The cardiometabolic transition in Mexico: cohort-level evidence from the ENNVIH, 2002–2009

Introduction Mexico experienced one of the fastest cardiometabolic transitions in Latin America between 2002 and 2009, but longitudinal evidence on its underlying drivers remains limited. This study aims to characterize within-cohort changes in four cardiometabolic indicators. Methods A strongly balanced pseudo-panel of 14 synthetic cohorts (7 age groups × 2 sexes; ages 12–74 in 2002) was constructed from three waves of the Mexican Family Life Survey (2002, 2005, and 2009), yielding 42 cohort-wave observations. Cohort fixed-effects models with robust standard errors clustered at the cohort level were estimated, using 2002 as reference year. Because official expansion factors were unavailable for the 2009 wave, estimates from this survey were derived from unweighted analyses and should be interpreted with appropriate caution. Results Mean BMI increased by 1.23 kg/m 2 (95% CI: 0.35–2.11; p = 0.010) between 2002 and 2009. Waist circumference increased more rapidly, by 8.55 cm (95% CI: 6.32–10.78; p < 0.001). The longitudinal waist-to-BMI relationship significantly exceeded the cross-sectional baseline, indicating that abdominal obesity progressed 2.75 times faster than expected from weight gain. Abdominal obesity rose from 49.1 to 73.0%, equivalent to 22.8 million additional adults meeting IDF criteria. By 2009, over 70% had abdominal obesity, versus only 30% classified obese by BMI. Self-reported diabetes increased by 4.0 percentage points and hypertension by 2.9 ( p ≤ 0.001). Discussion Mexico’s cardiometabolic transition was characterized by a rapid expansion of abdominal obesity that substantially outpaced BMI-defined weight gain. Routine measurement of waist circumference alongside BMI is warranted to improve cardiometabolic surveillance and guide prevention strategies targeting visceral adiposity, diabetes, and hypertension.