1. Epidemiology and Global Health

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

  1. NCD Risk Factor Collaboration (NCD-RisC)  Is a corresponding author
https://doi.org/10.7554/eLife.60060
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  1. NCD Risk Factor Collaboration (NCD-RisC)
(2021)
Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight
eLife 10:e60060.
https://doi.org/10.7554/eLife.60060
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Abstract

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

Introduction

Underweight as well as obesity can lead to adverse health outcomes (Prospective Studies Collaboration et al., 2009; Global BMI Mortality Collaboration, 2016; Emerging Risk Factors Collaboration et al., 2011). For at least four decades, the prevalence of underweight has decreased, and that of obesity has increased, in most countries with significant variation in the magnitude of these changes across regions of the world (NCD Risk Factor Collaboration (NCD-RisC), 2017a; NCD Risk Factor Collaboration (NCD-RisC), 2019).

A shift in the whole distribution of body mass index (BMI) would simultaneously affect mean BMI as well as the prevalence of underweight and obesity (Razak et al., 2018; Rose and Day, 1990). In contrast, changes in the shape of BMI distribution – for example, widening or narrowing of the BMI distribution, becoming more or less skewed, or having a thinner or thicker tail – would affect the prevalence of underweight and obesity with only small impacts on the population mean, as shown schematically in Figure 1. Understanding these two mechanisms is essential as they may require different public health and clinical responses (Penman and Johnson, 2006). But it is unclear how much the two mechanisms have contributed to the observed decline in underweight and rise in obesity in different world regions.

Figure 1
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Schematic diagram of contribution of change in mean body mass index (BMI) to change in total prevalence of underweight or obesity.

(A) Change in the prevalence of underweight and obesity if the distribution shifts, represented by a change in its mean and its shape. In this example, the change (shown as the difference between blue and gray) results in a small decrease of underweight and a large increase in obesity. (B) Change in the prevalence of underweight and obesity when only mean BMI changes (shown as the difference between orange and gray), without a change in the shape of the distribution.

Some studies have investigated whether the rise in obesity or the decrease of underweight over time, or differences across countries, were due to a shift in BMI distribution versus changes in the low- or high-BMI tails of the distribution (Razak et al., 2018; Wang et al., 2007; Wagner et al., 2019; Vaezghasemi et al., 2016; Razak et al., 2013; Popkin and Slining, 2013; Popkin, 2010; Peeters et al., 2015; Ouyang et al., 2015; Monteiro et al., 2002; Midthjell et al., 2013; Lebel et al., 2018; Khang and Yun, 2010; Helmchen and Henderson, 2004; Hayes et al., 2015; Green et al., 2016; Flegal and Troiano, 2000; Stenholm et al., 2015; Hayes et al., 2017; Flegal et al., 2012; Bovet et al., 2008). Most of these studies focused on a single or small number of countries over relatively short durations or covered only one sex, a narrow age group, or specific social groups. To understand whether weight gain occurs across all BMI levels or disproportionately affects the underweight or obese segments of the distribution, and how this phenomenon varies geographically, there is a need for a population-based study that simultaneously investigates both underweight and obesity in relation to mean BMI in different regions of the world. We used a comprehensive global database to investigate how much change in mean BMI can explain the corresponding changes in prevalence of adults with underweight (defined as BMI <18.5 kg/m2), total obesity (BMI ≥30 kg/m2), and severe obesity (BMI ≥35 kg/m2) over three decades from 1985 to 2016 in different regions of the world.

Results

Data sources

The Non-Communicable Disease Risk Factor Collaboration (NCD-RisC) database contains 2896 population-based studies conducted from 1985 to 2019 with height and weight measurements of 187 million participants. Of these, 2033 studies had measurements of height and weight on 132.6 million participants aged 20–79 years. The number of studies with participants aged 20–79 years in different regions ranged from 53 in Oceania to 637 in the high-income western region. The number of data sources by country is shown in Figure 2. The list of data sources and their characteristics is provided in Supplementary file 4.

Figure 2
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Number of data sources with participants aged 20-79 years.

Change in mean BMI and prevalence of underweight, obesity, and severe obesity by region

In 2016, the age-standardised prevalence of underweight was highest (>16% in different sex-age groups) in South Asia; it was <2.5% in Central and Eastern Europe; the high-income western region; Latin America and the Caribbean; Oceania; and Central Asia, the Middle East, and North Africa for most age and sex groups. The age-standardised prevalence of obesity was highest (>24%) in these same regions for most age and sex groups. It was lowest (<7%) in men and women from South Asia; the high-income Asia Pacific region; and men from sub-Saharan Africa. The age-standardised prevalence of severe obesity was highest (12–18%) in women aged 50–79 years from Central Asia, the Middle East, and North Africa; the high-income western region; Central and Eastern Europe; and Latin America and the Caribbean. It was lowest (<2%) in South Asia; East and Southeast Asia; the high-income Asia Pacific region; and men in sub-Saharan Africa.

From 1985 to 2016, age-standardised mean BMI increased by 1–4 kg/m2 in all regions, with the exception of women in the high-income Asia Pacific region and Central and Eastern Europe whose mean BMI changed by less than 1 kg/m2 (Figure 3). The prevalence of underweight decreased or stayed unchanged and that of obesity and severe obesity increased from 1985 to 2016 in all regions, with the exception of an increase in the prevalence of underweight in younger women in the high-income Asia Pacific region. The largest absolute decrease in underweight prevalence from 1985 to 2016 was seen in South Asia; East and Southeast Asia; and sub-Saharan Africa, where it declined by 14–35 percentage points in different age–sex groups (Figure 4). Nonetheless, underweight prevalence remained higher in these three regions than elsewhere in 2016. Prevalence of underweight changed only marginally in regions such as Central and Eastern Europe and the high-income western region, where prevalence was already low in 1985.

Figure 3
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Change in mean body mass index (BMI) from 1985 to 2016 by region, sex, and age group.
Figure 4
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Change in prevalence of underweight, obesity, and severe obesity from 1985 to 2016 by region, sex, and age group.

The largest absolute increase in obesity prevalence from 1985 to 2016 occurred in Central Asia, the Middle East, and North Africa; the high-income western region; Latin America and the Caribbean; Oceania (women); and Central and Eastern Europe (men) (Figure 4). Women in these regions also experienced the largest increase in severe obesity prevalence, along with men in the high-income western region. In these regions and sexes, obesity prevalence increased by 16–24 percentage points in different age groups, and severe obesity increased by 5–13 percentage points. The increase in obesity was less than five percentage points in the high-income Asia Pacific region; South Asia; and in men in sub-Saharan Africa; in the same regions, along with East and Southeast Asia, the increase in severe obesity was less than two percentage points.

Associations of underweight, obesity, and severe obesity prevalence with mean BMI

There was a strong association between the prevalence of underweight, obesity, and severe obesity with mean BMI as measured by R-squared of the regressions of prevalence on mean (Supplementary files 1 and 2). These indicate that 93% (men) and 96% (women) of variation in obesity, and between 83% and 92% of variation in underweight and severe obesity, were explained by mean BMI and other variables (year, region, and age group) in the regression models. The coefficients of the mean BMI terms represent the changes in (probit-transformed) prevalence associated with a unit change in mean BMI, and their interactions with region represent variations in this association across regions. For all three outcomes, the association of prevalence with mean BMI varied across regions.

The inter-regional variation in the prevalence–mean association was stronger for obesity and severe obesity than underweight, as seen in larger inter-regional range of the interaction terms. The extent to which prevalence changes with any variation in mean BMI in each region is an outcome of the main BMI term and its interaction with region; to be epidemiologically interpretable, this will have to be converted from probit-transformed to original prevalence scale. For example, in the year 2016, for women aged 50–59 years, at a mean BMI of 25 kg/m2 (which was approximately the global age-standardised mean level of BMI) (NCD Risk Factor Collaboration (NCD-RisC), 2017a), prevalence of underweight would have varied by seven percentage points across regions, being lowest in Central and Eastern Europe and highest in sub-Saharan Africa; a unit increase in mean BMI would have been associated with a relative change in prevalence ranging from −49% in the high-income Asia Pacific region to −14% in Oceania. Also for women aged 50–59 years and a mean BMI of 25 kg/m2, the prevalence of obesity and severe obesity would both have been the highest in Oceania and the lowest in the high-income Asia Pacific region, with a difference of 12 and 6 percentage points, respectively, for the two outcomes; a unit increase in mean BMI would have been associated with a relative change ranging from 21% to 46% for obesity and from 30% to 59% for severe obesity, the smallest change for both being in Oceania and the largest in East and Southeast Asia. There was similar inter-regional variation in the other year–age–sex strata.

Contribution of mean BMI to changes in underweight and obesity prevalence

The rise in mean BMI accounted for >82% of the decline in underweight in different age–sex groups in South Asia, where underweight prevalence declined by over 16 percentage points for all age–sex groups (Figure 5). The remainder of the decline was due to change in the shape of the BMI distribution which reduced underweight prevalence beyond the effects of the population mean. In contrast, in sub-Saharan Africa and East and Southeast Asia, the total change in prevalence of underweight (3–12 percentage points) was 20–80% less than what was expected based on the increase in mean BMI (Figure 5). In other words, in these regions the underweight tail of the BMI distribution was left behind as the distribution shifted.

Figure 5
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Contribution of change in mean body mass index (BMI) to total change from 1985 to 2016 in prevalence of underweight, obesity, or severe obesity by region, sex, and age group.

Blue arrows show the total change in prevalence of underweight, obesity, or severe obesity. Orange arrows show the contribution of change in mean BMI to the change in prevalence. The difference between these two arrows is shown with a line, whose colour follows the shorter arrow.

Where obesity increased the most – Central Asia, the Middle East, and North Africa; Latin America and the Caribbean; and the high-income western region – the rise in mean BMI accounted for over three quarters of the increase in different age–sex groups (Figure 5). In Oceania, the actual rise in prevalence of obesity (8–14 percentage points for all age–sex groups) was about two-thirds to one-half of what would have been expected by the observed increase in mean BMI in men and women (Figure 5). Change in mean BMI consistently accounted for a smaller share of the change in severe obesity than it did for change in total obesity. Specifically, in regions where prevalence of severe obesity changed by more than one percentage point, the contribution of change in mean BMI to change in severe obesity in different regions was 53–90% of the corresponding contribution for total obesity (Figure 5).

In other regions, the change in the prevalence of underweight, obesity, or severe obesity was too small for the contribution of change in mean BMI to be epidemiologically relevant (Figure 5).

Discussion

We found that the trends in the prevalence of underweight, total obesity, and, to a lesser extent, severe obesity are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. The notable exceptions to this pattern were the decline in the prevalence of underweight in East and Southeast Asia and sub-Saharan Africa and the rise of obesity in Oceania, which were both smaller than expected based on change in mean BMI.

Our results are consistent with a recent cross-sectional study (Razak et al., 2018) using data from women in low- and middle-income countries that found a strong association between mean BMI and prevalence of obesity, and a moderate association between mean BMI and prevalence of underweight. Being cross-sectional, this study did not consider changes over time, as we have. Our results are also consistent with another study which found that changes in median BMI contributed more than 75% to the increase in obesity in the USA from 1980 to 2000 (Helmchen and Henderson, 2004).

Previous studies used one or more approaches to investigate changes in population BMI distribution: some analysed percentiles of the BMI distribution (Wagner et al., 2019; Vaezghasemi et al., 2016; Razak et al., 2013; Popkin and Slining, 2013; Popkin, 2010; Peeters et al., 2015; Ouyang et al., 2015; Lebel et al., 2018; Hayes et al., 2015), others focused on the change in prevalence above or below pre-specified BMI thresholds (Wang et al., 2007; Razak et al., 2013; Popkin, 2010; Peeters et al., 2015; Ouyang et al., 2015; Khang and Yun, 2010; Flegal and Troiano, 2000), or evaluated how the shape of the BMI distribution has changed via examining metrics such as standard deviation and skewness (Peeters et al., 2015; Ouyang et al., 2015; Lebel et al., 2018; Khang and Yun, 2010; Hayes et al., 2015; Flegal and Troiano, 2000). Most of these studies reached the same conclusion as our study that, as the BMI distribution shifts upwards, the prevalence of underweight declines somewhat more slowly than the prevalence of obesity rises.

Our study has strengths in scope, data, and methods: the strengths of our study include presenting the first global analysis of how much the rise in mean BMI versus changes in the shape of its distribution influenced changes in both underweight and obesity prevalence. We used an unprecedented amount of data from different regions covering three decades and used only measured data on height and weight to avoid biases in self-reported data.

As with all global analyses, our study has some limitations. Despite using the most comprehensive global collection of population-based studies to date, some regions, especially Oceania and sub-Saharan Africa, had less data, especially early in our analysis period. Further, given the large number of age, sex, and region subgroups of population in our analysis, and its long duration, it was not possible to visually explore how the shape of BMI distribution has changed in the underweight and obesity ranges where changes in the mean did not fully explain change in prevalence. Finally, there are variations in characteristics such as response rate and measurement protocol across studies. Some of these, such as exclusion of studies with self-reported height and weight, were a part of our inclusion and exclusion criteria. Others may affect population mean or prevalence.

The finding that the majority of the rise in the prevalence of obesity from 1985 to 2016 is mostly the result of a distributional shift points towards an important role for societal drivers, including lower availability and higher price of healthy and fresh foods compared to caloric-dense and nutrient-deficient foods (Swinburn et al., 2011), and mechanisation of work and motorisation of transport throughout the world that have reduced energy expenditure in populations around the world (NCD Risk Factor Collaboration (NCD-RisC), 2019; Ng and Popkin, 2012). First, although there is a genetic component to BMI at the individual level (Silventoinen et al., 2017; Silventoinen et al., 2016; Locke et al., 2015; Brandkvist et al., 2019), genetics explain only a small part of changes over time, especially when people have access to healthy food and living environment. When the environment becomes more obesogenic, some people or population subgroups may gain more weight than others, implying that the environment remains the main contributor (Brandkvist et al., 2019). This interplay of genetic predisposition and changes in the environment might account for some of the excess rise in obesity and severe obesity beyond the effect of distributional shift alone (Brandkvist et al., 2019). The exception observed in Oceania is possibly because in 1985 obesity prevalence in this region was already so high (NCD Risk Factor Collaboration (NCD-RisC), 2017a) that the rise in BMI did not change overall obesity status (but there was a substantial increase in those with severe obesity, mostly accounted for by the change in mean BMI). The smaller decline in underweight than expected in sub-Saharan Africa and East and Southeast Asia may be because underweight is associated with lower socioeconomic status, food insecurity, and for sub-Saharan Africa widening difference between rural and urban BMI levels which is different from other regions (NCD Risk Factor Collaboration (NCD-RisC), 2019; Brandkvist et al., 2019; Di Cesare et al., 2015; Subramanian and Smith, 2006; Di Cesare et al., 2013). If the benefits of economic development do not sufficiently reach the poor, they remain nutritionally vulnerable, as has been seen for height and weight during childhood and adolescence (NCD Risk Factor Collaboration (NCD-RisC), 2020; Subramanyam et al., 2011; Sanchez and Swaminathan, 2005; Pongou et al., 2006; Haddad, 2003; Stevens et al., 2012). Together with the rise in mean BMI and obesity (and short stature which is not a topic of this paper but addressed in other studies) (NCD Risk Factor Collaboration (NCD-RisC), 2020; Stevens et al., 2012; NCD Risk Factor Collaboration (NCD-RisC), 2016a), this creates a double burden of malnutrition (Popkin et al., 2020).

In summary, we found that the worldwide rise in obesity and the decline in underweight are primarily driven by the shift in the population distribution of BMI. At the same time, there is an evidence of both excess obesity, and especially severe obesity, and persistent underweight beyond the distributional shift in some regions, which may be related to growing social inequalities that restrict access to healthy foods in those at highest risk of undernutrition (Popkin et al., 2020; Wells et al., 2020; Darmon and Drewnowski, 2015). The response to these trends must motivate ‘double-duty actions’ that prevent and tackle all forms of malnutrition through both fiscal and regulatory restrictions on unhealthy foods, and making healthy foods available, accessible, and affordable especially to those at high risks of underweight and obesity (Powell et al., 2013; Hawkes et al., 2020; Bleich et al., 2017).

