Let them eat cake
Michael Shin & William McCarthy
Preventive Medicine, forthcoming
Objective: We examined whether stable, county-level, voter preferences were significantly associated with county-level obesity prevalence using data from the 2012 US presidential election. County voting preference for the 2012 Republican Party presidential candidate was used as a proxy for voter endorsement of personal responsibility approaches to reducing population obesity risk versus approaches featuring government-sponsored, multi-sectoral efforts like those recommended by the Centers for Disease Control (CDC, 2009).
Method: Cartographic visualization and spatial analysis were used to evaluate the geographic clustering of obesity prevalence rates by county, and county-level support for the Republican Party candidate in the 2012 U.S. presidential election. The spatial analysis informed the spatial econometric approach employed to model the relationship between political preferences and other covariates with obesity prevalence.
Results: After controlling for poverty rate, percent African American and Latino populations, educational attainment, and spatial autocorrelation in the error term, we found that higher county-level obesity prevalence rates were associated with higher levels of support for the 2012 Republican Party presidential candidate.
Conclusion: Future public health efforts to understand and reduce obesity risk may benefit from increased surveillance of this and similar linkages between political preferences and health risks.
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Yann Cornil & Pierre Chandon
Psychological Science, forthcoming
Abstract:
Using archival and experimental data, we showed that vicarious defeats experienced by fans when their favorite football team loses lead them to consume less healthy food. On the Mondays following a Sunday National Football League (NFL) game, saturated-fat and food-calorie intake increase significantly in cities with losing teams, decrease in cities with winning teams, and remain at their usual levels in comparable cities without an NFL team or with an NFL team that did not play. These effects are greater in cities with the most committed fans, when the opponents are more evenly matched, and when the defeats are narrow. We found similar results when measuring the actual or intended food consumption of French soccer fans who had previously been asked to write about or watch highlights from victories or defeats of soccer teams. However, these unhealthy consequences of vicarious defeats disappear when supporters spontaneously self-affirm or are given the opportunity to do so.
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Effects of Proximate Foreclosed Properties on Individuals’ Weight Gain in Massachusetts, 1987–2008
Mariana Arcaya et al.
American Journal of Public Health, September 2013, Pages e50-e56
Objectives: We assessed the extent to which living near foreclosed properties is associated with individuals’ subsequent weight gain.
Methods: We linked health and address information on 2068 Framingham Offspring Cohort members (7830 assessments) across 5 waves (1987–2008) to records of all Massachusetts foreclosures during that period. We used counts of lender-owned foreclosed properties within 100 meters of participants’ homes to predict body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) and the odds of being overweight (BMI ≥ 25), adjusted for individual and area-level covariates.
Results: Mean BMI increased from 26.6 in 1987–1991 to 28.5 in 2005–2008; overweight prevalence increased from 59.0% to 71.3%. Foreclosures were within 100 meters of 159 (7.8%) participants’ homes on 187 occasions (1.8%), in 42 municipalities (21%). For each additional foreclosure, BMI increased by 0.20 units (95% confidence interval [CI] = 0.03, 0.36), and the odds ratio for being overweight associated with proximity to a foreclosure was 1.77 (95% CI = 1.02, 3.05).
Conclusions: We found a robust association between living near foreclosures and BMI, suggesting that neighbors’ foreclosures may spur weight gain.
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Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009
Ronald Iannotti & Jing Wang
Pediatrics, forthcoming
Objective: The high prevalence of adolescent obesity in the United States has been attributed to population changes in physical activity (PA), sedentary behaviors, and dietary behaviors. This study examines 8-year trends in these behaviors in US adolescents ages 11 to 16.
Methods: Nationally representative samples of US students in grades 6 to 10 were recruited during the 2001–2002 (N = 14 607), 2005–2006 (N = 9150), and 2009–2010 (N = 10 848) school years by using multistage stratified designs, with census regions and grades as strata, and school districts as the primary sampling units. African-American and Hispanic students were oversampled to obtain better estimates for those groups. Using the Health Behavior in School-aged Children quadrennial surveys, identical questions assessed BMI, PA, and sedentary and dietary behaviors at each school year. Logistic and linear regression analyses were conducted taking into account the sampling design and controlling for age, gender, race/ethnicity, and family affluence.
