianse, Inger; Aris, Tahir; Arlappa, Nimmathota; Arveiler, Dominique; Aryal, Krishna K.; Aspelund, Thor; Assah, Felix K.; Assuncao, Maria Cecilia F.; Aung, May Soe; Avdicova, Maria; Azevedo, Ana; Azizi, Fereidoun; Babu, Bontha V.; Bahijri, Suhad; Baker, Jennifer L.; Balakrishna, Nagalla; Bamoshmoosh, Mohamed; Banach, Maciej; Bandosz, Piotr; Banegas, Jose R.; Barbagallo, Carlo M.; Barcelo, Alberto; Barkat, Amina; Barros, Aluisio J. D.; Barros, Mauro V. G.; Bata, Iqbal; Batieha, Anwar M.; Batista, Rosangela L.; Batyrbek, Assembekov; Baur, Louise A.; Beaglehole, Robert; Ben Romdhane, Habiba; Benedics, Judith; Benet, Mikhail; Bennet, James E.; Bernabe, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bhargava, Santosh K.; Bhatti, Zaid; Bhutta, Zulfiqar A.; Bi, Hongsheng; Bi, Yufang; Biehl, Anna; Bikbov, Mukharram; Bista, Bihungum; Bjelica, Dusko J.; Bjerregaard, Peter; Bjertnes, Espen; Bjness, Marius B.; Bjorkelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boddy, Lynne M.; Boehm, Bernhard O.; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bonaccio, Marialaura; Bongard, Vanina; Bovet, Pascal; Braeckevelt, Lien; Braeckman, Lutgart; Bragt, Marjolijn C. E.; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Breda, Joao; Brenner, Hermann; Brewster, Lizzy M.; Brian, Garry R.; Brinduse, Lacramioara; Bruno, Graziella; Bueno-de-Mesquita, H. B.; Bugge, Anna; Buoncristiano, Marta; Burazeri, Genc; Burns, Con; Cabrera de Leon, Antonio; Cacciottolo, Joseph; Cai, Hui; Cama, Tilema; Cameron, Christine; Camola, Jose; Can, Gunay; Candido, Ana P. C. C.; Capanzana, Mario; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Maria J.; Casanueva, Felipe F.; Casas, Juan Pablo; Caserta, Carmelo A.; 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; Chikova-Iscener, Ekaterina; Chiolero, Arnaud; Chiou, Shu-Ti; Chirlaque, Maria-Dolores; Cho, Belong; Cho, Yumi; Christensen, Kaare; Christofaro, Diego G.; Chudek, Jerzy; Cifkova, Renata; Cinteza, Eliza; Claessens, Frank; Clays, Els; Concin, Hans; Confortin, Susana C.; Cooper, Cyrus; Cooper, Rachel; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crujeiras, Ana B.; Cucu, Alexandra; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Damsgaard, Camilla T.; Danae, Goodarz; Dankner, Rachel; Dantoft, Thomas M.; Dastgiri, Saeed; Dauchet, Luc; Davletov, Kairat; De Backer, Guy; De Bacquer, Dirk; De Curtis, Amalia; de Gaetano, Giovanni; De Henauw, Stefaan; de Oliveira, Paula Duarte; De Ridder, Karin; De Smedt, Delphine; Deepa, Mohan; Deev, Alexander D.; Dehghan, Abbas; Delisle, Helene; Delpeuch, Francis; Deschamps, Valerie; Dhana, Klodian; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dika, Zivka; Djalalinia, Shirin; Do, Ha T. P.; Dobson, Annette J.; Donati, Maria Benedetta; Donfrancesco, Chiara; Donoso, Silvana P.; Doering, Angela; Dorobantu, Maria; Dorosty, Ahmad