Materials and methods

Study design

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Our aim was to quantify, for all regions of the world, how much of the change in prevalence of underweight (defined as BMI <18.5 kg/m2), (total) obesity (BMI ≥30 kg/m2), and severe obesity (BMI ≥35 kg/m2) among men and women aged 20–79 years from 1985 to 2016 could be accounted for by change in mean BMI. In the first step, we used data from a global database of human anthropometry to estimate the associations of the prevalence of underweight, prevalence of obesity, or prevalence of severe obesity with population mean BMI, including how the association varies in relation to age group and region. We then used the fitted association to estimate the contribution of change in the population mean BMI to change in the prevalence of underweight, obesity, or severe obesity in different regions.

Data sources

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In the first step of the analysis, we estimated the prevalence-mean associations, using data from a comprehensive database on cardiometabolic risk factors collated by NCD-RisC as described below. In the second step, we needed consistent estimates of mean BMI for all regions. For this purpose, we used data from a recent comprehensive analysis of worldwide trends in mean BMI from 1985 to 2016 (NCD Risk Factor Collaboration (NCD-RisC), 2017a) which had fitted a Bayesian hierarchical model to the NCD-RisC data.

Data in the NCD-RisC database were obtained from publicly available multi-country and national measurement surveys (e.g., Demographic and Health Surveys, WHO-STEPwise approach to Surveillance [STEPS] surveys, and those identified via the Inter-University Consortium for Political and Social Research and European Health Interview and Health Examination Surveys Database). With the help of the World Health Organization (WHO) and its regional and country offices as well as the World Heart Federation, we identified and accessed population-based survey data from national health and statistical agencies. We searched and reviewed published studies as detailed previously (NCD Risk Factor Collaboration (NCD-RisC), 2017a) and invited eligible studies to join NCD-RisC, as we did with data holders from earlier pooled analysis of cardiometabolic risk factors (Finucane et al., 2011; Farzadfar et al., 2011; Danaei et al., 2011a; Danaei et al., 2011b).

Data inclusion and exclusion

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We carefully checked that each data source met our inclusion criteria as listed below:

  • measurement data on height and weight were available;

  • study participants were 5 years of age and older (as described earlier data used here were for those 20–79 years);

  • data were collected using a probabilistic sampling method with a defined sampling frame;

  • data were from population samples at the national, sub-national (i.e., covering one or more sub-national regions, with more than three urban or five rural communities), or community level; and

  • data were from the countries and territories listed in Supplementary file 3.

We excluded all data sources that only used self-reported weight and height without a measurement component because these data are subject to biases that vary with geography, time, age, sex, and socioeconomic characteristics (Tolonen et al., 2014; Hayes et al., 2011; Ezzati et al., 2006). We also excluded data on population subgroups whose anthropometric status may differ systematically from the general population, including

  • studies that had included or excluded people based on their health status or cardiovascular risk;

  • studies whose participants were only ethnic minorities;

  • specific educational, occupational, or socioeconomic subgroups, with the exception noted below; and

  • those recruited through health facilities, with the exception noted below.

We included school-based data in countries and age–sex groups with enrolment of 70% or higher. We also included data whose sampling frame was health insurance schemes in countries where at least 80% of the population were insured. Finally, we included data collected through general practice and primary care systems in high-income and Central European countries with universal insurance because contact with the primary care systems tends to be as good as or better than the response rates for population-based surveys. The list of data sources with participants aged 20–79 years and their characteristics is provided in Supplementary file 4, with additional information in Source data 1.

Duplicate data were identified by comparing studies from the same country and year, and then discarded. All NCD-RisC members are also periodically asked to review the list of sources from their country, to verify that the included data meet the inclusion criteria and are not duplicates, and to suggest additional sources. The NCD-RisC database is continuously updated through all the above routes. For each data source, we recorded the study population, sampling approach, years of measurement, and measurement methods. Only population-representative data were included, and these were assessed in terms of whether they covered the whole country, multiple sub-national regions, or one or a small number of communities, and whether rural, urban, or both participants were included. All submitted data were checked independently by at least two persons. Questions and clarifications were discussed with NCD-RisC members and resolved before data were incorporated in the database.

We calculated mean BMI and the associated standard errors by sex and age. All analyses incorporated sample weights and complex survey design, when applicable, in calculating summary statistics, with computer code provided to NCD-RisC members who requested assistance.

Additionally, summary statistics for nationally representative data from sources that were identified but not accessed via the above routes were extracted from published reports. Data were also extracted for nine STEPS surveys that were not publicly available, one Countrywide Integrated Non-communicable Diseases Intervention survey, and five sites of the WHO Multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) project that were not deposited in the MONICA Data Centre. We also included data from a previous global data pooling study (Finucane et al., 2011) when they had not been accessed as described above.

Here, to estimate the association of underweight, obesity, and severe obesity prevalence with mean BMI as described below, we used data collected from 1985 to 2019 with measured height and weight among men and women aged 20–79 years, in 10-year age groups. Data that did not cover the complete 10-year age groups, for example, 25–29 or 60–64 years, were excluded. We included data from study–age–sex strata with a prevalence between 0 and 1 to allow probit transformation and with at least 25 participants in each stratum. These data were summarised into 11,652 study–age–sex-specific pairs of mean and prevalence of adults with underweight, obesity, or severe obesity.

Statistical methods

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Anonymised data from studies in the NCD-RisC database were reanalysed according to a common protocol. We calculated mean BMI and prevalence of underweight, obesity, and severe obesity by sex and age group in each study in the NCD-RisC database from 1985 to 2019. We used data through 2019 so that the prevalence–mean association is informed by as much data as possible. All calculations took into account complex survey design where relevant. We excluded study–age–sex groups with less than 25 participants because their means and prevalence have larger uncertainty.

We then estimated the relationship between probit-transformed prevalence of underweight, obesity, and severe obesity and mean BMI in a regression model, separately for each of these prevalences. The correlation coefficient between mean BMI and median BMI was ≥0.98 in different age–sex groups, indicating a strong correlation between the two. In our statistical model, described below, the prevalence of underweight, obesity, or severe obesity depends on population mean BMI as well as on age group, region, and year.

All analyses were done separately for men and women. We chose a probit-transformed prevalence because it changes in an approximately linear manner as the mean changes, thus providing a better fit to the data. The regressions also included age group in 10-year bands, region and the year when the data were collected. The regions, used in previous analyses of cardiometabolic risk factors (NCD Risk Factor Collaboration (NCD-RisC), 2017a; NCD Risk Factor Collaboration (NCD-RisC), 2019; NCD Risk Factor Collaboration (NCD-RisC), 2020; NCD Risk Factor Collaboration (NCD-RisC), 2016a; NCD Risk Factor Collaboration (NCD-RisC), 2018; NCD Risk Factor Collaboration (NCD-RisC), 2017b; NCD Risk Factor Collaboration (NCD-RisC), 2016b; NCD Risk Factor Collaboration (NCD-RisC), 2016c), were Central and Eastern Europe; Central Asia, the Middle East, and North Africa; East and Southeast Asia; high-income Asia Pacific region; high-income western region; Latin America and the Caribbean; Oceania; South Asia; and sub-Saharan Africa. Countries in each region are listed in Supplementary file 3. The model also included interactions between mean BMI and age group, mean BMI and region, age group and region, age group and year, and year and region. These terms allowed the prevalence–mean association to vary by age group, region, and over time. The models were fitted in statistical software R (version 4.0.2) (Source code 1). The coefficients of the regression models are presented in Supplementary files 1 and 2.

We used the fitted regressions to quantify how much of the change over time in the prevalence of underweight, obesity, or severe obesity in each region and age group can be explained by the corresponding change in mean BMI. To do so, we first used the region- and age–sex-specific mean BMI in 1985 and 2016 in the fitted association and then estimated the total change in prevalence of underweight, obesity, or severe obesity by region. The mean BMI values were from a recent comprehensive analysis of worldwide trends in mean BMI (NCD Risk Factor Collaboration (NCD-RisC), 2017a) and are listed in Supplementary file 5. We then calculated the contribution of change in mean BMI to the change in prevalence of underweight or obesity by allowing mean BMI for each age group and region to change over time, while keeping year fixed at 1985. Results were calculated by 10-year age group and then aggregated into two age bands, 20–49 and 50–79 years, by taking weighted average of age-specific results using weights from the WHO standard population (Ahmad et al., 2001).

Data availability

Names and characteristics of data sources included in this pooling analysis are listed in Supplementary file 4. Of these data, some are from public sources, for which we have provided the data in Source data 1. Others are from individual researchers and/or from government and international agencies; these should be requested from the data holders on a study to study basis using the information in Source data 1.

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Decision letter

  1. Christine M Friedenreich
    Reviewing Editor; University of Calgary, Canada
  2. Eduardo Franco
    Senior Editor; McGill University, Canada
  3. Simon Capewell
    Reviewer

In the interests of transparency, eLife publishes the most substantive revision requests and the accompanying author responses.

Acceptance summary:

This paper will be of interest to public health scientists and practitioners concerned with non-communicable diseases related to body weight. The authors have compiled global data on body mass index (BMI) and body weight classification to assess the association between changes in mean BMI and weight classification over three decades. These data will also be of value for policy reviews and evidence syntheses.

Decision letter after peer review:

Thank you for submitting your article "Heterogeneous contributions of change in population mean body-mass index to changes in obesity and underweight" for consideration by eLife. Your article has been reviewed by three peer reviewers, and the evaluation has been overseen by a Reviewing Editor and a Senior Editor. The following individual involved in review of your submission has agreed to reveal their identity: Simon Capewell (Reviewer #1).

As is customary in eLife, the reviewers have discussed their critiques with one another. What follows below is the Reviewing Editor's edited compilation of the essential and ancillary points provided by reviewers in their critiques and in their interaction post-review. Please submit a revised version that addresses these concerns directly. Although we expect that you will address these comments in your response letter we also need to see the corresponding revision in the text of the manuscript. Some of the reviewers' comments may seem to be simple queries or challenges that do not prompt revisions to the text. Please keep in mind, however, that readers may have the same perspective as the reviewers. Therefore, it is essential that you attempt to amend or expand the text to clarify the narrative accordingly.

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Summary:

This potentially important analysis of three-decade trends in BMI distribution involved an impressive international collaboration with a dataset comprising 2,675 population-based studies with over 160 million participants. The prevalence of underweight decreased while obesity increased in most regions, being largely driven by shifts in the distribution of BMI, with only small contributions from changes in the shape of the distribution. Despite overall falls, substantial levels of underweight persisted in sub-Saharan Africa and parts of Asia. Overall, the paper makes a good descriptive contribution.

Essential revisions:

The authors have collated measured data from 9 global regions to examine changes in mean BMI and prevalence of underweight, overweight, and severe overweight categories among adults between 1985 and 2016. The key questions are how much change in mean BMI explains changing category prevalences over the period, and how these effects vary by region. The analysis is potentially informative and interesting, but concerns were raised that the best approach to answering the question is not used, primarily due to reliance upon means and categorical outcomes to assess distribution shape changes. It is not apparent how the data and interpretation would substantially change understanding or practice.

One main comment is that the conclusion (i.e., the heterogeneity of the association between mean and distribution) is not quite clearly communicated, and secondly what does this mean? The authors should expand substantially on detailing the nature of this heterogeneity and its implications at the country-specific level perhaps by reviewing the epidemiologic evolution of the BMI. Without that the paper does not add much to the "overall" knowledge on this subject which has been explored before as a critical observation that was missed. While the authors cite those papers, besides taking that to scale with more data there is not much that is novel in terms of the idea per se. Another issue is the "heterogeneity" in the data source itself that introduces considerable measurement noise which, in turn, can influence the variance or change in the parameter with respect to the distribution.

1) Given access to the individual-level data, why were distribution characteristics not examined in the continuous data, e.g. using percentiles? Using classification data adds another source of error (misclassification) that depends on choice of cut-points (recognizing that consistent criteria were used across studies). If the authors did not have access to individual ht/wt data, but only mean BMI and prevalences of weight categories from each of the data sources, this should be clarified.

2) Discussion – related to the above, is it unclear why visual examination of distribution changes was not possible. With 2 sexes, 2 age groups, and 9 regions, the numbers do not seem excessive to examine distributions.

3) The authors discuss how changes in prevalence are accounted for by changes in mean BMI, but because the mean is disproportionately affected by extreme values, could causality not go in the other direction with the mean being affected by changes in the tails?

4) Discussion, first sentence of the last paragraph – this sentence seems to state a tautology. The remainder of the paragraph, while perhaps noteworthy and true, does not seem to be data-based from this analysis. Perhaps a clearer link to the data is needed.

5) Subsection “Statistical methods”, last paragraph – again, related to issues of what data were available, this paragraph states mean BMI were derived from a previous publication and not calculated from the pooled data.

https://doi.org/10.7554/eLife.60060.sa1

Author response

Essential revisions:

The authors have collated measured data from 9 global regions to examine changes in mean BMI and prevalence of underweight, overweight, and severe overweight categories among adults between 1985 and 2016. The key questions are how much change in mean BMI explains changing category prevalences over the period, and how these effects vary by region. The analysis is potentially informative and interesting, but concerns were raised that the best approach to answering the question is not used, primarily due to reliance upon means and categorical outcomes to assess distribution shape changes. It is not apparent how the data and interpretation would substantially change understanding or practice.

As the reviewers and Editors correctly point out, it is possible to describe distributional change through other approaches – for example reporting changes in its second and third moments (standard deviation and skewness) or in different quantiles of distribution. However, these approaches generate results that are internal to the distribution for each study. As a result, the results are neither comparable across regions, nor map to clinical and epidemiological measures such as underweight and obesity. As we state in the paper’s Introduction, our aim was to understand how much change in underweight and obesity, which are commonly used to make clinical and public health decisions, are driven by change in population mean vs. change in the shape of the distribution. As we state in the Introduction, understanding the relative contributions of these mechanisms has public health implications. Specifically, our finding that change in mean BMI contributed to the majority of change in the prevalence of underweight, obesity and severe obesity argues for population-wide approaches as opposed to clinical management of high-risk individuals (subsection “Study design”).

One main comment is that the conclusion (i.e, the heterogeneity of the association between mean and distribution) is not quite clearly communicated, and secondly what does this mean? The authors should expand substantially on detailing the nature of this heterogeneity and its implications at the country-specific level perhaps by reviewing the epidemiologic evolution of the BMI. Without that the paper does not add much to the "overall" knowledge on this subject which has been explored before as a critical observation that was missed. While the authors cite those papers, besides taking that to scale with more data there is not much that is novel in terms of the idea per se. Another issue is the "heterogeneity" in the data source itself that introduces considerable measurement noise which, in turn, can influence the variance or change in the parameter with respect to the distribution.

As the comment correctly states, previous studies have used a small number of surveys in one or a few countries and reported, graphically or with summary statistics, how the distribution may have shifted or changed. Using a small number of data sources gives an impression of precision in measured change compared to using a larger number of data sources. This is not the same as less “measurement noise” but rather overlooking the fact that each single study is only a sample of the world. By pooling a large number of data sources, we get much closer to more valid estimates of how much distributional shift and change have contributed to changing prevalence.

Our paper is novel and important because of both the unprecedented scale of data, and because it is (to our knowledge) the first ever to report and compare the contributions of distributional shift vs. change to changes in underweight and obesity prevalence for all regions of the world. The specific size of these contributions, and their variations across regions, is a major new result.

In addition to these contributions, as raised by this comment, our analysis allowed for the relationship between underweight/obesity prevalence and mean BMI to vary across regions by including interactions between region and mean BMI (subsection “Statistical methods”). These results are in Supplementary files 1 and 2 of the revised paper but had not been explicitly stated in the paper. We have added a new section on the association between prevalence and mean, and its inter-region variability (subsection “Associations of underweight, obesity and severe obesity prevalence with mean BMI”).

1) Given access to the individual-level data, why were distribution characteristics not examined in the continuous data, e.g. using percentiles? Using classification data adds another source of error (misclassification) that depends on choice of cut-points (recognizing that consistent criteria were used across studies). If the authors did not have access to individual ht/wt data, but only mean BMI and prevalences of weight categories from each of the data sources, this should be clarified.

As stated above, we could have used continuous data to report changes in its second and third moments or in different quantiles of distribution. However, these approaches generate results that are internal to the distribution for each region. While these alternatives are statistically as valid as our approach, they are neither comparable across regions, nor do they map to clinical and epidemiological measures such as underweight and obesity. In contrast, underweight and obesity are measures that are used for clinical and public health purposes, and reported in virtually every policy report. If of interest, we would be happy to also report some information on changes in measures such as standard deviation (Author response image 1) and skewness (Author response image 2) emphasising with the above caveat that these are not directly related to underweight and obesity.

Author response image 1
Download asset Open asset
Standard deviation of BMI from 1985 to 2019 by sex and age group.

