Epidemiology of overweight, obesity in children and adolescents in Asia: A systematic review and meta-analysis

Background Overweight and obesity among children and adolescents has become one of the key issues of the public health in Asia due to the high pace of urbanization, lifestyle shift, and socioeconomic transformation. The evidence in the region is still disparate, and it is not possible to assess the region as a whole. Purpose The purpose of the research is to estimate prevalence rates of overweight and obese children and adolescents in Asian countries and to analyze the sources of heterogeneity in terms of the demographic, geographic, and methodological factors. Methods The systematic review and meta-analysis were done in accordance with PRISMA. Population-based observational studies were searched in PubMed/MEDLINE, Scopus, Web of Science and Google Scholar that included the prevalence of overweight and/or obesity among children and youth in Asian countries, and were published since 2015. The estimation of pooled prevalence estimates in 95% confidence intervals (CIs) was done using random-effects models. The Cochran Q and the I 2 statistic were used to determine heterogeneity. The subgroup and sensitivity analyses were conducted in terms of age group, sex and region, and BMI classification criteria. Findings Eighty-one articles with 3,267,024 participants in 20 countries in Asia were incorporated. Prevalence of overweight (13.7–15.2) and obesity (10.3%-11.6) were as 14.4 and 10.3 percent, respectively. There was a high level of heterogeneity among studies (I 2 >99%). The rates of higher prevalence were always said to be in an urban, not in a rural, environment, and obvious sex and regional differences were also observed. East Asia and Middle East had higher prevalence among boys but the higher prevalence among adolescent girls was in some parts of South Asia. Change in prevalence was also noted in different BMI classification systems. Risk factors that were frequently seen were poor dietary habits, lack of exercise, screen time, and lack of sleep, whereas protective factors were breastfeeding and higher fruit and vegetable consumption. Conclusions Obesity and overweight in children and adolescents in Asia: This is a heterogeneous and serious burden of public health. Multisectoral prevention interventions that are context-specific and target modifiable lifestyle and socioeconomic disparities are urgently required to help curb the increasing epidemic and are associated with the resultant health effects.