Reza; Doua, Kouamelan; Drygas, Wojciech; Duan, Jia Li; Duante, Charmaine; Duleva, Vesselka; Dulskiene, Virginija; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Egbagbe, Eruke E.; Eggertsen, Robert; Eiben, Gabriele; Ekelund, Ulf; El Ati, Jalila; Elliott, Paul; Engle-Stone, Reina; Erasmus, Rajiv T.; Erem, Cihangir; Eriksen, Louise; Eriksson, Johan G.; Escobedo, Jorge; Evans, Alun; Faeh, David; Fall, Caroline H.; Sant'Angelo, Victoria Farrugia; Farzadfar, Farshad; Felix-Redondo, Francisco J.; Ferguson, Trevor S.; Fernandes, Romulo A.; 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; Forsner, Maria; Fouad, Heba M.; Francis, Damian K.; Franco, Maria do Carmo Pinho [UNIFESP]; Franco, Oscar H.; Frontera, Guillermo; Fuchs, Flavio D.; Fuch, Sandra C.; Fujita, Yuki; Furusawa, Takuro; Gaciong, Zbigniew; Gafencu, Mihai; Galeone, Daniela; Galvano, Fabio; Garcia-de-la-Hera, Manoli; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gates, Louise; Geiger, Harald; Geleijnse, Johanna M.; Ghasemian, Anoosheh; Giampaoli, Simona; Gianfagna, Francesco; Gill, Tiffany K.; Giovannelli, Jonathan; Giwerman, Aleksander; Godos, Justyna; Gogen, Sibel; Goldsmith, Rebecca A.; Goltzman, David; Goncalves, Helen; Gonzalez-Leon, Margot; Gonzalez-Rivas, Juan P.; Gonzalez-Gross, Marcela; Gottrand, Frederic; Graca, Antonio Pedro; Graff-Iversen, Sidsel; Grafnetter, Dusan; Grajda, Aneta; Grammatikopoulou, Maria G.; Gregor, Ronald D.; Grodzicki, Tomasz; Grontved, Anders; Grosso, Giuseppe; Gruden, Gabriella; Grujic, Vera; Gu, Dongfeng; Gualdi-Russo, Emanuela; Guallar-Castillon, Pilar; Guan, Ong Peng; Gudmundsson, Elias F.; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc; Guo, Xiuhua; Guo, Yin; Gupta, Prakash C.; Gupta, Rajeev; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Hadaegh, Farzad; Hadjigeorgiou, Charalambos A.; Si-Ramlee, Khairil; Halkjaer, Jytte; Hambleton, Ian R.; Hardy, Rebecca; Kumar, Rachakulla Hari; Hassapidou, Maria; Hata, Jun; Hayes, Alison J.; He, Jiang; Heidinger-Felso, Regina; Heinen, Mirjam; Hendriks, Marleen Elisabeth; Henriques, Ana; Cadena, Leticia Hernandez; Herrala, Sauli; Herrera, Victor M.; Herter-Aeberli, Isabelle; Heshmat, Ramin; Hihtaniemi, Ilpo Tapani; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Hofman, Albert; Hopman, Wilma M.; Horimoto, Andrea R. V. R.; Hormiga, Claudia M.; Horta, Bernardo L.; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Htike, Maung Maung Than; Hu, Yonghua; Huerta, Jose Maria; Petrescu, Constanta Huidumac; Huisman, Martijn; Husseini, Abdullatif; Chinh Nguyen Huu; Huybrechts, Inge; Hwalla, Nahla; Hyska, Jolanda; Iacoviello, Licia; Iannone, Anna G.; Ibarluzea, Jesus M.; Ibrahim, Mohsen M.; Ikeda, Nayu; Ikram, M. Arfan; Irazola, Vilma E.; Islam, Muhammad; Ismail, Aziz al-Safi; Ivkovic, Vanja; Iwasaki, Masanori; Jackson, Rod T.; Jacobs, Jeremy M.; Jaddou, Hashem; Jafar, Tazeen; Jamil, Kazi