Each point shows one age-sex group in one study. The size of each point is proportional to its sample size. Colour for each point indicates the region it is from.

Author response image 2
Download asset Open asset
Skewness of BMI from 1985 to 2019 by sex and age group.

Each point shows one age-sex group in one study. The size of each point is proportional to its sample size. Colour for each point indicates the region it is from.

2) Discussion – related to the above, is it unclear why visual examination of distribution changes was not possible. With 2 sexes, 2 age groups, and 9 regions, the numbers do not seem excessive to examine distributions.

Studies that visually inspect distributions often use 2 or 3 data sources. However, our usage of over 2,800 makes it impossible to make visual comparisons as seen in Author response image 3 for one age group.

Author response image 3
Download asset Open asset
Distributions of BMI in NCD-RisC studies for 50-59-year old by sex and region.

Each curve is a single study and the colour indicates its year from 1985 to 2019.

3) The authors discuss how changes in prevalence are accounted for by changes in mean BMI, but because the mean is disproportionately affected by extreme values, could causality not go in the other direction with the mean being affected by changes in the tails?

Author response image 4 shows a comparison of mean and median in those studies for which we had data on median (~70% of all the studies used for the analysis). As seen in the figure, they are highly correlated (correlation coefficient ≥ 0.98 for all age groups and genders) indicating that while this issue is theoretically possible, in practice it does not affect our analysis.

Author response image 4
Download asset Open asset
Comparison of mean and median BMI by sex and age group.

Each point represents a sex-age group in a study conducted between 1985 and 2019.

4) Discussion, first sentence of the last paragraph – this sentence seems to state a tautology. The remainder of the paragraph, while perhaps noteworthy and true, does not seem to be data-based from this analysis. Perhaps a clearer link to the data is needed.

We have reworded to more directly relate to our results as appropriately suggested (Discussion).

5) Subsection “Statistical methods”, last paragraph – again, related to issues of what data were available, this paragraph states mean BMI were derived from a previous publication and not calculated from the pooled data.

This is a good point which we have clarified at the beginning of the subsection ”Data sources”. In brief, we used original data – directly in the first step of the analysis and after fitting a Bayesian model in the second step.