Results: Across the quadrennial surveys, significant increases were identified in number of days with at least 60 minutes of PA, daily consumption of fruits and vegetables, eating breakfast on weekdays and weekends, and BMI. Television viewing and consumption of sweets and sweetened beverages decreased across this same period. These same patterns were seen in all racial/ethnic groups.
Conclusions: These patterns suggest that public health efforts to improve the obesity-related behaviors of US adolescents may be having some success. However, alternative explanations for the increase in BMI over the same period need to be considered.
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Who Pays for Obesity? Evidence from Health Insurance Benefit Mandates
James Bailey
Economics Letters, forthcoming
Abstract:
Is there an obesity externality? A quasi-random natural experiment shows no evidence for the claim that the obese pass their health costs on to others through employer-based health insurance. In the late 1990’s and early 2000’s, many state governments began requiring health insurance plans to cover treatments for diabetes. These treatments are expensive, and diabetes is about four more prevalent among the obese, so the mandates raised the relative cost of insuring obese people. Using difference-in-difference analysis of restricted geocode data from the 1979 National Longitudinal Survey of Youth to compare wages across states with and without diabetes mandates, I find that obese people pay for all of their own increased health costs in the form of lower wages, rather than passing them on to employers, insurers, and co-workers.
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The effect of physical activity on long-term income
Ari Hyytinen & Jukka Lahtonen
Social Science & Medicine, November 2013, Pages 129–137
Abstract:
Empirical evidence for the direct effects of physical activities on long-term labor market outcomes is limited. This state of affairs is surprising, because there is a growing amount of support on the positive effects of physical activities on health on the one hand and on the effects of good health on labor market outcomes on the other hand. We examine the long-term income effects of physical activity using a large sample (N = 5042) of male twins from Finland (Older Finnish Twin Cohort Study, 1975, 1981, 1990), matched to detailed register-based income data (Finnish Longitudinal Employer-Employee Data, 1990-2004). Our primary income measure is calculated over a fifteen-year period and it covers the prime working age of the twins that we study. We use the twin dimension of the data to control for unobservable genetic and family confounding factors. Our within-twin estimates show that being physically active has a positive impact on the long-term income. We argue that our results are not easily reconciled with the intuitive explanation of physical activity enhancing long-term income via health or more intense labor market attachment. We reason that instead, there may be various non-cognitive mechanisms at work: Physical activity can, for example, make people more persistent in the face of work-related difficulties and increase their desire to partake in competitive situations, with greater expected pecuniary rewards.
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Spillovers of Health Education at School on Parents' Physical Activity
Lucila Berniell, Dolores de la Mata & Nieves Valdés
Health Economics, September 2013, Pages 1004–1020
Abstract:
This paper exploits state health education (HED) reforms as quasi-natural experiments to estimate the causal impact of HED received by children on their parents' physical activity. We use data from the Panel Study of Income Dynamics for the period 1999–2005 merged with data on state HED reforms from the National Association of State Boards of Education Health Policy Database and the 2000 and 2006 School Health Policies and Programs Study. To identify the spillover effects of HED requirements on parents' behavior, we use several methodologies (triple differences, changes in changes, and difference in differences) in which we allow for different types of treatments. We find a positive effect of HED reforms at the elementary school on the probability of parents doing light physical activity. Introducing major changes in HED increases the probability of fathers engaging in physical activity by between 6.3 and 13.7 percentage points, whereas on average, this probability for mothers does not seem to be affected. We analyze several heterogeneous impacts of the HED reforms to unveil the mechanisms behind these spillovers. We find evidence consistent with hypotheses such as gender specialization of parents in childcare activities or information sharing between children and parents.
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It takes some effort. How minimal physical effort reduces consumption volume
Thomas Brunner
Appetite, December 2013, Pages 89–94
Abstract:
Plenty of studies have demonstrated that effort influences food choice. However, few have been conducted to analyze the effect of effort on consumption volume. Moreover, the few studies that have measured consumption volume all have strong limitations. The goal of the present paper is to disentangle confounding variables in earlier research and to rule out various alternative explanations. In a tasting setting focusing on snacking behavior, either unwrapping a food product or grabbing it with sugar tongs was enough to significantly reduce consumption, regardless of whether an unhealthy or healthy food item was used. Hardly any cognitive resources seem to be necessary for the effect to occur, as cognitive load did not affect the findings. In light of obesity being a pressing concern, these findings might be valuable for individuals as well as for the food industry.
