Plenary discussion

In 2012, as part of an implementation plan to improve maternal, infant and young child nutrition, the World Health Assembly set a global target of no increase in child overweight by 2025. The aim of this research is to review the existing available data to see whether we are on track to meet this target. The NCD-RisC collaboration estimated worldwide trends in obesity in children and adolescents from pooled population data of mean body mass index (BMI) collected between 1975 and 2016. While there is undisputed evidence that mean BMI has increased over the past four decades, there is some indication that child and adolescent BMI is plateauing in certain developed countries. This finding has been observed from several other sources, but there is little room for complacency. The levels of overweight and obesity in many of these countries are leveling at a rate that is still unacceptably high. In 2017, the Organisation for Economic Cooperation and Development reported rates of childhood obesity across 29 countries which ranged from 10% to 30%; if the prevalence of overweight is included, this would extend up to 50%. Furthermore, data from the World Health Organisation Childhood Obesity Surveillance Initiative indicates that within developed countries, the leveling of overweight and obesity is not being observed in children who experience disadvantage. In low income countries, the challenge of undernutrition is still omni-present and, with growing populations, the number of underweight or stunted children and adolescents continues to be higher than the number of overweight or obese children and adolescents. Nevertheless, many of these countries are also facing the double burden of malnutrition with children being undernourished and adults suffering from overweight and obesity. There are also stark figures from countries with growing economies, which experience a ‘nutrition transition’ that typically manifests in accelerated rates of child obesity. The global experience of childhood overweight and obesity continues to be discordant. Policies and interventions designed too reduce rates of obesity must ensure that no child is left behind.