https://doi.org/10.7554/eLife.60060.sa2

Article and author information

Author details

  1. NCD Risk Factor Collaboration (NCD-RisC)

    Contribution
    Conceptualization, Resources, Data curation, Software, Formal analysis, Supervision, Funding acquisition, Validation, Investigation, Visualization, Methodology, Writing - original draft, Writing - review and editing, Project administration
    For correspondence
    1. majid.ezzati@imperial.ac.uk
    2. s.filippi@imperial.ac.uk
    Competing interests
    No competing interests declared
    1. Maria LC Iurilli, Imperial College London, London, United Kingdom
    2. Bin Zhou, Imperial College London, London, United Kingdom
    3. James E Bennett, Imperial College London, London, United Kingdom
    4. Rodrigo M Carrillo-Larco, Imperial College London, London, United Kingdom
    5. Marisa K Sophiea, Imperial College London, London, United Kingdom
    6. Andrea Rodriguez-Martinez, Imperial College London, London, United Kingdom
    7. Honor Bixby, Imperial College London, London, United Kingdom
    8. Bethlehem D Solomon, Imperial College London, London, United Kingdom
    9. Cristina Taddei, Imperial College London, London, United Kingdom
    10. Goodarz Danaei, Harvard TH Chan School of Public Health, Boston, United States
    11. Mariachiara Di Cesare, Middlesex University, London, United Kingdom
    12. Gretchen A Stevens, Independent researcher, Los Angeles, United States
    13. Leanne M Riley, World Health Organization, Geneva, Switzerland
    14. Stefan Savin, World Health Organization, Geneva, Switzerland
    15. Melanie J Cowan, World Health Organization, Geneva, Switzerland
    16. Pascal Bovet, Ministry of Health, Victoria, Seychelles
    17. Albertino Damasceno, Eduardo Mondlane University, Maputo, Mozambique
    18. Adela Chirita-Emandi, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
    19. Alison J Hayes, University of Sydney, Sydney, Australia
    20. Nayu Ikeda, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
    21. Rod T Jackson, University of Auckland, Auckland, New Zealand
    22. Young-Ho Khang, Seoul National University, Seoul, Republic of Korea
    23. Avula Laxmaiah, ICMR - National Institute of Nutrition, Hyderabad, India
    24. Jing Liu, Capital Medical University Beijing An Zhen Hospital, Beijing, China
    25. J Jaime Miranda, Universidad Peruana Cayetano Heredia, Lima, Peru
    26. Olfa Saidi, University Tunis El Manar, Tunis, Tunisia
    27. Sylvain Sebert, University of Oulu, Oulu, Finland
    28. Maroje Sorić, University of Zagreb, Zagreb, Croatia
    29. Gregor Starc, University of Ljubljana, Ljubljana, Slovenia
    30. Edward W Gregg, Imperial College London, London, United Kingdom
    31. Leandra Abarca-Gómez, Caja Costarricense de Seguro Social, San José, Costa Rica
    32. Ziad A Abdeen, Al-Quds University, East Jerusalem, State of Palestine
    33. Shynar Abdrakhmanova, National Center of Public Healthcare, Nur-Sultan, Kazakhstan
    34. Suhaila Abdul Ghaffar, Ministry of Health, Kuala Lumpur, Malaysia
    35. Hanan F Abdul Rahim, Qatar University, Doha, Qatar
    36. Niveen M Abu-Rmeileh, Birzeit University, Birzeit, State of Palestine
    37. Jamila Abubakar Garba, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
    38. Benjamin Acosta-Cazares, Instituto Mexicano del Seguro Social, Mexico City, Mexico
    39. Robert J Adams, Flinders University, Adelaide, Australia
    40. Wichai Aekplakorn, Mahidol University, Nakhon Pathom, Thailand
    41. Kaosar Afsana, BRAC James P Grant School of Public Health, Dhaka, Bangladesh
    42. Shoaib Afzal, University of Copenhagen, Copenhagen, Denmark
    43. Imelda A Agdeppa, Food and Nutrition Research Institute, Taguig, Philippines
    44. Javad Aghazadeh-Attari, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
    45. Carlos A Aguilar-Salinas, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico
    46. Charles Agyemang, University of Amsterdam, Amsterdam, Netherlands
    47. Mohamad Hasnan Ahmad, Ministry of Health, Kuala Lumpur, Malaysia
    48. Noor Ani Ahmad, Ministry of Health, Kuala Lumpur, Malaysia
    49. Ali Ahmadi, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
    50. Naser Ahmadi, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    51. Soheir H Ahmed, University of Oslo, Oslo, Norway
    52. Wolfgang Ahrens, University of Bremen, Bremen, Germany
    53. Gulmira Aitmurzaeva, Republican Center for Health Promotion, Bishkek, Kyrgyzstan
    54. Kamel Ajlouni, National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
    55. Hazzaa M Al-Hazzaa, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
    56. Badreya Al-Lahou, Kuwait Institute for Scientific Research, Kuwait City, Kuwait
    57. Rajaa Al-Raddadi, King Abdulaziz University, Jeddah, Saudi Arabia
    58. Monira Alarouj, Dasman Diabetes Institute, Kuwait City, Kuwait
    59. Fadia AlBuhairan, Aldara Hospital and Medical Center, Riyadh, Saudi Arabia
    60. Shahla AlDhukair, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
    61. Mohamed M Ali, World Health Organization, Geneva, Switzerland
    62. Abdullah Alkandari, Dasman Diabetes Institute, Kuwait City, Kuwait
    63. Ala'a Alkerwi, Luxembourg Institute of Health, Strassen, Luxembourg
    64. Kristine Allin, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    65. Mar Alvarez-Pedrerol, Barcelona Institute for Global Health CIBERESP, Barcelona, Spain
    66. Eman Aly, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
    67. Deepak N Amarapurkar, Bombay Hospital and Medical Research Centre, Mumbai, India
    68. Parisa Amiri, Research Center for Social Determinants of Health, Tehran, Islamic Republic of Iran
    69. Norbert Amougou, UMR CNRS-MNHN 7206 Eco-anthropologie, Paris, France
    70. Philippe Amouyel, University of Lille, France
    71. Lars Bo Andersen, Western Norway University of Applied Sciences, Sogndal, Norway
    72. Sigmund A Anderssen, Norwegian School of Sport Sciences, Oslo, Norway
    73. Lars Ängquist, University of Copenhagen, Copenhagen, Denmark
    74. Ranjit Mohan Anjana, Madras Diabetes Research Foundation, Chennai, India
    75. Alireza Ansari-Moghaddam, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
    76. Hajer Aounallah-Skhiri, National Institute of Public Health, Tunis, Tunisia
    77. Joana Araújo, Institute of Public Health of the University of Porto, Porto, Portugal
    78. Inger Ariansen, Norwegian Institute of Public Health, Oslo, Norway
    79. Tahir Aris, Ministry of Health, Kuala Lumpur, Malaysia
    80. Raphael E Arku, University of Massachusetts Amherst, Amherst, United States
    81. Nimmathota Arlappa, ICMR - National Institute of Nutrition, Hyderabad, India
    82. Krishna K Aryal, Abt Associates, Kathmandu, Nepal
    83. Thor Aspelund, University of Iceland, Reykjavik, Iceland
    84. Felix K Assah, University of Yaoundé 1, Yaoundé, Cameroon
    85. Maria Cecília F Assunção, Federal University of Pelotas, Pelotas, Brazil
    86. May Soe Aung, University of Medicine 1, Yangon, Myanmar
    87. Juha Auvinen, University of Oulu, Oulu, Finland
    88. Mária Avdicová, Banska Bystrica Regional Authority of Public Health, Banska Bystrica, Slovakia
    89. Shina Avi, Tel-Aviv University, Tel-Aviv, Israel
    90. Ana Azevedo, University of Porto Medical School, Porto, Portugal
    91. Mohsen Azimi-Nezhad, Neyshabur University of Medical Sciences, Neyshabur, Islamic Republic of Iran
    92. Fereidoun Azizi, Research Institute for Endocrine Sciences, Tehran, Islamic Republic of Iran
    93. Mehrdad Azmin, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    94. Bontha V Babu, Indian Council of Medical Research, New Delhi, India
    95. Maja Bæksgaard Jørgensen, National Institute of Public Health, Copenhagen, Denmark
    96. Azli Baharudin, Ministry of Health, Kuala Lumpur, Malaysia
    97. Suhad Bahijri, King Abdulaziz University, Jeddah, Saudi Arabia
    98. Jennifer L Baker, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    99. Nagalla Balakrishna, ICMR - National Institute of Nutrition, Hyderabad, India
    100. Mohamed Bamoshmoosh, University of Science and Technology, Sana'a, Yemen
    101. Maciej Banach, Medical University of Lodz, Lodz, Poland
    102. Piotr Bandosz, Medical University of Gdansk, Gdansk, Poland
    103. José R Banegas, Universidad Autónoma de Madrid CIBERESP, Madrid, Spain
    104. Joanna Baran, University of Rzeszów, Rzeszów, Poland
    105. Carlo M Barbagallo, University of Palermo, Palermo, Italy
    106. Alberto Barceló, Pan American Health Organization, Washington DC, United States
    107. Amina Barkat, Mohammed V University de Rabat, Rabat, Morocco
    108. Aluisio JD Barros, Federal University of Pelotas, Pelotas, Brazil
    109. Mauro Virgílio Gomes Barros, University of Pernambuco, Recife, Brazil
    110. Abdul Basit, Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan
    111. Joao Luiz D Bastos, Federal University of Santa Catarina, Florianópolis, Brazil
    112. Iqbal Bata, Dalhousie University, Halifax, Canada
    113. Anwar M Batieha, Jordan University of Science and Technology, Irbid, Jordan
    114. Rosangela L Batista, Federal University of Maranhão, São Luís, Brazil
    115. Zhamilya Battakova, National Center of Public Healthcare, Nur-Sultan, Kazakhstan
    116. Assembekov Batyrbek, Al-Farabi Kazakh National University, Almaty, Kazakhstan
    117. Louise A Baur, University of Sydney, Sydney, Australia
    118. Robert Beaglehole, University of Auckland, Auckland, New Zealand
    119. Silvia Bel-Serrat, University College Dublin, Dublin, Ireland
    120. Antonisamy Belavendra, Christian Medical College, Vellore, India
    121. Habiba Ben Romdhane, University Tunis El Manar, Tunis, Tunisia
    122. Judith Benedics, Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Vienna, Austria
    123. Mikhail Benet, Cafam University Foundation, Bogota, Colombia
    124. Ingunn Holden Bergh, Norwegian Institute of Public Health, Oslo, Norway
    125. Salim Berkinbayev, Kazakh National Medical University, Almaty, Kazakhstan
    126. Antonio Bernabe-Ortiz, Universidad Peruana Cayetano Heredia, Lima, Peru
    127. Gailute Bernotiene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    128. Heloísa Bettiol, University of São Paulo, São Paulo, Brazil
    129. Jorge Bezerra, University of Pernambuco, Recife, Brazil
    130. Aroor Bhagyalaxmi, B J Medical College, Ahmedabad, India
    131. Sumit Bharadwaj, Chirayu Medical College, New Delhi, India
    132. Santosh K Bhargava, Sunder Lal Jain Hospital, Delhi, India
    133. Zulfiqar A Bhutta, The Hospital for Sick Children, Toronto, Canada
    134. Hongsheng Bi, Shandong University of Traditional Chinese Medicine, Jinan, China
    135. Yufang Bi, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
    136. Daniel Bia, Universidad de la República, Montevideo, Uruguay
    137. Elysée Claude Bika Lele, Institute of Medical Research and Medicinal Plant Studies, Yaoundé, Cameroon
    138. Mukharram M Bikbov, Ufa Eye Research Institute, Ufa, Russian Federation
    139. Bihungum Bista, Nepal Health Research Council, Kathmandu, Nepal
    140. Dusko J Bjelica, University of Montenegro, Niksic, Montenegro
    141. Peter Bjerregaard, University of Southern Denmark, Copenhagen, Denmark
    142. Espen Bjertness, University of Oslo, Oslo, Norway
    143. Marius B Bjertness, University of Oslo, Oslo, Norway
    144. Cecilia Björkelund, University of Gothenburg, Gothenburg, Sweden
    145. Katia V Bloch, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
    146. Anneke Blokstra, National Institute for Public Health and the Environment, Bilthoven, Netherlands
    147. Simona Bo, University of Turin, Turin, Italy
    148. Martin Bobak, University College London, London, United Kingdom
    149. Lynne M Boddy, Liverpool John Moores University, Liverpool, United Kingdom
    150. Bernhard O Boehm, Nanyang Technological University Singapore, Singapore, Singapore
    151. Heiner Boeing, German Institute of Human Nutrition, Potsdam, Germany
    152. Jose G Boggia, Universidad de la República, Montevideo, Uruguay
    153. Elena Bogova, Endocrinology Research Centre, Moscow, Russian Federation
    154. Carlos P Boissonnet, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
    155. Stig E Bojesen, Copenhagen University Hospital, Copenhagen, Denmark
    156. Marialaura Bonaccio, IRCCS Neuromed, Pozzilli, Italy
    157. Vanina Bongard, Toulouse University School of Medicine, Toulouse, France
    158. Alice Bonilla-Vargas, Caja Costarricense de Seguro Social, San José, Costa Rica
    159. Matthias Bopp, University of Zurich, Zurich, Switzerland
    160. Herman Borghs, University Hospital KU Leuven, Leuven, Belgium
    161. Lien Braeckevelt, Flemish Agency for Care and Health, Brussels, Belgium
    162. Lutgart Braeckman, Ghent University, Ghent, Belgium
    163. Marjolijn CE Bragt, FrieslandCampina, Amersfoort, Netherlands
    164. Imperia Brajkovich, Universidad Central de Venezuela, Caracas, Venezuela
    165. Francesco Branca, World Health Organization, Geneva, Switzerland
    166. Juergen Breckenkamp, Bielefeld University, Bielefeld, Germany
    167. João Breda, World Health Organization Regional Office for Europe, Moscow, Russian Federation
    168. Hermann Brenner, German Cancer Research Center, Heidelberg, Germany
    169. Lizzy M Brewster, University of Amsterdam, Amsterdam, Netherlands
    170. Garry R Brian, The Fred Hollows Foundation, Auckland, New Zealand
    171. Lacramioara Brinduse, University of Medicine and Pharmacy Bucharest, Bucharest, Romania
    172. Sinead Brophy, Swansea University, Swansea, United Kingdom
    173. Graziella Bruno, University of Turin, Turin, Italy
    174. H Bas Bueno-de-Mesquita, National Institute for Public Health and the Environment, Bilthoven, Netherlands
    175. Anna Bugge, University College Copenhagen, Copenhagen, Denmark
    176. Marta Buoncristiano, World Health Organization Regional Office for Europe, Moscow, Russian Federation
    177. Genc Burazeri, Institute of Public Health, Tirana, Albania
    178. Con Burns, Munster Technological University, Cork, Ireland
    179. Antonio Cabrera de León, Universidad de La Laguna, Tenerife, Spain
    180. Joseph Cacciottolo, University of Malta, Msida, Malta
    181. Hui Cai, Vanderbilt University, Nashville, United States
    182. Tilema Cama, Ministry of Health, Tongatapu, Tonga
    183. Christine Cameron, Canadian Fitness and Lifestyle Research Institute, Ottawa, Canada
    184. José Camolas, Hospital Santa Maria, Lisbon, Portugal
    185. Günay Can, Istanbul University - Cerrahpasa, Istanbul, Turkey
    186. Ana Paula C Cândido, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
    187. Felicia Cañete, Ministry of Public Health, Asunción, Paraguay
    188. Mario V Capanzana, Food and Nutrition Research Institute, Taguig, Philippines
    189. Nadežda Capková, National Institute of Public Health, Prague, Czech Republic
    190. Eduardo Capuano, Gaetano Fucito Hospital, Mercato San Severino, Italy
    191. Vincenzo Capuano, Gaetano Fucito Hospital, Mercato San Severino, Italy
    192. Marloes Cardol, University of Groningen, Groningen, Netherlands
    193. Viviane C Cardoso, University of São Paulo, São Paulo, Brazil
    194. Axel C Carlsson, Karolinska Institutet, Huddinge, Sweden
    195. Esteban Carmuega, Centro de Estudios sobre Nutrición Infantil, Buenos Aires, Argentina
    196. Joana Carvalho, University of Porto, Porto, Portugal
    197. José A Casajús, University of Zaragoza, Zaragoza, Spain
    198. Felipe F Casanueva, Santiago de Compostela University, Santiago de Compostela, Spain
    199. Ertugrul Celikcan, Ministry of Health, Ankara, Turkey
    200. Laura Censi, Council for Agricultural Research and Economics, Rome, Italy
    201. Marvin Cervantes-Loaiza, Caja Costarricense de Seguro Social, San José, Costa Rica
    202. Juraci A Cesar, Federal University of Rio Grande, Rio Grande, Brazil
    203. Snehalatha Chamukuttan, India Diabetes Research Foundation, Chennai, India
    204. Angelique W Chan, Duke-NUS Medical School, Singapore, Singapore
    205. Queenie Chan, Imperial College London, London, United Kingdom
    206. Himanshu K Chaturvedi, ICMR - National Institute of Medical Statistics, New Delhi, India
    207. Nish Chaturvedi, University College London, London, United Kingdom
    208. Norsyamlina Che Abdul Rahim, Ministry of Health, Kuala Lumpur, Malaysia
    209. Miao Li Chee, Singapore Eye Research Institute, Singapore, Singapore
    210. Chien-Jen Chen, Academia Sinica, Taipei, Taiwan
    211. Fangfang Chen, Capital Institute of Pediatrics, Beijing, China
    212. Huashuai Chen, Duke University, Durham, United States
    213. Shuohua Chen, Kailuan General Hospital, Tangshan, China
    214. Zhengming Chen, University of Oxford, Oxford, United Kingdom
    215. Ching-Yu Cheng, Duke-NUS Medical School, Singapore, Singapore
    216. Bahman Cheraghian, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran
    217. Angela Chetrit, The Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
    218. Ekaterina Chikova-Iscener, National Centre of Public Health and Analyses, Sofia, Bulgaria
    219. Arnaud Chiolero, University of Fribourg, Fribourg, Switzerland
    220. Shu-Ti Chiou, Ministry of Health and Welfare, Taipei, Taiwan
    221. María-Dolores Chirlaque, CIBER Epidemiología y Salud Pública, Murcia, Spain
    222. Belong Cho, Seoul National University, Seoul, Republic of Korea
    223. Kaare Christensen, University of Southern Denmark, Odense, Denmark
    224. Diego G Christofaro, Universidade Estadual Paulista, Presidente Prudente, Brazil
    225. Jerzy Chudek, Medical University of Silesia, Katowice, Poland
    226. Renata Cifkova, Charles University, Prague, Czech Republic
    227. Michelle Cilia, Primary Health Care, Floriana, Malta
    228. Eliza Cinteza, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
    229. Frank Claessens, Katholieke Universiteit Leuven, Leuven, Belgium
    230. Janine Clarke, Statistics Canada, Ottawa, Canada
    231. Els Clays, Ghent University, Ghent, Belgium
    232. Emmanuel Cohen, UMR CNRS-MNHN 7206 Eco-anthropologie, Marseille, France
    233. Hans Concin, Agency for Preventive and Social Medicine, Bregenz, Austria
    234. Susana C Confortin, Federal University of Maranhão, São Luís, Brazil
    235. Cyrus Cooper, University of Southampton, Southampton, United Kingdom
    236. Tara C Coppinger, Munster Technological University, Cork, Ireland
    237. Eva Corpeleijn, University of Groningen, Groningen, Netherlands
    238. Simona Costanzo, IRCCS Neuromed, Pozzilli, Italy
    239. Dominique Cottel, Institut Pasteur de Lille, Lille, France