M.; Jamrozik, Konrad; Janszky, Imre; Jarani, Juel; Jasienska, Grazyna; Jelakovic, Ana; Jelakovic, Bojan; Jennings, Garry; Jeong, Seung-Lyeal; Jiang, Chao Qiang; Magaly Jimenez-Acosta, Santa; Joffres, Michel; Johansson, Mattias; Jonas, Jost B.; Jorgensen, Torben; Joshi, Pradeep; Jovic, Dragana P.; Jozwiak, Jacek; Juolevi, Anne; Jurak, Gregor; Juresa, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kajantie, Eero O.; Kalter-Leibovici, Ofra; Kamaruddin, Nor Azmi; Kapantais, Efthymios; Karki, Khem B.; Kasaeian, Amir; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli; Keil, Ulrich; Boker, Lital Keinan; Keinanen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kelleher, Cecily; Kemper, Han C. G.; Kengne, Andre P.; Kerimkulova, Alina; Kersting, Mathilde; Key, Timothy; Khader, Ousef Saleh; Khalili, Davood; Khang, Young-Ho; Khateeb, Mohammad; Khaw, Kay-Tee; Khouw, Ilse M. S. L.; Kiechl-Kohlendorfer, Ursula; Kiech, Stefan; Killewo, Japhet; Kim, Jeongseon; Kim, Yeon-Yong; Klimont, Jeannette; Klumbiene, Jurate; Knoflach, Michael; Koirala, Bhawesh; Kolle, Elin; Kolsteren, Patrick; Korrovits, Paul; Kos, Jelena; Koskinen, Seppo; Kouda, Katsuyasu; Kovacs, Viktoria A.; Kowlessur, Sudhir; Koziel, Slawomir; Kratzer, Wolfgang; Kriemler, Susi; Kristensen, Peter Lund; Krokstad, Steinar; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kuh, Diana; Kujala, Urho M.; Kulaga, Zbigniew; Kumar, R. Krishna; Kunesova, Marie; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kuulasmaa, Kari; Kyobutungi, Catherine; Quang Ngoc La; Laamiri, Fatima Zahra; Laatikainen, Tina; Lachat, Carl; Laid, Youcef; Lam, Tai Hing; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Laugsand, Lars E.; Lauria, Laura; Laxmaiah, Avula; Khanh Le Nguyen Bao; Tuyen D Le; Lebanan, May Antonnette O.; Leclercq, Catherine; Lee, Jeannette; Lee, Jeonghee; Lehtimaki, Terho; Leon-Munoz, Luz M.; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Fernanda Lima-Costa, M.; Lin, Hsien-Ho; Lin, Xu; Lind, Lars; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Liu, Jing; Loit, Helle-Mai; Lopes, Luis; Lorbeer, Roberto; Lotufo, Paulo A.; Eugenio Lozano, Jose; Luksiene, Dalia; Lundqvist, Annamari; Lunet, Nuno; Lytsy, Per; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L. L.; Machado-Rodrigues, Aristides M.; Machi, Suka; Maggi, Stefania; Magliano, Dianna J.; Magriplis, Emmanuella; Mahaletchumy, Alagappan; Maire, Bernard; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Reza; Malhotra, Rahul; Rao, Kodavanti Mallikharjuna; Malyutina, Sofia; Manios, Yannis; Mann, Jim I.; Manzato, Enzo; Margozzini, Paula; Markaki, Anastasia; Markey, Oonagh; Marques, Larissa P.; Marques-Vidal, Pedro; Marrugat, Jaume; Martin-Prevel, Yves; Martin, Rosemarie; Martorell, Reynaldo; Martos, Eva; Marventano, Stefano; Masoodi, Shariq R.; Mathiesen, Ellisiv B.; Matijasevich, Alicia; Matsha, Tandi