title: Sugar consumption and global prevalence of obesity and hypertension: an ecological analysis.
abstract: OBJECTIVE
  The nutrition transition model provides an integrated approach to analyse global changes in food consumption and lifestyle patterns. Whether variability in food availability for consumption, lifestyle and sociodemographic factors is associated with the worldwide prevalence distribution of overweight, obesity and hypertension is unclear.
  
  
  METHODS
  Ecological analysis.
  
  
  METHODS
  Country-specific prevalence estimates of overweight, obesity and hypertension were obtained. Prevalence estimates were then matched to year- and country-specific food and energy availability for consumption of cereals, sugar, sweeteners and honey, vegetable oils, fruits, starchy roots, pulses, total vegetables, alcoholic beverages, total meat, animal fat, eggs, milk, and fish and seafood. The per capita Gross Domestic Product (GDP), urbanization rates and prevalence of physical inactivity for each country were also obtained.
  
  
  METHODS
  The overweight, obesity and hypertension databases included information from 128, 123 and seventy-nine countries, respectively.
  
  
  RESULTS
  Consumption of sugar and animal products were directly associated with GDP and urbanization rates. In a multivariate regression model, physical inactivity (B = 0·01, se = 0·005, P = 0·003), cereal consumption (B = -0·02, se = 0·006, P < 0·001) and sugar consumption (B = 0·03, se = 0·01, P = 0·03) were significant predictors of obesity prevalence. Midpoint age (B = 0·21, se = 0·10, P = 0·02), prevalence of overweight (B = 0·18, se = 0·08, P = 0·02) and consumption of cereals (B = -0·22, se = 0·10, P = 0·02) were significant predictors of hypertension. Women appeared to have a significant obesity excess compared with men.
  
  
  CONCLUSIONS
  High sugar consumption and sedentary lifestyle are associated with increased obesity prevalence. The non-linear association of sugar consumption with prevalence of obesity suggests that effective strategies to reduce its consumption may have differential effects in countries at different stages of the nutrition transition.
authors: 1 Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
authors: Mario
authors: M
authors: Siervo
authors: 2 Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK.
authors: Concetta
authors: C
authors: Montagnese
authors: 1 Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
authors: John C
authors: JC
authors: Mathers
authors: 1 Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
authors: Katrina R
authors: KR
authors: Soroka
authors: 3 Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors: Blossom C M
authors: BC
authors: Stephan
authors: 2 Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK.
authors: Jonathan C K
authors: JC
authors: Wells
mesh_terms: D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005523:Food Supply / Q000191:economics / Q000592:standards; D014943:Global Health / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D057185:Sedentary Behavior; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data; D014944:World Health Organization
chemical_list: D004040:Dietary Carbohydrates; D019422:Dietary Sucrose