    240. Chris Cowell, University of Sydney, Sydney, Australia
    241. Cora L Craig, Canadian Fitness and Lifestyle Research Institute, Ottawa, Canada
    242. Amelia C Crampin, Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
    243. Ana B Crujeiras, CIBEROBN, Madrid, Spain
    244. Semánová Csilla, University of Debrecen, Debrecen, Hungary
    245. Alexandra M Cucu, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
    246. Liufu Cui, Kailuan General Hospital, Tangshan, China
    247. Felipe V Cureau, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    248. Ewelina Czenczek-Lewandowska, University of Rzeszów, Rzeszów, Poland
    249. Graziella D'Arrigo, National Research Council, Reggio Calabria, Italy
    250. Eleonora d'Orsi, Federal University of Santa Catarina, Florianópolis, Brazil
    251. Liliana Dacica, Eftimie Murgu University Resita, Resita, Romania
    252. María Ángeles Dal Re Saavedra, Spanish Agency for Food Safety and Nutrition, Madrid, Spain
    253. Jean Dallongeville, Institut Pasteur de Lille, Lille, France
    254. Camilla T Damsgaard, University of Copenhagen, Copenhagen, Denmark
    255. Rachel Dankner, The Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
    256. Thomas M Dantoft, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    257. Parasmani Dasgupta, Indian Statistical Institute, Kolkata, India
    258. Saeed Dastgiri, Tabriz Health Services Management Research Center, Tabriz, Islamic Republic of Iran
    259. Luc Dauchet, University of Lille, Lille, France
    260. Kairat Davletov, Al-Farabi Kazakh National University, Almaty, Kazakhstan
    261. Guy De Backer, Ghent University, Ghent, Belgium
    262. Dirk De Bacquer, Ghent University, Ghent, Belgium
    263. Giovanni de Gaetano, IRCCS Neuromed, Pozzilli, Italy
    264. Stefaan De Henauw, Ghent University, Ghent, Belgium
    265. Paula Duarte de Oliveira, Federal University of Pelotas, Pelotas, Brazil
    266. David De Ridder, Geneva University Hospitals, Geneva, Switzerland
    267. Karin De Ridder, Sciensano, Brussels, Belgium
    268. Susanne R de Rooij, University Medical Centers, Groningen, Netherlands
    269. Delphine De Smedt, Ghent University, Ghent, Belgium
    270. Mohan Deepa, Madras Diabetes Research Foundation, Chennai, India
    271. Alexander D Deev, National Research Centre for Preventive Medicine, Moscow, Russian Federation
    272. Vincent Jr DeGennaro, Innovating Health International, Port-au-Prince, Haiti
    273. Abbas Dehghan, Imperial College London, London, United Kingdom
    274. Hélène Delisle, University of Montreal, Montreal, Canada
    275. Francis Delpeuch, French National Research Institute for Sustainable Development, Montpellier, France
    276. Stefaan Demarest, Sciensano, Brussels, Belgium
    277. Elaine Dennison, University of Southampton, Southampton, United Kingdom
    278. Katarzyna Dereń, University of Rzeszów, Rzeszów, Poland
    279. Valérie Deschamps, French Public Health Agency, St Maurice, France
    280. Meghnath Dhimal, Nepal Health Research Council, Kathmandu, Nepal
    281. Augusto F Di Castelnuovo, Mediterranea Cardiocentro, Naples, Italy
    282. Juvenal Soares Dias-da-Costa, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
    283. María Elena Díaz-Sánchez, National Institute of Hygiene, Epidemiology and Microbiology, Havana, Cuba
    284. Alejandro Diaz, National Council of Scientific and Technical Research, Buenos Aires, Argentina
    285. Zivka Dika, University of Zagreb, Zagreb, Croatia
    286. Shirin Djalalinia, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
    287. Visnja Djordjic, University of Novi Sad, Novi Sad, Serbia
    288. Ha TP Do, National Institute of Nutrition, Hanoi, Viet Nam
    289. Annette J Dobson, University of Queensland, Brisbane, Australia
    290. Maria Benedetta Donati, IRCCS Neuromed, Pozzilli, Italy
    291. Chiara Donfrancesco, Istituto Superiore di Sanità, Rome, Italy
    292. Silvana P Donoso, Universidad de Cuenca, Cuenca, Ecuador
    293. Angela Döring, Helmholtz Zentrum München, Munich, Germany
    294. Maria Dorobantu, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
    295. Ahmad Reza Dorosty, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    296. Kouamelan Doua, Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
    297. Nico Dragano, University Hospital Düsseldorf, Düsseldorf, Germany
    298. Wojciech Drygas, National Institute of Cardiology, Warsaw, Poland
    299. Jia Li Duan, Beijing Center for Disease Prevention and Control, Beijing, China
    300. Charmaine A Duante, Food and Nutrition Research Institute, Taguig, Philippines
    301. Priscilla Duboz, UMI 3189 ESS, Marseille, France
    302. Rosemary B Duda, Beth Israel Deaconess Medical Center, Boston, United States
    303. Vesselka Duleva, National Centre of Public Health and Analyses, Sofia, Bulgaria
    304. Virginija Dulskiene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    305. Samuel C Dumith, Federal University of Rio Grande, Rio Grande, Brazil
    306. Anar Dushpanova, Scuola Superiore Sant'Anna, Pisa, Italy
    307. Vilnis Dzerve, University of Latvia, Riga, Latvia
    308. Elzbieta Dziankowska-Zaborszczyk, Medical University of Lodz, Lodz, Poland
    309. Ricky Eddie, Ministry of Health and Medical Services, Gizo, Solomon Islands
    310. Ebrahim Eftekhar, Hormozgan University of Medical Sciences, Bandar Abbas, Islamic Republic of Iran
    311. Eruke E Egbagbe, University of Benin, Benin City, Nigeria
    312. Robert Eggertsen, University of Gothenburg, Gothenburg, Sweden
    313. Sareh Eghtesad, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    314. Gabriele Eiben, University of Skövde, Skövde, Sweden
    315. Ulf Ekelund, Norwegian School of Sport Sciences, Oslo, Norway
    316. Mohammad El-Khateeb, National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
    317. Jalila El Ati, National Institute of Nutrition and Food Technology, Tunis, Tunisia
    318. Denise Eldemire-Shearer, The University of the West Indies, Kingston, Jamaica
    319. Marie Eliasen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    320. Paul Elliott, Imperial College London, London, United Kingdom
    321. Reina Engle-Stone, University of California Davis, Davis, United States
    322. Macia Enguerran, UMI 3189 ESS, Marseille, France
    323. Rajiv T Erasmus, University of Stellenbosch, Cape Town, South Africa
    324. Raimund Erbel, University of Duisburg-Essen, Duisburg, Germany
    325. Cihangir Erem, Karadeniz Technical University, Trabzon, Turkey
    326. Louise Eriksen, University of Southern Denmark, Copenhagen, Denmark
    327. Johan G Eriksson, University of Helsinki, Helsinki, Finland
    328. Jorge Escobedo-de la Peña, Instituto Mexicano del Seguro Social, Mexico City, Mexico
    329. Saeid Eslami, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
    330. Ali Esmaeili, Rafsanjan University of Medical Sciences, Rafsanjan, Islamic Republic of Iran
    331. Alun Evans, Queen's University of Belfast, Belfast, United Kingdom
    332. David Faeh, University of Zurich, Zurich, Switzerland
    333. Albina A Fakhretdinova, Ufa Eye Research Institute, Ufa, Russian Federation
    334. Caroline H Fall, University of Southampton, Southampton, United Kingdom
    335. Elnaz Faramarzi, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
    336. Mojtaba Farjam, Fasa University of Medical Sciences, Fasa, Islamic Republic of Iran
    337. Victoria Farrugia Sant'Angelo, Primary Health Care, Floriana, Malta
    338. Farshad Farzadfar, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    339. Mohammad Reza Fattahi, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
    340. Asher Fawwad, Baqai Medical University, Karachi, Pakistan
    341. Francisco J Felix-Redondo, Centro de Salud Villanueva Norte, Badajoz, Spain
    342. Trevor S Ferguson, The University of the West Indies, Kingston, Jamaica
    343. Romulo A Fernandes, Universidade Estadual Paulista, Presidente Prudente, Brazil
    344. Daniel Fernández-Bergés, Hospital Don Benito-Villanueva de la Serena, Badajoz, Spain
    345. Daniel Ferrante, Ministry of Health, Buenos Aires, Argentina
    346. Thomas Ferrao, Statistics Canada, Ottawa, Canada
    347. Marika Ferrari, Council for Agricultural Research and Economics, Rome, Italy
    348. Marco M Ferrario, University of Insubria, Varese, Italy
    349. Catterina Ferreccio, Pontificia Universidad Católica de Chile, Santiago, Chile
    350. Eldridge Ferrer, Food and Nutrition Research Institute, Taguig, Philippines
    351. Jean Ferrieres, Toulouse University School of Medicine, Toulouse, France
    352. Thamara Hubler Figueiró, Federal University of Santa Catarina, Florianópolis, Brazil
    353. Anna Fijalkowska, Institute of Mother and Child, Warsaw, Poland
    354. Günther Fink, Swiss Tropical and Public Health Institute, Basel, Switzerland
    355. Krista Fischer, University of Tartu, Tartu, Estonia
    356. Leng Huat Foo, Universiti Sains Malaysia, Kelantan, Malaysia
    357. Maria Forsner, Umeå University, Umeå, Sweden
    358. Heba M Fouad, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
    359. Damian K Francis, The University of the West Indies, Kingston, Jamaica
    360. Maria do Carmo Franco, Federal University of São Paulo, São Paulo, Brazil
    361. Ruth Frikke-Schmidt, University of Copenhagen, Copenhagen, Denmark
    362. Guillermo Frontera, Hospital Universitario Son Espases, Palma, Spain
    363. Flavio D Fuchs, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    364. Sandra C Fuchs, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    365. Isti I Fujiati, Universitas Sumatera Utara, Medan, Indonesia
    366. Yuki Fujita, Kindai University, Osaka-Sayama, Japan
    367. Matsuda Fumihiko, Kyoto University, Kyoto, Japan
    368. Takuro Furusawa, Kyoto University, Kyoto, Japan
    369. Zbigniew Gaciong, Medical University of Warsaw, Warsaw, Poland
    370. Mihai Gafencu, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
    371. Andrzej Galbarczyk, Jagiellonian University Medical College, Kraków, Poland
    372. Henrike Galenkamp, University of Amsterdam, Amsterdam, Netherlands
    373. Daniela Galeone, Ministero della Salute DG Prevenzione Sanitaria, Rome, Italy
    374. Myriam Galfo, Council for Agricultural Research and Economics, Rome, Italy
    375. Fabio Galvano, University of Catania, Catania, Italy
    376. Jingli Gao, Kailuan General Hospital, Tangshan, China
    377. Manoli Garcia-de-la-Hera, CIBER en Epidemiología y Salud Pública, Alicante, Spain
    378. Marta García-Solano, Spanish Agency for Food Safety and Nutrition, Madrid, Spain
    379. Dickman Gareta, Africa Health Research Institute, Mtubatuba, South Africa
    380. Sarah P Garnett, University of Sydney, Sydney, Australia
    381. Jean-Michel Gaspoz, Geneva University Medical School, Geneva, Switzerland
    382. Magda Gasull, CIBER en Epidemiología y Salud Pública, Barcelona, Spain
    383. Adroaldo Cesar Araujo Gaya, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    384. Anelise Reis Gaya, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    385. Andrea Gazzinelli, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
    386. Ulrike Gehring, Utrecht University, Utrecht, Netherlands
    387. Harald Geiger, Agency for Preventive and Social Medicine, Bregenz, Austria
    388. Johanna M Geleijnse, Wageningen University, Wageningen, Netherlands
    389. Ali Ghanbari, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    390. Erfan Ghasemi, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    391. Oana-Florentina Gheorghe-Fronea, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
    392. Simona Giampaoli, Istituto Superiore di Sanità, Rome, Italy
    393. Francesco Gianfagna, University of Insubria, Varese, Italy
    394. Tiffany K Gill, University of Adelaide, Adelaide, Australia
    395. Jonathan Giovannelli, University of Lille, Lille, France
    396. Glen Gironella, Food and Nutrition Research Institute, Taguig, Philippines
    397. Aleksander Giwercman, Lund University, Lund, Sweden
    398. Konstantinos Gkiouras, Aristotle University of Thessaloniki, Thessaloniki, Greece
    399. Justyna Godos, University of Catania, Catania, Italy
    400. Sibel Gogen, Ministry of Health, Ankara, Turkey
    401. Marcel Goldberg, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
    402. Rebecca A Goldsmith, Ministry of Health, Jerusalem, Israel
    403. David Goltzman, McGill University, Montreal, Canada
    404. Santiago F Gómez, Gasol Foundation, Barcelona, Spain
    405. Aleksandra Gomula, PASs Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland
    406. Bruna Goncalves Cordeiro da Silva, Federal University of Pelotas, Pelotas, Brazil
    407. Helen Gonçalves, Federal University of Pelotas, Pelotas, Brazil
    408. David A Gonzalez-Chica, University of Adelaide, Adelaide, Australia
    409. Marcela Gonzalez-Gross, Universidad Politécnica de Madrid, Madrid, Spain
    410. Margot González-Leon, Instituto Mexicano del Seguro Social, Mexico City, Mexico
    411. Juan P González-Rivas, St Anne's University Hospital, Brno, Czech Republic
    412. Clicerio González-Villalpando, National Institute of Public Health, Cuernavaca, Mexico
    413. María-Elena González-Villalpando, Centro de Estudios en Diabetes A.C., Mexico City, Mexico
    414. Angel R Gonzalez, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
    415. Frederic Gottrand, University of Lille, Lille, France
    416. Antonio Pedro Graça, Ministry of Health, Lisbon, Portugal
    417. Sidsel Graff-Iversen, Norwegian Institute of Public Health, Oslo, Norway
    418. Dušan Grafnetter, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
    419. Aneta Grajda, Children's Memorial Health Institute, Warsaw, Poland
    420. Maria G Grammatikopoulou, Aristotle University of Thessaloniki, Thessaloniki, Greece
    421. Ronald D Gregor, Dalhousie University, Halifax, Canada
    422. Tomasz Grodzicki, Jagiellonian University Medical College, Kraków, Poland
    423. Else Karin Grøholt, Norwegian Institute of Public Health, Oslo, Norway
    424. Anders Grøntved, University of Southern Denmark, Odense, Denmark
    425. Giuseppe Grosso, University of Catania, Catania, Italy
    426. Gabriella Gruden, University of Turin, Turin, Italy
    427. Dongfeng Gu, National Center of Cardiovascular Diseases, Beijing, China
    428. Emanuela Gualdi-Russo, University of Ferrara, Ferrara, Italy
    429. Pilar Guallar-Castillón, Universidad Autónoma de Madrid CIBERESP, Madrid, Spain
    430. Andrea Gualtieri, Authority Sanitaria San Marino, San Marino, San Marino
    431. Elias F Gudmundsson, Icelandic Heart Association, Kopavogur, Iceland
    432. Vilmundur Gudnason, University of Iceland, Reykjavik, Iceland
    433. Ramiro Guerrero, Universidad Icesi, Cali, Colombia
    434. Idris Guessous, Geneva University Hospitals, Geneva, Switzerland
    435. Andre L Guimaraes, State University of Montes Claros, Montes Claros, Brazil
    436. Martin C Gulliford, King's College London, London, United Kingdom
    437. Johanna Gunnlaugsdottir, Icelandic Heart Association, Kopavogur, Iceland
    438. Marc J Gunter, International Agency for Research on Cancer, Lyon, France
    439. Xiu-Hua Guo, Capital Medical University, Beijing, China
    440. Yin Guo, Capital Medical University Beijing Tongren Hospital, Beijing, China
    441. Prakash C Gupta, Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India
    442. Rajeev Gupta, Eternal Heart Care Centre and Research Institute, Jaipur, India
    443. Oye Gureje, University of Ibadan, Ibadan, Nigeria
    444. Beata Gurzkowska, Children's Memorial Health Institute, Warsaw, Poland
    445. Enrique Gutiérrez-González, Spanish Agency for Food Safety and Nutrition, Madrid, Spain
    446. Laura Gutierrez, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
    447. Felix Gutzwiller, University of Zurich, Zurich, Switzerland
    448. Seongjun Ha, National Health Insurance Service, Wonju, Republic of Korea
    449. Farzad Hadaegh, Prevention of Metabolic Disorders Research Center, Tehran, Islamic Republic of Iran
    450. Charalambos A Hadjigeorgiou, Research and Education Institute of Child Health, Nicosia, Cyprus
    451. Rosa Haghshenas, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    452. Hamid Hakimi, Rafsanjan University of Medical Sciences, Rafsanjan, Islamic Republic of Iran
    453. Jytte Halkjær, Danish Cancer Society Research Center, Copenhagen, Denmark
    454. Ian R Hambleton, The University of the West Indies, Cave Hill, Barbados
    455. Behrooz Hamzeh, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
    456. Dominique Hange, University of Gothenburg, Gothenburg, Sweden
    457. Abu AM Hanif, BRAC James P Grant School of Public Health, Dhaka, Bangladesh
    458. Sari Hantunen, University of Eastern Finland, Kuopio, Finland
    459. Jie Hao, Beijing Institute of Ophthalmology, Beijing, China
    460. Rachakulla Hari Kumar, ICMR - National Institute of Nutrition, Hyderabad, India
    461. Seyed Mohammad Hashemi-Shahri, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
    462. Maria Hassapidou, International Hellenic University, Thessaloniki, Greece
    463. Jun Hata, Kyushu University, Fukuoka, Japan
    464. Teresa Haugsgjerd, University of Bergen, Bergen, Norway
    465. Jiang He, Tulane University, New Orleans, United States
    466. Yuan He, National Research Institute for Health and Family Planning, Beijing, China
    467. Yuna He, Chinese Center for Disease Control and Prevention, Beijing, China
    468. Regina Heidinger-Felso, University of Pécs, Pécs, Hungary
    469. Mirjam Heinen, University College Dublin, Dublin, Ireland
    470. Tatjana Hejgaard, Danish Health Authority, Copenhagen, Denmark
    471. Marleen Elisabeth Hendriks, Joep Lange Institute, Amsterdam, Netherlands
    472. Rafael dos Santos Henrique, Federal University of Pernambuco, Recife, Brazil
    473. Ana Henriques, Institute of Public Health of the University of Porto, Porto, Portugal
    474. Leticia Hernandez Cadena, National Institute of Public Health, Cuernavaca, Mexico
    475. Sauli Herrala, Oulu University Hospital, Oulu, Finland
    476. Victor M Herrera, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
    477. Isabelle Herter-Aeberli, ETH Zurich, Zurich, Switzerland
    478. Ramin Heshmat, Chronic Diseases Research Center, Tehran, Islamic Republic of Iran
    479. Allan G Hill, University of Southampton, Southampton, United Kingdom
    480. Sai Yin Ho, University of Hong Kong, Hong Kong, China
    481. Suzanne C Ho, The Chinese University of Hong Kong, Hong Kong, China
