Obesity Transitions by Age, Period, and Cohort: A Population-Based Application of the Lancet Commission Framework in the United States and Korea

作者：Garam Jo, Dahyun Park, S. K. Kim, Hee Ju Jun, Faidon Magkos, Jordi Merino, Qi Sun, Rockli Kim, S.V. Subramanian, Paul W. Franks, Min-Jeong Shin · 发表于：Diabetes & Metabolism Journal · 年份：2026 · DOI：10.4093/dmj.2025.0918 · 被引用次数：1 · 研究领域：Obesity, Physical Activity, Diet、Chronic Disease Management Strategies、Obesity and Health Practices

Background: While emerging global classification frameworks highlight the need to redefine obesity beyond body mass index (BMI) to improve prevention strategies and public health policy, population-level applications remain scarce. We examined trends in BMI-based and newly proposed Lancet Commission definitions of obesity in the United States and South Korea, two countries with contrasting obesity trends. Methods: Using representative data from the United States National Health and Nutrition Examination Survey (NHANES, 2003-2016) and the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2023), we conducted age-standardized and age-period-cohort (APC) analyses to compare obesity trends. Results: Newly defined obesity phenotypes demonstrated a greater proportion of at-risk individuals than BMI alone, particularly among United States women and Korean men. Excess adiposity in the United States showed early increases from 55.6% to over 75%, followed by stabilization, while Korea exhibited a sustained upward trend. APC analyses revealed more divergent patterns. These sex-specific patterns align with differences in visceral adiposity by sex and in East Asian populations. Period effects on obesity were characterized by a high and sustained burden in the United States, but a more gradual yet persistent upward trend in Korea. Preclinical obesity displayed a U-shaped cohort effect in the United States, with higher prevalence in cohorts born after 1975, whereas clinic...