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Satiation from Sensory Simulation: Evaluating Foods Decreases Enjoyment of Similar Foods
Jeffrey Larson, Joseph Redden & Ryan Elder
Journal of Consumer Psychology, forthcoming
Abstract:
We demonstrate in two studies that people get more satiated on a food after repeatedly rating or choosing among similar foods shown in pictures. Repeated evaluations of food apparently have an effect similar to actual consumption — decreased enjoyment of foods that share a similar taste characteristic (i.e., sensory-specific satiety). We provide mediation evidence to show that satiation manifests because considering a food engenders spontaneous simulations of the taste of that food item, which by itself is enough to produce satiation. These findings establish sensory simulations as an important mechanism underlying satiation, and provide behavioral evidence that simple evaluations can produce sensory-specific satiety.
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Interoceptive sensitivity deficits in women recovered from bulimia nervosa
Megan Klabunde et al.
Eating Behaviors, forthcoming
Abstract:
Self-report studies suggest that patients with Bulimia Nervosa (BN) evidence difficulties with interoceptive awareness. Indeed, interoceptive deficits may persist after recovery of BN and may be a biological trait that predisposes symptom development in BN. However, no studies to date have directly assessed interoceptive sensitivity, or accuracy in detecting and perceiving internal body cues, in patients with or recovered from BN. Nine women who had recovered from BN and 10 healthy control women completed the Heart Beat Perception Task (HBPT) in which individuals were required to estimate the number of heartbeats between intervals of time. Accuracy scores were compared between groups. Significant differences were found between the groups on the HBPT ((F1,19) = 7.78, p = .013, Cohen’s d = 1.16) when controlling for age. These results suggest that deficits in interoceptive sensitivity are present in individuals recovered from BN. Thus interoceptive deficits may be one factor that bridges the gap between brain dysfunction and symptom presentation in BN.
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Daniel Belsky et al.
American Journal of Epidemiology, forthcoming
Abstract:
Cross-sectional studies have found that obesity is associated with low intellectual ability and neuroimaging abnormalities in adolescence and adulthood. Some have interpreted these associations to suggest that obesity causes intellectual decline in the first half of the life course. We analyzed data from a prospective longitudinal study to test whether becoming obese was associated with intellectual decline from childhood to midlife. We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (1972–1973) through their fourth decade of life with a 95% retention rate. Intelligence quotient (IQ) was measured in childhood and adulthood. Anthropometric measurements were taken at birth and at 12 subsequent in-person assessments. As expected, cohort members who became obese had lower adulthood IQ scores. However, obese cohort members exhibited no excess decline in IQ. Instead, these cohort members had lower IQ scores since childhood. This pattern remained consistent when we accounted for children's birth weights and growth during the first years of life, as well as for childhood-onset obesity. Lower IQ scores among children who later developed obesity were present as early as 3 years of age. We observed no evidence that obesity contributed to a decline in IQ, even among obese individuals who displayed evidence of the metabolic syndrome and/or elevated systemic inflammation.
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Obesity persistence and duration dependence: Evidence from a cohort of US adults (1985-2010)
Joan Daouli et al.
Economics & Human Biology, forthcoming
Abstract:
This study investigates dynamic patterns of obesity persistence and identifies the determinants of obesity-spell exits and re-entries. We utilize longitudinal data from the NLSY79 covering the period 1985-2010. Non-parametric techniques are applied to investigate the relationship between exit from obesity and spell duration. Multivariate discrete hazard models are also estimated, taking into account duration dependence and observed and time-invariant unobserved heterogeneity. In all cases, the probability of exiting obesity is inversely related to the duration of the obesity spell. Without controlling for unobserved heterogeneity, the probability of exit after one wave in obesity is 31.5 per cent; it is reduced to 3.8 per cent after seven or more waves. When time-invariant unobserved heterogeneity is taken into account, the estimated probabilities are slightly larger and broadly similar (36.8 and 10.3, respectively), which suggests that the identified negative duration dependence is not primarily due to composition effects. The obtained results indicate that public health interventions targeting the newly obese may be particularly effective at reducing incidence of long durations of obesity.
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Food Insecurity Is Linked to a Food Environment Promoting Obesity in Households With Children
Lisa Nackers & Bradley Appelhans
Journal of Nutrition Education and Behavior, forthcoming
Objective: To determine the extent to which the presence and accessibility of healthful and less healthful foods in children's homes vary with level of food security.
Methods: A total of 41 parents or primary caregivers who had at least 1 child ages 2–13 and resided in a low-income area with limited food access completed a home food inventory and a validated measure assessing household food security.