    482. Michael Hobbs, University of Western Australia, Perth, Australia
    483. Michelle Holdsworth, French National Research Institute for Sustainable Development, Montpellier, France
    484. Reza Homayounfar, Fasa University of Medical Sciences, Fasa, Islamic Republic of Iran
    485. Clara Homs, Gasol Foundation, Spain
    486. Wilma M Hopman, Kingston Health Sciences Centre, Kingston, Canada
    487. Andrea RVR Horimoto, University of São Paulo, São Paulo, Brazil
    488. Claudia M Hormiga, Fundación Oftalmológica de Santander, Bucaramanga, Colombia
    489. Bernardo L Horta, Federal University of Pelotas, Pelotas, Brazil
    490. Leila Houti, University Oran 1, Oran, Algeria
    491. Christina Howitt, The University of the West Indies, Cave Hill, Barbados
    492. Thein Thein Htay, Independent Public Health Specialist, Nay Pyi Taw, Myanmar
    493. Aung Soe Htet, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
    494. Maung Maung Than Htike, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
    495. Yonghua Hu, Peking University, Beijing, China
    496. José María Huerta, CIBER en Epidemiología y Salud Pública, Murcia, Spain
    497. Ilpo Tapani Huhtaniemi, Imperial College London, London, United Kingdom
    498. Laetitia Huiart, Luxembourg Institute of Health, Luxembourg, Luxembourg
    499. Constanta Huidumac Petrescu, National Institute of Public Health, Bucharest, Romania
    500. Martijn Huisman, VU University Medical Center, Amsterdam, Netherlands
    501. Abdullatif Husseini, Birzeit University, Birzeit, State of Palestine
    502. Chinh Nguyen Huu, National Institute of Nutrition, Hanoi, Viet Nam
    503. Inge Huybrechts, International Agency for Research on Cancer, Lyon, France
    504. Nahla Hwalla, American University of Beirut, Beirut, Lebanon
    505. Jolanda Hyska, Institute of Public Health, Tirana, Albania
    506. Licia Iacoviello, IRCCS Neuromed, Pozzilli, Italy
    507. Jesús M Ibarluzea, CIBER en Epidemiología y Salud Pública, San Sebastian, Spain
    508. Mohsen M Ibrahim, Cairo University, Cairo, Egypt
    509. Norazizah Ibrahim Wong, Ministry of Health, Kuala Lumpur, Malaysia
    510. M Arfan Ikram, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
    511. Violeta Iotova, Medical University Varna, Varna, Bulgaria
    512. Vilma E Irazola, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
    513. Takafumi Ishida, The University of Tokyo, Tokyo, Japan
    514. Muhammad Islam, The Hospital for Sick Children, Toronto, Canada
    515. Sheikh Mohammed Shariful Islam, Deakin University, Geelong, Australia
    516. Masanori Iwasaki, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
    517. Jeremy M Jacobs, Hadassah University Medical Center, Jerusalem, Israel
    518. Hashem Y Jaddou, Jordan University of Science and Technology, Irbid, Jordan
    519. Tazeen Jafar, Duke-NUS Medical School, Singapore, Singapore
    520. Kenneth James, The University of the West Indies, Kingston, Jamaica
    521. Kazi M Jamil, Kuwait Institute for Scientific Research, Safat, Kuwait
    522. Konrad Jamrozik, University of Adelaide, Adelaide, Australia
    523. Imre Janszky, Norwegian University of Science and Technology, Trondheim, Norway
    524. Edward Janus, University of Melbourne, Melbourne, Australia
    525. Juel Jarani, Sports University of Tirana, Tirana, Albania
    526. Marjo-Riitta Jarvelin, Imperial College London, London, United Kingdom
    527. Grazyna Jasienska, Jagiellonian University Medical College, Kraków, Poland
    528. Ana Jelakovic, University Hospital Center Zagreb, Zagreb, Croatia
    529. Bojan Jelakovic, University of Zagreb School of Medicine, Zagreb, Croatia
    530. Garry Jennings, Heart Foundation, Melbourne, Australia
    531. Anjani Kumar Jha, Nepal Health Research Council, Kathmandu, Nepal
    532. Chao Qiang Jiang, Guangzhou 12th Hospital, Guangzhou, China
    533. Ramon O Jimenez, Universidad Eugenio Maria de Hostos, Santo Domingo, Dominican Republic
    534. Karl-Heinz Jöckel, University of Duisburg-Essen, Duisburg, Germany
    535. Michel Joffres, Simon Fraser University, Burnaby, Canada
    536. Mattias Johansson, International Agency for Research on Cancer, Lyon, France
    537. Jari J Jokelainen, Oulu University Hospital, Oulu, Finland
    538. Jost B Jonas, Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
    539. Jitendra Jonnagaddala, University of New South Wales, Sydney, Australia
    540. Torben Jørgensen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    541. Pradeep Joshi, World Health Organization Country Office, Delhi, India
    542. Farahnaz Joukar, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
    543. Dragana P Jovic, Institute of Public Health, Belgrade, Serbia
    544. Jacek J Jóźwiak, University of Opole, Opole, Poland
    545. Anne Juolevi, Finnish Institute for Health and Welfare, Helsinki, Finland
    546. Gregor Jurak, University of Ljubljana, Ljubljana, Slovenia
    547. Iulia Jurca Simina, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
    548. Vesna Juresa, University of Zagreb, Zagreb, Croatia
    549. Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany
    550. Felix O Kaducu, Gulu University, Gulu, Uganda
    551. Anthony Kafatos, University of Crete, Heraklion, Greece
    552. Eero O Kajantie, Finnish Institute for Health and Welfare, Helsinki, Finland
    553. Zhanna Kalmatayeva, Al-Farabi Kazakh National University, Almaty, Kazakhstan
    554. Ofra Kalter-Leibovici, The Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
    555. Yves Kameli, French National Research Institute for Sustainable Development, Montpellier, France
    556. Freja B Kampmann, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    557. Kodanda R Kanala, Sri Venkateswara University, Tirupati, India
    558. Srinivasan Kannan, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
    559. Efthymios Kapantais, Hellenic Medical Association for Obesity, Athens, Greece
    560. Argyro Karakosta, National and Kapodistrian University of Athens, Athens, Greece
    561. Line L Kårhus, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    562. Khem B Karki, Maharajgunj Medical Campus, Kathmandu, Nepal
    563. Marzieh Katibeh, Aarhus University, Aarhus, Denmark
    564. Joanne Katz, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
    565. Peter T Katzmarzyk, Pennington Biomedical Research Center, Baton Rouge, United States
    566. Jussi Kauhanen, University of Eastern Finland, Kuopio, Finland
    567. Prabhdeep Kaur, National Institute of Epidemiology, Chennai, India
    568. Maryam Kavousi, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
    569. Gyulli M Kazakbaeva, Ufa Eye Research Institute, Ufa, Russian Federation
    570. Ulrich Keil, University of Münster, Münster, Germany
    571. Lital Keinan Boker, Israel Center for Disease Control, Ramat Gan, Israel
    572. Sirkka Keinänen-Kiukaanniemi, Oulu University Hospital, Oulu, Finland
    573. Roya Kelishadi, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan, Islamic Republic of Iran
    574. Cecily Kelleher, University College Dublin, Dublin, Ireland
    575. Han CG Kemper, Amsterdam UMC Public Health Research Institute, Amsterdam, Netherlands
    576. Andre P Kengne, South African Medical Research Council, Cape Town, South Africa
    577. Maryam Keramati, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
    578. Alina Kerimkulova, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
    579. Mathilde Kersting, Research Institute of Child Nutrition, Dortmund, Germany
    580. Timothy Key, University of Oxford, Oxford, United Kingdom
    581. Yousef Saleh Khader, Jordan University of Science and Technology, Irbid, Jordan
    582. Davood Khalili, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
    583. Kay-Tee Khaw, University of Cambridge, Cambridge, United Kingdom
    584. Bahareh Kheiri, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
    585. Motahareh Kheradmand, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
    586. Alireza Khosravi, Hypertension Research Center, Isfahan, Islamic Republic of Iran
    587. Ilse MSL Khouw, FrieslandCampina, Amersfoort, Netherlands
    588. Ursula Kiechl-Kohlendorfer, Medical University of Innsbruck, Innsbruck, Austria
    589. Stefan Kiechl, Medical University of Innsbruck, Innsbruck, Austria
    590. Japhet Killewo, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
    591. Dong Wook Kim, National Health Insurance Service, Wonju, Republic of Korea
    592. Hyeon Chang Kim, Yonsei University College of Medicine, Seoul, Republic of Korea
    593. Jeongseon Kim, National Cancer Center, Goyang-si, Republic of Korea
    594. Jenny M Kindblom, University of Gothenburg, Gothenburg, Sweden
    595. Heidi Klakk, University College South Denmark, Haderslev, Denmark
    596. Magdalena Klimek, Jagiellonian University Medical College, Kraków, Poland
    597. Jeannette Klimont, Statistics Austria, Vienna, Austria
    598. Jurate Klumbiene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    599. Michael Knoflach, Medical University of Innsbruck, Innsbruck, Austria
    600. Bhawesh Koirala, B P Koirala Institute of Health Sciences, Dharan, Nepal
    601. Elin Kolle, Norwegian School of Sport Sciences, Oslo, Norway
    602. Patrick Kolsteren, Ghent University, Ghent, Belgium
    603. Jürgen König, University of Vienna, Vienna, Austria
    604. Raija Korpelainen, University of Oulu, Oulu, Finland
    605. Paul Korrovits, Tartu University Clinics, Tartu, Estonia
    606. Magdalena Korzycka, Institute of Mother and Child, Warsaw, Poland
    607. Jelena Kos, University Hospital Center Zagreb, Zagreb, Croatia
    608. Seppo Koskinen, Finnish Institute for Health and Welfare, Helsinki, Finland
    609. Katsuyasu Kouda, Kansai Medical University, Hirakata, Japan
    610. Viktoria A Kovacs, Hungarian School Sport Federation, Budapest, Hungary
    611. Sudhir Kowlessur, Ministry of Health and Quality of Life, Port Louis, Mauritius
    612. Slawomir Koziel, PASs Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland
    613. Jana Kratenova, National Institute of Public Health, Prague, Czech Republic
    614. Wolfgang Kratzer, University Hospital Ulm, Ulm, Germany
    615. Susi Kriemler, University of Zurich, Zurich, Switzerland
    616. Peter Lund Kristensen, University of Southern Denmark, Odense, Denmark
    617. Steinar Krokstad, Norwegian University of Science and Technology, Trondheim, Norway
    618. Daan Kromhout, University of Groningen, Groningen, Netherlands
    619. Herculina S Kruger, North-West University, Potchefstroom, South Africa
    620. Ruzena Kubinova, National Institute of Public Health, Prague, Czech Republic
    621. Renata Kuciene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    622. Urho M Kujala, University of Jyväskylä, Jyväskylä, Finland
    623. Enisa Kujundzic, Institute of Public Health, Podgorica, Montenegro
    624. Zbigniew Kulaga, Children's Memorial Health Institute, Warsaw, Poland
    625. R Krishna Kumar, Amrita Institute of Medical Sciences, Cochin, India
    626. Marie Kunešová, Institute of Endocrinology, Prague, Czech Republic
    627. Pawel Kurjata, National Institute of Cardiology, Warsaw, Poland
    628. Yadlapalli S Kusuma, All India Institute of Medical Sciences, New Delhi, India
    629. Kari Kuulasmaa, Finnish Institute for Health and Welfare, Helsinki, Finland
    630. Catherine Kyobutungi, African Population and Health Research Center, Nairobi, Kenya
    631. Quang Ngoc La, Hanoi University of Public Health, Hanoi, Viet Nam
    632. Fatima Zahra Laamiri, Hassan First University of Settat, Settat, Morocco
    633. Tiina Laatikainen, Finnish Institute for Health and Welfare, Helsinki, Finland
    634. Carl Lachat, Ghent University, Ghent, Belgium
    635. Youcef Laid, Ministry of Health, Algiers, Algeria
    636. Tai Hing Lam, University of Hong Kong, Hong Kong, China
    637. Christina-Paulina Lambrinou, Harokopio University, Athens, Greece
    638. Edwige Landais, French National Research Institute for Sustainable Development, Montpellier, France
    639. Vera Lanska, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
    640. Georg Lappas, Sahlgrenska Academy, Gothenburg, Sweden
    641. Bagher Larijani, Endocrinology and Metabolism Research Center, Tehran, Islamic Republic of Iran
    642. Tint Swe Latt, University of Public Health, Yangon, Myanmar
    643. Laura Lauria, Istituto Superiore di Sanità, Rome, Italy
    644. Maria Lazo-Porras, Universidad Peruana Cayetano Heredia, Lima, Peru
    645. Gwenaëlle Le Coroller, Luxembourg Institute of Health, Strassen, Luxembourg
    646. Khanh Le Nguyen Bao, National Institute of Nutrition, Hanoi, Viet Nam
    647. Agnès Le Port, International Food Policy Research Institute, Dakar, Senegal
    648. Tuyen D Le, National Institute of Nutrition, Hanoi, Viet Nam
    649. Jeannette Lee, National University of Singapore, Singapore, Singapore
    650. Jeonghee Lee, National Cancer Center, Goyang-si, Republic of Korea
    651. Paul H Lee, Hong Kong Polytechnic University, Hong Kong, China
    652. Nils Lehmann, University of Duisburg-Essen, Duisburg, Germany
    653. Terho Lehtimäki, Tampere University Hospital, Tampere, Finland
    654. Daniel Lemogoum, University of Douala, Douala, Cameroon
    655. Naomi S Levitt, University of Cape Town, Cape Town, South Africa
    656. Yanping Li, Harvard TH Chan School of Public Health, Boston, United States
    657. Merike Liivak, National Institute for Health Development, Tallinn, Estonia
    658. Christa L Lilly, West Virginia University, Morgantown, United States
    659. Wei-Yen Lim, National University of Singapore, Singapore, Singapore
    660. M Fernanda Lima-Costa, Oswaldo Cruz Foundation Rene Rachou Research Institute, Belo Horizonte, Brazil
    661. Hsien-Ho Lin, National Taiwan University, Taipei, Taiwan
    662. Xu Lin, University of Chinese Academy of Sciences, Shanghai, China
    663. Yi-Ting Lin, Uppsala University, Uppsala, Sweden
    664. Lars Lind, Uppsala University, Uppsala, Sweden
    665. Allan Linneberg, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    666. Lauren Lissner, University of Gothenburg, Gothenburg, Sweden
    667. Mieczyslaw Litwin, Children's Memorial Health Institute, Warsaw, Poland
    668. Lijuan Liu, Capital Medical University Beijing Tongren Hospital, Beijing, China
    669. Wei-Cheng Lo, Taipei Medical University, Taipei, Taiwan
    670. Helle-Mai Loit, National Institute for Health Development, Tallinn, Estonia
    671. Khuong Quynh Long, Hanoi University of Public Health, Hanoi, Viet Nam
    672. Luis Lopes, University of Porto, Porto, Portugal
    673. Oscar Lopes, Sports Medical Center of Minho, Braga, Portugal
    674. Esther Lopez-Garcia, Universidad Autónoma de Madrid CIBERESP, Madrid, Spain
    675. Tania Lopez, Universidad San Martín de Porres, Lima, Peru
    676. Paulo A Lotufo, University of São Paulo, São Paulo, Brazil
    677. José Eugenio Lozano, Consejería de Sanidad Junta de Castilla y León, Valladolid, Spain
    678. Janice L Lukrafka, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
    679. Dalia Luksiene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    680. Annamari Lundqvist, Finnish Institute for Health and Welfare, Helsinki, Finland
    681. Robert Lundqvist, Norrbotten County Council, Luleå, Sweden
    682. Nuno Lunet, University of Porto, Porto, Portugal
    683. Charles Lunogelo, Ilembula Lutheran Hospital, Ilembula, United Republic of Tanzania
    684. Michala Lustigová, Charles University, Prague, Czech Republic
    685. Edyta Łuszczki, University of Rzeszów, Rzeszów, Poland
    686. Guansheng Ma, Peking University, Beijing, China
    687. Jun Ma, Peking University, Beijing, China
    688. Xu Ma, National Research Institute for Health and Family Planning, Beijing, China
    689. George LL Machado-Coelho, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
    690. Aristides M Machado-Rodrigues, University of Coimbra, Coimbra, Portugal
    691. Luisa M Macieira, Coimbra University Hospital Center, Coimbra, Portugal
    692. Ahmed A Madar, University of Oslo, Oslo, Norway
    693. Stefania Maggi, Institute of Neuroscience of the National Research Council, Padua, Italy
    694. Dianna J Magliano, Baker Heart and Diabetes Institute, Melbourne, Australia
    695. Sara Magnacca, Mediterranea Cardiocentro, Naples, Italy
    696. Emmanuella Magriplis, Agricultural University of Athens, Athens, Greece
    697. Gowri Mahasampath, Christian Medical College, Vellore, India
    698. Bernard Maire, French National Research Institute for Sustainable Development, Montpellier, France
    699. Marjeta Majer, University of Zagreb, Zagreb, Croatia
    700. Marcia Makdisse, Hospital Israelita Albert Einstein, São Paulo, Brazil
    701. Päivi Mäki, Finnish Institute for Health and Welfare, Helsinki, Finland
    702. Fatemeh Malekzadeh, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    703. Reza Malekzadeh, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    704. Rahul Malhotra, Duke-NUS Medical School, Singapore, Singapore
    705. Kodavanti Mallikharjuna Rao, ICMR - National Institute of Nutrition, Hyderabad, India
    706. Sofia K Malyutina, SB RAS Federal Research Center Institute of Cytology and Genetics, Novosibirsk, Russian Federation
    707. Lynell V Maniego, Food and Nutrition Research Institute, Taguig, Philippines
    708. Yannis Manios, Harokopio University, Athens, Greece
    709. Jim I Mann, University of Otago, Dunedin, New Zealand
    710. Fariborz Mansour-Ghanaei, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
    711. Enzo Manzato, University of Padua, Padua, Italy
    712. Paula Margozzini, Pontificia Universidad Católica de Chile, Santiago, Chile
    713. Anastasia Markaki, Hellenic Mediterranean University, Siteia, Greece
    714. Oonagh Markey, Loughborough University, Loughborough, United Kingdom
    715. Eliza Markidou Ioannidou, Ministry of Health, Nicosia, Cyprus
    716. Pedro Marques-Vidal, Lausanne University Hospital, Lausanne, Switzerland
    717. Larissa Pruner Marques, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, Brazil
    718. Jaume Marrugat, CIBERCV, Madrid, Spain
    719. Yves Martin-Prevel, French National Research Institute for Sustainable Development, Montpellier, France
    720. Rosemarie Martin, Mary Immaculate College, Limerick, Ireland
    721. Reynaldo Martorell, Emory University, Atlanta, United States
    722. Eva Martos, Hungarian Society of Sports Medicine, Budapest, Hungary
    723. Katharina Maruszczak, Paracelsus Medical University, Salzburg, Austria
    724. Stefano Marventano, University of Catania, Catania, Italy