E.; Mazur, Artur; Mbanya, Jean Claude N.; McFarlane, Shelly R.; McGarvey, Stephen T.; McKee, Martin; McLac, Stela; McLean, Rachael M.; McLean, Scott B.; McNulty, Breige A.; Yusof, Safiah Md; Mediene-Benchekor, Sounnia; Medzioniene, Jurate; Meirhaeghe, Aline; Meisfjord, Jorgen; Meisinger, Christa; Menezes, Ana Maria B.; Menon, Geetha R.; Mensink, Gert B. M.; Meshram, Indrapal I.; Metspalu, Andres; Meyer, Haakon E.; Mi, Jie; Michaelsen, Kim F.; Michels, Nathalie; Mikkel, Kairit; Miller, Jody C.; Minderico, Claudia S.; Miquel, Juan Francisco; Miranda, J. Jaime; Mirkopoulou, Daphne; Mirrakhimov, Erkin; Misigoj-Durakovic, Marjeta; Mistretta, Antonio; Mocanu, Veronica; Modesti, Pietro A.; Mohamed, Mostafa K.; Mohammad, Kazem; Mohammadifard, Noushin; Mohan, Viswanathan; Mohanna, Salim; Yusoff, Muhammad Fadhli Mohd; Molbo, Drude; Mollehave, Line T.; Moller, Niels C.; Molnar, Denes; Momenan, Amirabbas; Mondo, Charles K.; Monterrubio, Eric A.; Monyeki, Kotsedi Daniel K.; Moon, Jin Soo; Moreira, Leila B.; Morejo, Alain; Moreno, Luis A.; Morgan, Karen; Mortensen, Erik Lykke; Moschonis, George; Mossakowska, Malgorzata; Mostafa, Aya; Mota, Jorge; Mota-Pinto, Anabela; Motlag, Mohammad Esmaeel; Motta, Jorge; Mu, Thet Thet; Muc, Magdalena; Muiesan, Maria Lorenza; Mueller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Murtagh, Elaine M.; Musil, Vera; Nabipour, Iraj; Nagel, Gabriele; Naidu, Balkish M.; Nakamura, Harunobu; Namesna, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Nankap, Martin; Narake, Sameer; Nardone, Paola; Navarrete-Munoz, Eva Maria; Neal, William A.; Nenko, Ilona; Neovius, Martin; Nervi, Flavio; Nguyen, Chung T.; Nguyen, Nguyen D.; Quang Ngoc Nguye; Nieto-Martinez, Ramfis E.; Ning, Guang; Ninomiya, Toshiharu; Nishtar, Sania; Noale, Marianna; Noboa, Oscar A.; Norat, Teresa; Norie, Sawada; Noto, Davide; Al Nsour, Mohannad; O'Reilly, Dermot; Obreja, Galina; Oda, Eiji; Oehlers, Glenn; Oh, Kyungwon; Ohara, Kumiko; Olafsson, Orn; Anselmo Olinto, Maria Teresa; Oliveira, Isabel O.; Oltarzewski, Maciej; Omar, Mohd Azahadi; Onat, Altan; Ong, Sok King; Ono, Lariane M.; Ordunez, Pedro; Ornelas, Rui; Ortiz, Ana P.; Osler, Merete; Osmond, Clive; Ostojic, Sergej M.; Ostovar, Afshin; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; Pajak, Andrzej; Palli, Domenico; Palloni, Alberto; Palmieri, Luigi; Pan, Wen-Harn; Panda-Jonas, Songhomitra; Pandey, Arvind; Panza, Francesco; Papandreou, Dimitrios; Park, Soon-Woo; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pascanu, Ionela M.; Patel, Nikhil D.; Pecin, Ivan; Pednekar, Mangesh S.; Peer, Nasheeta; Peeters, Petra H.; Peixoto, Sergio Viana; Peltonen, Markku; Pereira, Alexandre C.; Perez-Farinos, Napoleon; Perez, Cynthia M.; Peters, Annette; Petkeviciene, Janina; Petrauskiene, Ausra; Peykari, Niloofar; Son Thai