Results: Compared with food-secure participants, marginal or low/very low food-secure caregivers reported significantly more obesity-promoting foods in the home, more microwavable or quick-cook frozen foods, and greater access to less healthful foods in the kitchen (all Ps < .05).
Conclusions and Implications: Given the greater presence and accessibility of less healthful foods, targeting home food environment may improve diet quality and health status in children of low-income, food insecure households.
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Matthew Tryon et al.
Physiology & Behavior, 15 August 2013, Pages 233–242
Abstract:
Exaggerated reactivity to food cues involving calorically-dense foods may significantly contribute to food consumption beyond caloric need. Chronic stress, which can induce palatable “comfort” food consumption, may trigger or reinforce neural pathways leading to stronger reactions to highly rewarding foods. We implemented functional magnetic resonance imaging (fMRI) to assess whether chronic stress influences activation in reward, motivation and executive brain regions in response to pictures of high calorie and low calorie foods in thirty women. On separate lab visits, we also assessed food intake from a snack food buffet and circulating cortisol. In women reporting higher chronic stress (HCS), pictures of high calorie foods elicited exaggerated activity in regions of the brain involving reward, motivation, and habitual decision-making. In response to pictures of high calorie food, higher chronic stress was also associated with significant deactivation in frontal regions (BA10; BA46) linked to strategic planning and emotional control. In functional connectivity analysis, HCS strengthened connectivity between amygdala and the putamen, while LCS enhanced connectivity between amygdala and the anterior cingulate and anterior prefrontal cortex (BA10). A hypocortisolemic signature and more consumption of high calorie foods from the snack buffet were observed in the HCS group. These results suggest that persistent stress exposure may alter the brain's response to food in ways that predispose individuals to poor eating habits which, if sustained, may increase risk for obesity.
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James Ruff et al.
Nature Communications, August 2013
Abstract:
Consumption of added sugar has increased over recent decades and is correlated with numerous diseases. Rodent models have elucidated mechanisms of toxicity, but only at concentrations beyond typical human exposure. Here we show that comparatively low levels of added sugar consumption have substantial negative effects on mouse survival, competitive ability, and reproduction. Using Organismal Performance Assays — in which mice fed human-relevant concentrations of added sugar (25% kcal from a mixture of fructose and glucose, modeling high fructose corn syrup) and control mice compete in seminatural enclosures for territories, resources and mates — we demonstrate that fructose/glucose-fed females experience a twofold increase in mortality while fructose/glucose-fed males control 26% fewer territories and produce 25% less offspring. These findings represent the lowest level of sugar consumption shown to adversely affect mammalian health. Clinical defects of fructose/glucose-fed mice were decreased glucose clearance and increased fasting cholesterol. Our data highlight that physiological adversity can exist when clinical disruptions are minor, and suggest that Organismal Performance Assays represent a promising technique for unmasking negative effects of toxicants.
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Facial affective reactions to bitter-tasting foods and body mass index in adults
D. Garcia-Burgos & M.C. Zamora
Appetite, December 2013, Pages 178–186
Abstract:
Differences in food consumption among body-weight statuses (e.g., higher fruit intake linked with lower body mass index (BMI) and energy-dense products with higher BMI) has raised the question of why people who are overweight or are at risk of becoming overweight eat differently from thinner people. One explanation, in terms of sensitivity to affective properties of food, suggests that palatability-driven consumption is likely to be an important contributor to food intake, and therefore body weight. Extending this approach to unpalatable tastes, we examined the relationship between aversive reactions to foods and BMI. We hypothesized that people who have a high BMI will show more negative affective reactions to bitter-tasting stimuli, even after controlling for sensory perception differences. Given that hedonic reactions may influence consumption even without conscious feelings of pleasure/displeasure, the facial expressions were included in order to provide more direct access to affective systems than subjective reports. Forty adults (28 females, 12 males) participated voluntarily. Their ages ranged from 18 to 46 years (M = 24.2, SD = 5.8). On the basis of BMI, participants were classified as low BMI (BMI < 20; n = 20) and high BMI (BMI > 23; n = 20). The mean BMI was 19.1 for low BMI (SD = 0.7) and 25.2 for high BMI participants (SD = 1.8). Each subject tasted 5 mL of a grapefruit juice drink and a bitter chocolate drink. Subjects rated the drinks’ hedonic and incentive value, familiarity and bitter intensity immediately after each stimulus presentation. The results indicated that high BMI participants reacted to bitter stimuli showing more profound changes from baseline in neutral and disgust facial expressions compared with low BMI. No differences between groups were detected for the subjective pleasantness and familiarity. The research here is the first to examine how affective facial reactions to bitter food, apart from taste responsiveness, can predict differences in BMI.