    725. Luis P Mascarenhas, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
    726. Shariq R Masoodi, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
    727. Ellisiv B Mathiesen, UiT The Arctic University of Norway, Tromsø, Norway
    728. Prashant Mathur, ICMR - National Centre for Disease Informatics and Research, Bengaluru, India
    729. Alicia Matijasevich, University of São Paulo, São Paulo, Brazil
    730. Tandi E Matsha, Cape Peninsula University of Technology, Cape Town, South Africa
    731. Christina Mavrogianni, Harokopio University, Athens, Greece
    732. Artur Mazur, University of Rzeszów, Rzeszów, Poland
    733. Jean Claude N Mbanya, University of Yaoundé 1, Yaoundé, Cameroon
    734. Shelly R McFarlane, The University of the West Indies, Kingston, Jamaica
    735. Stephen T McGarvey, Brown University, Providence, United States
    736. Martin McKee, London School of Hygiene & Tropical Medicine, London, United Kingdom
    737. Stela McLachlan, University of Edinburgh, Edinburgh, United Kingdom
    738. Rachael M McLean, University of Otago, Dunedin, New Zealand
    739. Scott B McLean, Statistics Canada, Ottawa, Canada
    740. Breige A McNulty, University College Dublin, Dublin, Ireland
    741. Sounnia Mediene Benchekor, University Oran 1, Oran, Algeria
    742. Jurate Medzioniene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    743. Parinaz Mehdipour, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    744. Kirsten Mehlig, University of Gothenburg, Gothenburg, Sweden
    745. Amir Houshang Mehrparvar, Shahid Sadoughi University of Medical Sciences, Tehran, Islamic Republic of Iran
    746. Aline Meirhaeghe, Institut National de la Santé et de la Recherche Médicale, Lille, France
    747. Jørgen Meisfjord, Norwegian Institute of Public Health, Oslo, Norway
    748. Christa Meisinger, Helmholtz Zentrum München, Munich, Germany
    749. Ana Maria B Menezes, Federal University of Pelotas, Pelotas, Brazil
    750. Geetha R Menon, ICMR - National Institute of Medical Statistics, New Delhi, India
    751. Gert BM Mensink, Robert Koch Institute, Berlin, Germany
    752. Maria Teresa Menzano, Ministero della Salute DG Prevenzione Sanitaria, Rome, Italy
    753. Alibek Mereke, Al-Farabi Kazakh National University, Almaty, Kazakhstan
    754. Indrapal I Meshram, ICMR - National Institute of Nutrition, Hyderabad, India
    755. Andres Metspalu, University of Tartu, Tartu, Estonia
    756. Haakon E Meyer, University of Oslo, Oslo, Norway
    757. Jie Mi, Capital Institute of Pediatrics, Beijing, China
    758. Kim F Michaelsen, University of Copenhagen, Copenhagen, Denmark
    759. Nathalie Michels, Ghent University, Ghent, Belgium
    760. Kairit Mikkel, University of Tartu, Tartu, Estonia
    761. Karolina Milkowska, Jagiellonian University Medical College, Kraków, Poland
    762. Jody C Miller, University of Otago, Dunedin, New Zealand
    763. Cláudia S Minderico, Universidade de Lisboa, Lisbon, Portugal
    764. GK Mini, Women’s Social and Health Studies Foundation, Trivandrum, India
    765. Juan Francisco Miquel, Pontificia Universidad Católica de Chile, Santiago, Chile
    766. Mohammad Reza Mirjalili, Shahid Sadoughi University of Medical Sciences, Tehran, Islamic Republic of Iran
    767. Daphne Mirkopoulou, Democritus University, Alexandroupolis, Greece
    768. Erkin Mirrakhimov, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
    769. Marjeta Mišigoj-Durakovic, University of Zagreb, Zagreb, Croatia
    770. Antonio Mistretta, University of Catania, Catania, Italy
    771. Veronica Mocanu, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
    772. Pietro A Modesti, Università degli Studi di Firenze, Florence, Italy
    773. Sahar Saeedi Moghaddam, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    774. Bahram Mohajer, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    775. Mostafa K Mohamed, Ain Shams University, Cairo, Egypt
    776. Shukri F Mohamed, African Population and Health Research Center, Nairobi, Kenya
    777. Kazem Mohammad, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    778. Zahra Mohammadi, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    779. Noushin Mohammadifard, Isfahan Cardiovascular Research Center, Isfahan, Islamic Republic of Iran
    780. Reza Mohammadpourhodki, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
    781. Viswanathan Mohan, Madras Diabetes Research Foundation, Chennai, India
    782. Salim Mohanna, Universidad Peruana Cayetano Heredia, Lima, Peru
    783. Muhammad Fadhli Mohd Yusoff, Ministry of Health, Kuala Lumpur, Malaysia
    784. Iraj Mohebbi, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
    785. Farnam Mohebi, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    786. Marie Moitry, University of Strasbourg, Strasbourg, France
    787. Drude Molbo, University of Copenhagen, Copenhagen, Denmark
    788. Line T Møllehave, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    789. Niels C Møller, University of Southern Denmark, Odense, Denmark
    790. Dénes Molnár, University of Pécs, Pécs, Hungary
    791. Amirabbas Momenan, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
    792. Charles K Mondo, Mulago Hospital, Kampala, Uganda
    793. Michele Monroy-Valle, University of San Carlos of Guatemala, Guatemala City, Guatemala
    794. Eric Monterrubio-Flores, National Institute of Public Health, Cuernavaca, Mexico
    795. Kotsedi Daniel K Monyeki, University of Limpopo, Sovenga, South Africa
    796. Jin Soo Moon, Seoul National University, Seoul, Republic of Korea
    797. Mahmood Moosazadeh, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
    798. Leila B Moreira, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    799. Alain Morejon, University of Medical Sciences of Cienfuegos, Cienfuegos, Cuba
    800. Luis A Moreno, University of Zaragoza, Zaragoza, Spain
    801. Karen Morgan, Royal College of Surgeons in Ireland, Dublin, Ireland
    802. Suzanne N Morin, McGill University, Montreal, Canada
    803. Erik Lykke Mortensen, University of Copenhagen, Copenhagen, Denmark
    804. George Moschonis, La Trobe University, Melbourne, Australia
    805. Malgorzata Mossakowska, International Institute of Molecular and Cell Biology, Warsaw, Poland
    806. Aya Mostafa, Ain Shams University, Cairo, Egypt
    807. Anabela Mota-Pinto, University of Coimbra, Coimbra, Portugal
    808. Jorge Mota, University of Porto, Porto, Portugal
    809. Mohammad Esmaeel Motlagh, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran
    810. Jorge Motta, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
    811. Marcos André Moura-dos-Santos, University of Pernambuco, Recife, Brazil
    812. Malay K Mridha, BRAC James P Grant School of Public Health, Dhaka, Bangladesh
    813. Kelias P Msyamboza, World Health Organization Country Office, Lilongwe, Malawi
    814. Thet Thet Mu, Department of Public Health, Nay Pyi Taw, Myanmar
    815. Magdalena Muc, University of Coimbra, Coimbra, Portugal
    816. Boban Mugoša, Institute of Public Health, Podgorica, Montenegro
    817. Maria L Muiesan, University of Brescia, Brescia, Italy
    818. Parvina Mukhtorova, Ministry of Health and Social Protection, Dushanbe, Tajikistan
    819. Martina Müller-Nurasyid, Helmholtz Zentrum München, Munich, Germany
    820. Neil Murphy, International Agency for Research on Cancer, Lyon, France
    821. Jaakko Mursu, University of Eastern Finland, Kuopio, Finland
    822. Elaine M Murtagh, University of Limerick, Limerick, Ireland
    823. Kamarul Imran Musa, Universiti Sains Malaysia, Kelantan, Malaysia
    824. Sanja Music Milanovic, Croatian Institute of Public Health, Zagreb, Croatia
    825. Vera Musil, University of Zagreb, Zagreb, Croatia
    826. Norlaila Mustafa, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    827. Iraj Nabipour, Bushehr University of Medical Sciences, Bushehr, Islamic Republic of Iran
    828. Shohreh Naderimagham, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    829. Gabriele Nagel, Ulm University, Ulm, Germany
    830. Balkish M Naidu, Department of Statistics, Kuala Lumpur, Malaysia
    831. Farid Najafi, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
    832. Harunobu Nakamura, Kobe University, Kobe, Japan
    833. Jana Námešná, Banska Bystrica Regional Authority of Public Health, Banska Bystrica, Slovakia
    834. Ei Ei K Nang, National University of Singapore, Singapore, Singapore
    835. Vinay B Nangia, Suraj Eye Institute, Nagpur, India
    836. Martin Nankap, UNICEF, Yaoundé, Cameroon
    837. Sameer Narake, Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India
    838. Paola Nardone, Istituto Superiore di Sanità, Rome, Italy
    839. Matthias Nauck, University Medicine Greifswald, Greifswald, Germany
    840. William A Neal, West Virginia University, Morgantown, United States
    841. Azim Nejatizadeh, Hormozgan University of Medical Sciences, Bandar Abbas, Islamic Republic of Iran
    842. Chandini Nekkantti, University of New South Wales, Sydney, Australia
    843. Keiu Nelis, National Institute for Health Development, Tallinn, Estonia
    844. Liis Nelis, National Institute for Health Development, Tallinn, Estonia
    845. Ilona Nenko, Jagiellonian University Medical College, Kraków, Poland
    846. Martin Neovius, Karolinska Institutet, Stockholm, Sweden
    847. Flavio Nervi, Pontificia Universidad Católica de Chile, Santiago, Chile
    848. Chung T Nguyen, National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
    849. Nguyen D Nguyen, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
    850. Quang Ngoc Nguyen, Hanoi Medical University, Hanoi, Viet Nam
    851. Ramfis E Nieto-Martínez, LifeDoc Health, Memphis, United States
    852. Yury P Nikitin, SB RAS Federal Research Center Institute of Cytology and Genetics, Novosibirsk, Russian Federation
    853. Guang Ning, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
    854. Toshiharu Ninomiya, Kyushu University, Fukuoka, Japan
    855. Sania Nishtar, Heartfile, Islamabad, Pakistan
    856. Marianna Noale, Institute of Neuroscience of the National Research Council, Padua, Italy
    857. Oscar A Noboa, Universidad de la República, Montevideo, Uruguay
    858. Helena Nogueira, University of Coimbra, Coimbra, Portugal
    859. Teresa Norat, Imperial College London, London, United Kingdom
    860. Maria Nordendahl, Umeå University, Umeå, Sweden
    861. Børge G Nordestgaard, Copenhagen University Hospital, Copenhagen, Denmark
    862. Davide Noto, University of Palermo, Palermo, Italy
    863. Natalia Nowak-Szczepanska, PASs Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland
    864. Mohannad Al Nsour, Eastern Mediterranean Public Health Network, Amman, Jordan
    865. Irfan Nuhoglu, Karadeniz Technical University, Trabzon, Turkey
    866. Eha Nurk, National Institute for Health Development, Tallinn, Estonia
    867. Terence W O'Neill, University of Manchester, Manchester, United Kingdom
    868. Dermot O'Reilly, Queen's University of Belfast, Belfast, United Kingdom
    869. Galina Obreja, State University of Medicine and Pharmacy, Chisinau, Moldova
    870. Caleb Ochimana, Harvard TH Chan School of Public Health, Boston, United States
    871. Angélica M Ochoa-Avilés, Universidad de Cuenca, Cuenca, Ecuador
    872. Eiji Oda, Tachikawa General Hospital, Nagaoka, Japan
    873. Kyungwon Oh, Korea Centers for Disease Control and Prevention, Cheongju-si, Republic of Korea
    874. Kumiko Ohara, Kindai University, Osaka-Sayama, Japan
    875. Claes Ohlsson, University of Gothenburg, Gothenburg, Sweden
    876. Ryutaro Ohtsuka, Japan Wildlife Research Center, Tokyo, Japan
    877. Örn Olafsson, Icelandic Heart Association, Kopavogur, Iceland
    878. Maria Teresa A Olinto, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
    879. Isabel O Oliveira, Federal University of Pelotas, Pelotas, Brazil
    880. Mohd Azahadi Omar, Ministry of Health, Kuala Lumpur, Malaysia
    881. Altan Onat, Istanbul University, Istanbul, Turkey
    882. Sok King Ong, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
    883. Lariane M Ono, Universidade Federal do Paraná, Curitiba, Brazil
    884. Pedro Ordunez, Pan American Health Organization, Washington DC, United States
    885. Rui Ornelas, University of Madeira, Funchal, Portugal
    886. Ana P Ortiz, University of Puerto Rico, San Juan, Puerto Rico
    887. Pedro J Ortiz, Universidad Peruana Cayetano Heredia, Lima, Peru
    888. Merete Osler, Center for Clinical Research and Prevention, Glostrup, Denmark
    889. Clive Osmond, MRC Lifecourse Epidemiology Unit, Southampton, United Kingdom
    890. Sergej M Ostojic, University of Novi Sad, Novi Sad, Serbia
    891. Afshin Ostovar, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    892. Johanna A Otero, Fundación Oftalmológica de Santander, Bucaramanga, Colombia
    893. Kim Overvad, Aarhus University, Aarhus, Denmark
    894. Ellis Owusu-Dabo, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
    895. Fred Michel Paccaud, UniSanté, Lausanne, Switzerland
    896. Cristina Padez, University of Coimbra, Coimbra, Portugal
    897. Ioannis Pagkalos, International Hellenic University, Thessaloniki, Greece
    898. Elena Pahomova, University of Latvia, Riga, Latvia
    899. Karina Mary de Paiva, Federal University of Santa Catarina, Florianópolis, Brazil
    900. Andrzej Pajak, Jagiellonian University Medical College, Kraków, Poland
    901. Domenico Palli, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
    902. Alberto Palloni, University of Wisconsin-Madison, Madison, United States
    903. Luigi Palmieri, Istituto Superiore di Sanità, Rome, Italy
    904. Wen-Harn Pan, Academia Sinica, Taipei, Taiwan
    905. Songhomitra Panda-Jonas, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
    906. Arvind Pandey, ICMR - National Institute of Medical Statistics, New Delhi, India
    907. Francesco Panza, IRCCS Ente Ospedaliero Specializzato in Gastroenterologia S. de Bellis, Bari, Italy
    908. Dimitrios Papandreou, Zayed University, Abu Dhabi, United Arab Emirates
    909. Soon-Woo Park, Catholic University of Daegu, Daegu, Republic of Korea
    910. Suyeon Park, Korea Centers for Disease Control and Prevention, Cheongju-si, Republic of Korea
    911. Winsome R Parnell, University of Otago, Dunedin, New Zealand
    912. Mahboubeh Parsaeian, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    913. Ionela M Pascanu, University of Medicine, Pharmacy, Science and Technology of Târgu Mures, Târgu Mures, Romania
    914. Patrick Pasquet, UMR CNRS-MNHN 7206 Eco-anthropologie, Paris, France
    915. Nikhil D Patel, Jivandeep Hospital, Anand, India
    916. Ivan Pecin, University Hospital Center Zagreb, Zagreb, Croatia
    917. Mangesh S Pednekar, Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India
    918. Nasheeta Peer, South African Medical Research Council, Durban, South Africa
    919. Gao Pei, Peking University, Beijing, China
    920. Sergio Viana Peixoto, Oswaldo Cruz Foundation Rene Rachou Research Institute, Belo Horizonte, Brazil
    921. Markku Peltonen, Finnish Institute for Health and Welfare, Helsinki, Finland
    922. Alexandre C Pereira, University of São Paulo, São Paulo, Brazil
    923. Marco A Peres, National Dental Care Centre Singapore, Singapore, Singapore
    924. Napoleón Pérez-Farinós, Universidad de Málaga, Malaga, Spain
    925. Cynthia M Pérez, University of Puerto Rico, San Juan, Puerto Rico
    926. Valentina Peterkova, Endocrinology Research Centre, Moscow, Russian Federation
    927. Annette Peters, Helmholtz Zentrum München, Munich, Germany
    928. Astrid Petersmann, University Medicine Greifswald, Greifswald, Germany
    929. Janina Petkeviciene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    930. Ausra Petrauskiene, Lithuanian University of Health Sciences, Kaunas, Lithuania
    931. Emanuela Pettenuzzo, University Hospital of Varese, Varese, Italy
    932. Niloofar Peykari, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
    933. Son Thai Pham, Vietnam National Heart Institute, Hanoi, Viet Nam
    934. Rafael N Pichardo, Clínica de Medicina Avanzada Dr. Abel González, Santo Domingo, Dominican Republic
    935. Daniela Pierannunzio, Istituto Superiore di Sanità, Rome, Italy
    936. Iris Pigeot, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
    937. Hynek Pikhart, University College London, London, United Kingdom
    938. Aida Pilav, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
    939. Lorenza Pilotto, Cardiovascular Prevention Centre Udine, Udine, Italy
    940. Francesco Pistelli, Pisa University Hospital, Pisa, Italy
    941. Freda Pitakaka, Ministry of Health and Medical Services, Honiara, Solomon Islands
    942. Aleksandra Piwonska, National Institute of Cardiology, Warsaw, Poland
    943. Andreia N Pizarro, University of Porto, Porto, Portugal
    944. Pedro Plans-Rubió, Public Health Agency of Catalonia, Barcelona, Spain
    945. Bee Koon Poh, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    946. Hermann Pohlabeln, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
    947. Raluca M Pop, University of Medicine, Pharmacy, Science and Technology of Târgu Mures, Târgu Mures, Romania
    948. Stevo R Popovic, University of Montenegro, Niksic, Montenegro
    949. Miquel Porta, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
    950. Georg Posch, Agency for Preventive and Social Medicine, Bregenz, Austria
    951. Anil Poudyal, Nepal Health Research Council, Kathmandu, Nepal
    952. Dimitrios Poulimeneas, International Hellenic University, Thessaloniki, Greece
    953. Hamed Pouraram, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    954. Farhad Pourfarzi, Ardabil University of Medical Sciences, Ardabil, Islamic Republic of Iran
    955. Akram Pourshams, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    956. Hossein Poustchi, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    957. Rajendra Pradeepa, Madras Diabetes Research Foundation, Chennai, India
    958. Alison J Price, London School of Hygiene & Tropical Medicine, London, United Kingdom
    959. Jacqueline F Price, University of Edinburgh, Edinburgh, United Kingdom
    960. Rui Providencia, University College London, London, United Kingdom
    961. Jardena J Puder, Lausanne University Hospital, Lausanne, Switzerland
    962. Iveta Pudule, Centre for Disease Prevention and Control, Riga, Latvia
    963. Soile E Puhakka, University of Oulu, Oulu, Finland
    964. Maria Puiu, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
    965. Margus Punab, Tartu University Clinics, Tartu, Estonia
