ArticleObesity pillars2026
Population trends in nutritional status and socioeconomic divergence in extreme obesity in Peru: geospatial dynamics and intergenerational risk.
Article in Obesity pillars, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Development and internal validation of a risk score for incident obesity among Peruvian formal workers.Obesity pillars · 2026Article
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Abstract
Background: Peru is undergoing a sustained nutrition transition; however, evidence on the simultaneous behavior of extreme phenotypes - geriatric underweight and class III obesity - and their generational determinants remains limited. We aimed to analyze the temporal, geospatial, socioeconomic, and intergenerational dynamics of population malnutrition over the last decade. Methods: This was a repeated cross-sectional, population-based analytical trend study with age-period-cohort (APC) analysis, using data from the Peruvian Demographic and Family Health Survey (DHS) 2014-2024 (excluding 2020), including 257,264 individuals aged ≥15 years. Nutritional status was assessed using body mass index (BMI) and life-stage-specific cut-offs (adolescents: 2007 World Health Organization BMI-for-age Z-scores; adults: World Health Organization BMI criteria; older adults: Pan American Health Organization/Salud, Bienestar y Envejecimiento and Peruvian Ministry of Health criteria). Temporal trends were estimated using average annual percent change (AAPC) from weighted log-linear regressions. Economic inequality was quantified with the Erreygers Concentration Index (ECI). Generational risk was estimated through an APC model restricted to adults aged 20-80 years for class III obesity (BMI ≥40 kg/m Results: Among adults, normal weight prevalence fell markedly (AAPC -3.4%/year; p < 0.001), while class III obesity showed the largest proportional increase (+8.9%/year; p < 0.001). Underweight remained close to 20% in older adults by 2024, reflecting a persistent geriatric double burden. ECI showed that extreme obesity, initially concentrated in wealthier quintiles, spread toward lower and middle strata, though the pro-rich gradient persisted (ECI 2014: 0.008; ECI 2024: 0.011; both p = 0.002). Cohorts born in the 1990s and 2000s showed substantially higher relative rates of class III obesity compared with the 1970 reference cohort at equivalent biological age, reflecting a marked unfavorable generational shift. Conclusions: Peru exhibits a divergent double burden of malnutrition. The rise in class III obesity spans multiple socioeconomic strata, disproportionately affects recent cohorts, and coexists with persistently high underweight in the geriatric population.
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