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Eating me up inside: Priming attachment security and anxiety, and their effects on snacking
Laura Wilkinson, Angela Rowe & Georgina Heath
Journal of Social and Personal Relationships, September 2013, Pages 795-804
Abstract:
Recent research has shown that attachment anxiety (a model of interpersonal relationships characterised by a fear of abandonment) is a good predictor of disinhibited eating and, in turn, body mass index. However, this association has yet to be explored within an eating episode. The present study investigated the effect of priming attachment security and attachment anxiety on food intake. Normal weight participants (N = 21) were primed with security and anxiety on separate occasions and given ad libitum access to a snack food. Priming anxiety led to a significantly higher food intake than priming security (p = .016). We suggest that participants consumed more food in response to the anxious prime in an attempt to manage the resulting feelings of insecurity. These results provide behavioural evidence for a link between attachment anxiety and disinhibited eating.
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Acute sleep deprivation increases food purchasing in men
Colin Chapman et al.
Obesity, forthcoming
Objective: To investigate if acute sleep deprivation affects food purchasing choices in a mock supermarket.
Design and Methods: On the morning after one night of total sleep deprivation (TSD) or after one night of sleep, 14 normal-weight men were given a fixed budget (300 SEK—approximately 50 USD). They were instructed to purchase as much as they could out of a possible 40 items, including 20 high-caloric foods (>2 kcal/g) and 20 low-caloric foods (<2 kcal/g). The prices of the high-caloric foods were then varied (75%, 100% (reference price), and 125%) to determine if TSD affects the flexibility of food purchasing. Before the task, participants received a standardized breakfast, thereby minimizing the potential confound produced by hunger. In addition, morning plasma concentrations of the orexigenic hormone ghrelin were measured under fasting conditions.
Results: Independent of both type of food offered and price condition, sleep-deprived men purchased significantly more calories (+9%) and grams (+18%) of food than they did after one night of sleep (both P < 0.05). Morning plasma ghrelin concentrations were also higher after TSD (P < 0.05). However, this increase did not correlate with the effects of TSD on food purchasing.
Conclusions: This experiment demonstrates that acute sleep loss alters food purchasing behavior in men.
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Bisphenol A and Chronic Disease Risk Factors in US Children
Donna Eng et al.
Pediatrics, September 2013, Pages e637-e645
Objective: To evaluate the relationship between urinary bisphenol A (BPA) levels and measures of adiposity and chronic disease risk factors for a nationally representative US pediatric sample.
Methods: We used the NHANES 2003–2010 to evaluate cross-sectional associations between urinary BPA and multiple measures of adiposity, cholesterol, insulin, and glucose for children aged 6 to 18 years, adjusting for relevant covariates (eg, demographics, urine creatinine, tobacco exposure, and soda consumption).
Results: We found a higher odds of obesity (BMI ≥95th percentile) with increasing quartiles of BPA for quartiles 2 vs 1 (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.17–2.60, P = .008), 3 vs 1 (OR 1.64, 95% CI 1.09–2.47, P = .02), and 4 vs 1 (OR 2.01, 95% CI 1.36–2.98, P = .001). We also found a higher odds of having an abnormal waist circumference–to–height ratio (quartiles 2 vs 1 [OR 1.37, 95% CI 0.98–1.93, P = .07], 3 vs 1 [OR 1.41, 95% CI 1.07–1.87, P = .02], and 4 vs 1 [OR 1.55, 95% CI 1.12–2.15, P = .01]). We did not find significant associations of BPA with any other chronic disease risk factors.
Conclusions: Higher levels of urinary BPA were associated with a higher odds of obesity (BMI >95%) and abnormal waist circumference–to–height ratio. Longitudinal analyses are needed to elucidate temporal relationships between BPA exposure and the development of obesity and chronic disease risk factors in children.
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Kayla de la Haye et al.