Pham; Pierannunzio, Daniela; Pigeo, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pistelli, Francesco; Pitakaka, Freda; Piwonska, Aleksandra; Plans-Rubio, Pedro; Poh, Bee Koon; Pohlabeln, Hermann; Pop, Raluca M.; Popovic, Stevo R.; Porta, Miquel; Portegies, Marileen L. P.; Posch, Georg; Poulimeneas, Dimitrios; Pouraram, Hamed; Pourshams, Akram; Poustchi, Hossein; Pradeepa, Rajendra; Prashant, Mathur; Price, Jacqueline F.; Puder, Jardena J.; Pudule, Iveta; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Tran Quoc Bao; Radic, Ivana; Radisauskas, Ricardas; Rahman, Mahfuzar; Rahman, Mahmudur; Raitakari, Olli; Raj, Manu; Rao, Sudha Ramachandra; Ramachandran, Ambady; Ramke, Jacqueline; Ramos, Elisabete; Ramos, Rafel; Rampal, Lekhraj; Rampal, Sanjay; Rascon-Pacheco, Ramon A.; Redon, Josep; Reganit, Paul Ferdinand M.; Ribas-Barba, Lourdes; Ribeiro, Robespierre; Riboli, Elio; Rigo, Fernando; de Wit, Tobias F. Rinke; Rito, Ana; Ritti-Dias, Raphael M.; Rivera, Juan A.; Robinson, Sian M.; Robitaille, Cynthia; Rodrigues, Daniela; 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; Roy, Joel G. R.; Rubinstein, Adolfo; Ruhli, Frank J.; Ruiz-Betancourt, Blanca Sandra; Russo, Paola; Rutkowski, Marcin; Sabanayagam, Charumathi; Sachdev, Harshpal S.; Saidi, Olfa; Salanave, Benoit; Martinez, Eduardo Salazar; Salmeron, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sanchez-Abanto, Jose; Sandjaja; Sans, Susana; Marina, Loreto Santa; Santos, Diana A.; Santos, Ina S.; Santos, Osvaldo; dos Santos, Renata Nunes; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Sarrafzadegan, Nizal; Saum, Kai-Uwe; Savva, Savvas; Savy, Mathilde; Scazufca, Marcia; Rosario, Angelika Schaffrath; Schargrodsky, Herman; Schienkiewitz, Anja; Schipf, Sabine; Schmidt, Carsten O.; Schmidt, Ida Maria; Schultsz, Constance; Schutte, Aletta E.; Sein, Aye Aye; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Serra-Majem, Luis; Shalnova, Svetlana A.; Sharma, Sanjib K.; Shaw, Jonathan E.; Shibuya, Kenji; Shin, Dong Wook; Shin, Youchan; Shiri, Rahman; Siani, Alfonso; Siantar, Rosalynn; Sibai, Abla M.; Silva, Antonio M.; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A.; Sjoberg, Agneta; Sjostrom, Michael; Skovbjerg, Sine; 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; Song, Yi; Sorensen, Thorkild I. A.; Soric, Maroje; Jerome, Charles Sossa; Soumare, Aicha; Spinelli, Angela; Spiroski, Igor; Staessen, Jan A.; Stamm, Hanspeter; Starc, Gregor; Stathopoulou, Maria G.; Staub, Kaspar; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stockl, Doris; Stocks, Tanja; Stokwisze, Jakub; Stratton, Gareth; Stronks, Karien; Strufaldi, Maria Wany Louzada [UNIFESP]; Suarez-Medina, Ramon; Sun, Chien-An; Sundstrom, Johan; Sung, Yn-Tz; Sunyer, Jordi; Suriyawongpaisa, Paibul; Swinburn, Boyd A.; Sy, Rody G.; Szponar, Lucjan; Tai, E. Shyong; Tammesoo, Mari-Liis; Tamosiunas, Abdonas; Tan, Eng Joo; Tang, Xun; Tanser, Frank; Tao, Yong; Tarawneh, Mohammed