Journal of Research on Adolescence, September 2013, Pages 524–536
Abstract:
Adolescents’ consumption of low-nutrient, energy-dense (LNED) food often occurs out of home, and friends may be an important source of influence. This study tested whether observed similarities in LNED food intake among friends result from social influence and also explored underlying psychological mechanisms. Three waves of data were collected over 1 year from Grade 8 students in Australia (N = 378, 54% male), including measures of food intake and related cognitions, and friendships to grademates. The results of longitudinal social network models show that adolescent intake was predicted by their friends’ intake, accounting for pre-existing similarities and other potentially confounding factors. Changes to adolescents’ beliefs about LNED food do not appear to be the mechanisms underpinning influence from their friends.
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The Socioeconomic Origins of Physical Functioning among Older U.S. Adults
Jennifer Karas Montez
Advances in Life Course Research, December 2013, Pages 244–256
Abstract:
Mounting evidence finds that adult health reflects socioeconomic circumstances (SES) in early life and adulthood. However, it is unclear how the health consequences of SES in early life and adulthood accumulate — for example, additively, synergistically. This study tests four hypotheses about how the health effects of early-life SES (measured by parental education) and adult SES (measured by own education) accumulate to shape functional limitations, whether the accumulation differs between men and women, and the extent to which key mechanisms explain the accumulation. It uses data from the 1994-2010 Health and Retirement Study on U.S. adults 50-100 years of age (N = 24,026). The physical functioning benefits of parental and own education accumulated additively among men. While the physical functioning benefits generally accumulated among women, the functioning benefits from one's own education were dampened among women with low-educated mothers. The dampening partly reflected a strong tie between mothers’ education level and women's obesity risk. Taken together, the findings reveal subtle differences between men and women in the life course origins of physical functioning. They also shed light on a key mechanism — obesity — that may help explain why a growing number of studies find that early-life SES is especially important for women's health.
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Kelin Li & Ming Wen
Race and Social Problems, September 2013, Pages 147-156
Abstract:
Evidence has shown that racial/ethnic minorities in the United States are less likely than whites to engage in leisure-time physical activity (LTPA); yet few studies to date have included Asian subgroups in the analyses and mechanisms underlying these disparities are not well known. This study uses data from the 2007 California Health Interview Survey (N = 37,164) to examine racial/ethnic disparities in self-reported adherence to LTPA recommendations and to explore the mediating roles of socioeconomic status (SES), acculturation, and neighborhood perceptions. Nine racial/ethnic groups were included: non-Hispanic whites, non-Hispanic blacks, Mexicans, and six largest Asian subgroups. Results confirm that racial/ethnic minorities are, in general, less likely than whites to meet LTPA recommendations, whereas heterogeneity is also evident across Asian subgroups. No significant disparity is revealed for the Japanese and Filipinos but whites are advantaged compared to all other Asian groups. Educational attainment, percent of lifetime spent in the United States and access to park, playground, or open space are significantly associated with meeting LTPA recommendations. SES and acculturation play differential roles in explaining group disparities for blacks, Mexicans, and some Asian subgroups. Perceived neighborhood environment does not mediate LTPA disparities by race/ethnicity. Net of these mediators, the advantages of whites in meeting LTPA recommendations persist for blacks, Mexicans, the Chinese, and Koreans. Future research should theorize and operationalize additional multilevel pathways linking race/ethnicity and LTPA while assessing measurement errors in the existing constructs.
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New Dynamics in Global Obesity Facing Low- and Middle-Income Countries
Barry Popkin & Meghan Slining
Obesity Reviews, forthcoming
Abstract:
Levels of overweight and obesity across low- and-middle income countries (LMIC) have approached levels found in higher-income countries. This is particularly true in the Middle East and North Africa and in Latin America and the Caribbean. Using nationally representative samples of women aged 19–49, n = 815,609, this paper documents the annualized rate of increase of overweight from the first survey in early 1990 to the last survey in the present millennium. Overweight increases ranged from 0.31 percent per year to 0.92 percent per year for Latin America and the Caribbean and for the Middle East and North Africa, respectively. For a sample of eight countries, using quantile regression, we further demonstrate that mean body mass index at the ninety-fifth percentile has increased significantly across all regions, representing predicted weight increases of 5–10 kilograms. Furthermore we highlight a major new concern in LMICs, documenting waist circumference increases of 2-4 cm at the same BMI (.e.g. 25) over an 18 year period. In sum, this paper indicates growing potential for increased cardiometabolic problems linked with a large rightward shift in the BMI distribution and increased waist circumference at each BMI level.