Rasoul; Tarp, Jakob; Tarqui-Mamani, Carolina B.; Tautu, Oana-Florentina; Braunerova, Radka Taxova; Taylor, Anne; Tchibindat, Felicite; Theobald, Holger; Theodoridis, Xenophon; Thijs, Lutgarde; Thuesen, Betina H.; Tjonneland, Anne; Tolonen, Hanna K.; Tolstrup, Janne S.; Topbas, Murat; Topor-Madry, Roman; Tormo, Maria Jose; Tornaritis, Michael J.; Torrent, Maties; Toselli, Stefania; Traissac, Pierre; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T. H.; Trivedi, Atul; Tshepo, Lechaba; Tsigga, Maria; Tsugane, Shoichiro; Tulloch-Reid, Marshall K.; Tullu, Fikru; Tuomainen, Tomi-Pekka; Tuomilehto, Jaakko; Turley, Maria L.; Tynelius, Per; Tzotzas, Themistoklis; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice E.; Ukoli, Flora A. M.; Ulmer, Hanno; Unal, Belgin; Uusitalo, Hannu M. T.; Valdivia, Gonzalo; Vale, Susana; Valvi, Damaskini; van der Schouw, Yvonne T.; Van Herck, Koen; Hoang Van Minh; van Rossem, Lenie; Van Schoor, Natasja M.; van Valkengoed, Irene G. M.; Vanderschueren, Dirk; Vanuzzo, Diego; Vatten, Lars; Vega, Tomas; Veidebaum, Toomas; Velasquez-Melendez, Gustavo; Velika, Biruta; Veronesi, Giovanni; Verschuren, W. M. Monique; Victora, Cesar G.; Viegi, Giovanni; Viet, Lucie; Viikari-Juntura, Eira; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vlasoff, Tiina; Vollenweider, Peter; Voelzke, Henry; Voutilainen, Sari; Vrijheid, Martine; Wade, Alisha N.; Wagner, Aline; Waldhor, Thomas; Walton, Janette; Bebakar, Wan Mohamad Wan; Mohamud, Wan Nazaimoon Wan; Wanderley, Rildo S., Jr.; Wang, Ming-Dong; Wan, Qian; Wang, Ya Xing; Wannamethee, S. Goya; Wareham, Nicholas; Weber, Adelheid; Wedderkopp, Niels; Weerasekera, Deepa; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wiecek, Andrzej; Wijga, Alet H.; Wilks, Rainford J.; Willeit, Johann; Willeit, Peter; Wilsgaard, Tom; Wojtyniak, Bogdan; Wong-McClure, Roy A.; Wong, Justin Y. Y.; Wong, Jyh Eiin; Wong, Tien Yin; Woo, Jean; Woodward, Mark; Wu, Frederick C.; Wu, Jianfeng; Wu, Shouling; Xu, Haiquan; Xu, Liang; Yamborisut, Uruwan; Yan, Weili; Yang, Xiaoguang; Yardim, Nazan; Ye, Xingwang; Yiallouros, Panayiotis K.; Yngve, Agneta; Yoshihara, Akihiro; You, Qi Sheng; Younger-Coleman, Novie O.; Yusoff, Faudzi; Yusoff, Muhammad Fadhli M.; Zaccagni, Luciana; Zafiropulos, Vassilis; Zainuddin, Ahmad A.; Zambon, Sabina; Zampelas, Antonis; Zamrazilova, Hana; Zdrojewski, Tomasz; Zeng, Yi; Zhao, Dong; Zhao, Wenhua; Zheng, Wei; Zheng, Yingfeng; Zholdin, Bekbolat; Zhou, Maigeng; Zhu, Dan; Zhussupov, Baurzhan; Zimmermann, Esther; Cisneros, Julio Zuniga
    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/m2 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/m2 per decade (0·69–1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 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/m2 per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.