    966. Radwan F Qasrawi, Al-Quds University, East Jerusalem, State of Palestine
    967. Mostafa Qorbani, Alborz University of Medical Sciences, Karaj, Islamic Republic of Iran
    968. Tran Quoc Bao, Ministry of Health, Hanoi, Viet Nam
    969. Ivana Radic, University of Novi Sad, Novi Sad, Serbia
    970. Ricardas Radisauskas, Lithuanian University of Health Sciences, Kaunas, Lithuania
    971. Salar Rahimikazerooni, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
    972. Mahfuzar Rahman, Pure Earth, Dhaka, Bangladesh
    973. Mahmudur Rahman, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
    974. Olli Raitakari, University of Turku, Turku, Finland
    975. Manu Raj, Amrita Institute of Medical Sciences, Cochin, India
    976. Ellina Rakhimova, Ufa Eye Research Institute, Ufa, Russian Federation
    977. Sherali Rakhmatulloev, Ministry of Health and Social Protection, Dushanbe, Tajikistan
    978. Ivo Rakovac, World Health Organization Regional Office for Europe, Moscow, Russian Federation
    979. Sudha Ramachandra Rao, National Institute of Epidemiology, Chennai, India
    980. Ambady Ramachandran, India Diabetes Research Foundation, Chennai, India
    981. Jacqueline Ramke, University of Auckland, Auckland, New Zealand
    982. Elisabete Ramos, University of Porto Medical School, Porto, Portugal
    983. Rafel Ramos, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Girona, Spain
    984. Lekhraj Rampal, Universiti Putra Malaysia, Serdang, Malaysia
    985. Sanjay Rampal, University of Malaya, Kuala Lumpur, Malaysia
    986. Vayia Rarra, Sotiria Hospital, Athens, Greece
    987. Ramon A Rascon-Pacheco, Instituto Mexicano del Seguro Social, Mexico City, Mexico
    988. Mette Rasmussen, University of Southern Denmark, Odense, Denmark
    989. Cassiano Ricardo Rech, Federal University of Santa Catarina, Florianópolis, Brazil
    990. Josep Redon, University of Valencia, Valencia, Spain
    991. Paul Ferdinand M Reganit, University of the Philippines, Manila, Philippines
    992. Valéria Regecová, Slovak Academy of Sciences, Bratislava, Slovakia
    993. Luis Revilla, Universidad San Martín de Porres, Lima, Peru
    994. Abbas Rezaianzadeh, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
    995. Lourdes Ribas-Barba, Nutrition Research Foundation, Barcelona, Spain
    996. Robespierre Ribeiro, Minas Gerais State Secretariat for Health, Belo Horizonte, Brazil
    997. Elio Riboli, Imperial College London, London, United Kingdom
    998. Adrian Richter, University Medicine Greifswald, Greifswald, Germany
    999. Fernando Rigo, CS S. Agustín Ibsalut, Palma, Spain
    1000. Natascia Rinaldo, University of Ferrara, Ferrara, Italy
    1001. Tobias F Rinke de Wit, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
    1002. Ana Rito, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
    1003. Raphael M Ritti-Dias, Universidade Nove de Julho, São Paulo, Brazil
    1004. Juan A Rivera, National Institute of Public Health, Cuernavaca, Mexico
    1005. Cynthia Robitaille, Public Health Agency of Canada, Ottawa, Canada
    1006. Romana Roccaldo, Council for Agricultural Research and Economics, Rome, Italy
    1007. Daniela Rodrigues, University of Coimbra, Coimbra, Portugal
    1008. Fernando Rodríguez-Artalejo, Universidad Autónoma de Madrid CIBERESP, Madrid, Spain
    1009. María del Cristo Rodriguez-Perez, Canarian Health Service, Tenerife, Spain
    1010. Laura A Rodríguez-Villamizar, Universidad Industrial de Santander, Bucaramanga, Colombia
    1011. Ulla Roggenbuck, University of Duisburg-Essen, Duisburg, Germany
    1012. Rosalba Rojas-Martinez, National Institute of Public Health, Cuernavaca, Mexico
    1013. Nipa Rojroongwasinkul, Mahidol University, Nakhon Pathom, Thailand
    1014. Dora Romaguera, CIBEROBN, Madrid, Spain
    1015. Elisabetta L Romeo, Associazione Calabrese di Epatologia, Reggio Calabria, Italy
    1016. Rafaela V Rosario, University of Minho, Braga, Portugal
    1017. Annika Rosengren, University of Gothenburg, Gothenburg, Sweden
    1018. Ian Rouse, Fiji National University, Suva, Fiji
    1019. Joel GR Roy, Statistics Canada, Ottawa, Canada
    1020. Adolfo Rubinstein, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
    1021. Frank J Rühli, University of Zurich, Zurich, Switzerland
    1022. Jean-Bernard Ruidavets, Toulouse University School of Medicine, Toulouse, France
    1023. Blanca Sandra Ruiz-Betancourt, Instituto Mexicano del Seguro Social, Mexico City, Mexico
    1024. Maria Ruiz-Castell, Luxembourg Institute of Health, Strassen, Luxembourg
    1025. Emma Ruiz Moreno, Spanish Nutrition Foundation, Madrid, Spain
    1026. Iuliia A Rusakova, Ufa Eye Research Institute, Ufa, Russian Federation
    1027. Kenisha Russell Jonsson, Public Health Agency of Sweden, Stockholm, Sweden
    1028. Paola Russo, Institute of Food Sciences of the National Research Council, Avellino, Italy
    1029. Petra Rust, University of Vienna, Vienna, Austria
    1030. Marcin Rutkowski, Medical University of Gdansk, Gdansk, Poland
    1031. Charumathi Sabanayagam, Singapore Eye Research Institute, Singapore, Singapore
    1032. Elena Sacchini, Authority Sanitaria San Marino, San Marino, San Marino
    1033. Harshpal S Sachdev, Sitaram Bhartia Institute of Science and Research, New Delhi, India
    1034. Alireza Sadjadi, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    1035. Ali Reza Safarpour, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
    1036. Saeid Safiri, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
    1037. Nader Saki, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran
    1038. Benoit Salanave, French Public Health Agency, St Maurice, France
    1039. Eduardo Salazar Martinez, National Institute of Public Health, Cuernavaca, Mexico
    1040. Diego Salmerón, CIBER en Epidemiología y Salud Pública, Murcia, Spain
    1041. Veikko Salomaa, Finnish Institute for Health and Welfare, Helsinki, Finland
    1042. Jukka T Salonen, University of Helsinki, Helsinki, Finland
    1043. Massimo Salvetti, University of Brescia, Brescia, Italy
    1044. Margarita Samoutian, Kindergarten of Avlonari, Evia, Greece
    1045. Jose Sánchez-Abanto, National Institute of Health, Lima, Peru
    1046. Sandjaja, Ministry of Health, Jakarta, Indonesia
    1047. Susana Sans, Catalan Department of Health, Barcelona, Spain
    1048. Loreto Santa Marina, Biodonostia Health Research Institute, San Sebastian, Spain
    1049. Diana A Santos, Universidade de Lisboa, Lisbon, Portugal
    1050. Ina S Santos, Federal University of Pelotas, Pelotas, Brazil
    1051. Lèlita C Santos, Coimbra University Hospital Center, Coimbra, Portugal
    1052. Maria Paula Santos, University of Porto, Porto, Portugal
    1053. Osvaldo Santos, Instituto de Saúde Ambiental, Lisbon, Portugal
    1054. Rute Santos, University of Porto, Porto, Portugal
    1055. Sara Santos Sanz, Spanish Agency for Food Safety and Nutrition, Madrid, Spain
    1056. Jouko L Saramies, South Karelia Social and Health Care District, Lappeenranta, Finland
    1057. Luis B Sardinha, Universidade de Lisboa, Lisbon, Portugal
    1058. Nizal Sarrafzadegan, Isfahan Cardiovascular Research Center, Isfahan, Islamic Republic of Iran
    1059. Thirunavukkarasu Sathish, McMaster University, Hamilton, Canada
    1060. Kai-Uwe Saum, German Cancer Research Center, Heidelberg, Germany
    1061. Savvas Savva, Research and Education Institute of Child Health, Nicosia, Cyprus
    1062. Mathilde Savy, French National Research Institute for Sustainable Development, Montpellier, France
    1063. Norie Sawada, National Cancer Center, Tokyo, Japan
    1064. Mariana Sbaraini, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    1065. Marcia Scazufca, University of São Paulo Clinics Hospital, São Paulo, Brazil
    1066. Beatriz D Schaan, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    1067. Angelika Schaffrath Rosario, Robert Koch Institute, Berlin, Germany
    1068. Herman Schargrodsky, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
    1069. Anja Schienkiewitz, Robert Koch Institute, Berlin, Germany
    1070. Sabine Schipf, University Medicine Greifswald, Greifswald, Germany
    1071. Carsten O Schmidt, University Medicine Greifswald, Greifswald, Germany
    1072. Ida Maria Schmidt, Rigshospitalet, Copenhagen, Denmark
    1073. Peter Schnohr, Copenhagen University Hospital, Copenhagen, Denmark
    1074. Ben Schöttker, German Cancer Research Center, Heidelberg, Germany
    1075. Sara Schramm, University of Duisburg-Essen, Duisburg, Germany
    1076. Stine Schramm, University of Southern Denmark, Odense, Denmark
    1077. Helmut Schröder, CIBER en Epidemiología y Salud Pública, Barcelona, Spain
    1078. Constance Schultsz, Academic Medical Center of University of Amsterdam, Amsterdam, Netherlands
    1079. Aletta E Schutte, University of New South Wales, Sydney, Australia
    1080. Aye Aye Sein, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
    1081. Rusidah Selamat, Ministry of Health, Kuala Lumpur, Malaysia
    1082. Vedrana Sember, University of Ljubljana, Ljubljana, Slovenia
    1083. Abhijit Sen, Center for Oral Health Services and Research Mid-Norway, Trondheim, Norway
    1084. Idowu O Senbanjo, Lagos State University College of Medicine, Lagos, Nigeria
    1085. Sadaf G Sepanlou, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    1086. Victor Sequera, Ministry of Public Health, Asunción, Paraguay
    1087. Luis Serra-Majem, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
    1088. Jennifer Servais, Statistics Canada, Ottawa, Canada
    1089. Ludmila Ševcíková, Comenius University, Bratislava, Slovakia
    1090. Svetlana A Shalnova, National Research Centre for Preventive Medicine, Moscow, Russian Federation
    1091. Teresa Shamah-Levy, National Institute of Public Health, Cuernavaca, Mexico
    1092. Morteza Shamshirgaran, Neyshabur University of Medical Sciences, Neyshabur, Islamic Republic of Iran
    1093. Coimbatore Subramaniam Shanthirani, Madras Diabetes Research Foundation, Chennai, India
    1094. Maryam Sharafkhah, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    1095. Sanjib K Sharma, B P Koirala Institute of Health Sciences, Dharan, Nepal
    1096. Jonathan E Shaw, Baker Heart and Diabetes Institute, Melbourne, Australia
    1097. Amaneh Shayanrad, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
    1098. Ali Akbar Shayesteh, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran
    1099. Lela Shengelia, National Center for Disease Control and Public Health, Tbilisi, Georgia
    1100. Zumin Shi, Qatar University, Doha, Qatar
    1101. Kenji Shibuya, King's College London, London, United Kingdom
    1102. Hana Shimizu-Furusawa, Nippon Medical School, Tokyo, Japan
    1103. Dong Wook Shin, Sungkyunkwan University, Seoul, Republic of Korea
    1104. Majid Shirani, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
    1105. Rahman Shiri, Finnish Institute of Occupational Health, Helsinki, Finland
    1106. Namuna Shrestha, Public Health Promotion and Development Organization, Kathmandu, Nepal
    1107. Khairil Si-Ramlee, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
    1108. Alfonso Siani, Institute of Food Sciences of the National Research Council, Avellino, Italy
    1109. Rosalynn Siantar, Singapore Eye Research Institute, Singapore, Singapore
    1110. Abla M Sibai, American University of Beirut, Beirut, Lebanon
    1111. Antonio M Silva, Federal University of Maranhão, São Luís, Brazil
    1112. Diego Augusto Santos Silva, Federal University of Santa Catarina, Florianópolis, Brazil
    1113. Mary Simon, India Diabetes Research Foundation, Chennai, India
    1114. Judith Simons, St Vincent's Hospital, Sydney, Australia
    1115. Leon A Simons, University of New South Wales, Sydney, Australia
    1116. Agneta Sjöberg, University of Gothenburg, Gothenburg, Sweden
    1117. Michael Sjöström, Karolinska Institutet, Stockholm, Sweden
    1118. Gry Skodje, Nes Municipality, Aarnes, Norway
    1119. Jolanta Slowikowska-Hilczer, Medical University of Lodz, Lodz, Poland
    1120. Przemyslaw Slusarczyk, International Institute of Molecular and Cell Biology, Warsaw, Poland
    1121. Liam Smeeth, London School of Hygiene & Tropical Medicine, London, United Kingdom
    1122. Hung-Kwan So, University of Hong Kong, Hong Kong, China
    1123. Fernanda Cunha Soares, University of Pernambuco, Recife, Brazil
    1124. Grzegorz Sobek, University of Rzeszów, Rzeszów, Poland
    1125. Eugène Sobngwi, University of Yaoundé 1, Yaoundé, Cameroon
    1126. Morten Sodemann, University of Southern Denmark, Odense, Denmark
    1127. Stefan Söderberg, Umeå University, Umeå, Sweden
    1128. Moesijanti YE Soekatri, Health Polytechnic Jakarta II Institute, Jakarta, Indonesia
    1129. Agustinus Soemantri, Diponegoro University, Semarang, Indonesia
    1130. Reecha Sofat, University College London, London, United Kingdom
    1131. Vincenzo Solfrizzi, University of Bari, Bari, Italy
    1132. Mohammad Hossein Somi, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
    1133. Emily Sonestedt, Lund University, Lund, Sweden
    1134. Yi Song, Peking University, Beijing, China
    1135. Thorkild IA Sørensen, University of Copenhagen, Copenhagen, Denmark
    1136. Elin P Sørgjerd, Norwegian University of Science and Technology, Trondheim, Norway
    1137. Charles Sossa Jérome, Institut Régional de Santé Publique, Ouidah, Benin
    1138. Victoria E Soto-Rojas, Universidad Icesi, Cali, Colombia
    1139. Aïcha Soumaré, University of Bordeaux, Bordeaux, France
    1140. Slavica Sovic, University of Zagreb School of Medicine, Zagreb, Croatia
    1141. Bente Sparboe-Nilsen, Oslo Metropolitan University, Oslo, Norway
    1142. Karen Sparrenberger, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    1143. Angela Spinelli, Istituto Superiore di Sanità, Rome, Italy
    1144. Igor Spiroski, Institute of Public Health, Skopje, North Macedonia
    1145. Jan A Staessen, University of Leuven, Leuven, Belgium
    1146. Hanspeter Stamm, Lamprecht und Stamm Sozialforschung und Beratung AG, Zurich, Switzerland
    1147. Maria G Stathopoulou, Institut National de la Santé et de la Recherche Médicale, Nancy, France
    1148. Kaspar Staub, University of Zurich, Zurich, Switzerland
    1149. Bill Stavreski, Heart Foundation, Melbourne, Australia
    1150. Jostein Steene-Johannessen, Norwegian School of Sport Sciences, Oslo, Norway
    1151. Peter Stehle, Bonn University, Bonn, Germany
    1152. Aryeh D Stein, Emory University, Atlanta, United States
    1153. George S Stergiou, Sotiria Hospital, Sotiria, Greece
    1154. Jochanan Stessman, Hadassah University Medical Center, Jerusalem, Israel
    1155. Ranko Stevanovic, Croatian Institute of Public Health, Zagreb, Croatia
    1156. Jutta Stieber, Helmholtz Zentrum München, Munich, Germany
    1157. Doris Stöckl, Helmholtz Zentrum München, Munich, Germany
    1158. Tanja Stocks, Lund University, Lund, Sweden
    1159. Jakub Stokwiszewski, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
    1160. Ekaterina Stoyanova, Kalina Malina Kindergarten, Pazardjik, Bulgaria
    1161. Gareth Stratton, Swansea University, Swansea, United Kingdom
    1162. Karien Stronks, University of Amsterdam, Amsterdam, Netherlands
    1163. Maria Wany Strufaldi, Federal University of São Paulo, São Paulo, Brazil
    1164. Lela Sturua, National Center for Disease Control and Public Health, Tbilisi, Georgia
    1165. Ramón Suárez-Medina, National Institute of Hygiene, Epidemiology and Microbiology, Havana, Cuba
    1166. Machi Suka, The Jikei University School of Medicine, Tokyo, Japan
    1167. Chien-An Sun, Fu Jen Catholic University, Taipei, Taiwan
    1168. Johan Sundström, Uppsala University, Uppsala, Sweden
    1169. Yn-Tz Sung, The Chinese University of Hong Kong, Hong Kong, China
    1170. Jordi Sunyer, Barcelona Institute for Global Health CIBERESP, Barcelona, Spain
    1171. Paibul Suriyawongpaisal, Mahidol University, Nakhon Pathom, Thailand
    1172. Boyd A Swinburn, University of Auckland, Auckland, New Zealand
    1173. Rody G Sy, University of the Philippines, Manila, Philippines
    1174. Holly E Syddall, University of Southampton, Southampton, United Kingdom
    1175. René Charles Sylva, National Statistical Office, Praia, Cabo Verde
    1176. Moyses Szklo, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
    1177. Lucjan Szponar, National Institute of Public Health – National Institute of Hygiene, Warsaw, Poland
    1178. E Shyong Tai, National University of Singapore, Singapore, Singapore
    1179. Mari-Liis Tammesoo, University of Tartu, Tartu, Estonia
    1180. Abdonas Tamosiunas, Lithuanian University of Health Sciences, Kaunas, Lithuania
    1181. Eng Joo Tan, Deakin University, Sydney, Australia
    1182. Xun Tang, Peking University, Beijing, China
    1183. Maya Tanrygulyyeva, Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
    1184. Frank Tanser, University of Lincoln, Lincoln, United Kingdom
    1185. Yong Tao, Peking University, Beijing, China
    1186. Mohammed Rasoul Tarawneh, Ministry of Health, Amman, Jordan
    1187. Jakob Tarp, Norwegian School of Sport Sciences, Oslo, Norway
    1188. Carolina B Tarqui-Mamani, National Institute of Health, Lima, Peru
    1189. Radka Taxová Braunerová, Institute of Endocrinology, Prague, Czech Republic
    1190. Anne Taylor, University of Adelaide, Adelaide, Australia
    1191. Julie Taylor, University College London, London, United Kingdom
    1192. Félicité Tchibindat, UNICEF, Niamey, Niger
    1193. William R Tebar, Universidade Estadual Paulista, Presidente Prudente, Brazil
    1194. Grethe S Tell, University of Bergen, Bergen, Norway
    1195. Tania Tello, Universidad Peruana Cayetano Heredia, Lima, Peru
    1196. Yih Chung Tham, Singapore Eye Research Institute, Singapore, Singapore
    1197. KR Thankappan, Central University of Kerala, Kasaragod, India
    1198. Holger Theobald, Karolinska Institutet, Huddinge, Sweden
    1199. Xenophon Theodoridis, Aristotle University of Thessaloniki, Thessaloniki, Greece
    1200. Lutgarde Thijs, University of Leuven, Leuven, Belgium
    1201. Nihal Thomas, Christian Medical College, Vellore, India
    1202. Betina H Thuesen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
    1203. Lubica Tichá, Comenius University, Bratislava, Slovakia
    1204. Erik J Timmermans, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
    1205. Anne Tjonneland, Danish Cancer Society Research Center, Copenhagen, Denmark
    1206. Hanna K Tolonen, Finnish Institute for Health and Welfare, Helsinki, Finland
    1207. Janne S Tolstrup, University of Southern Denmark, Copenhagen, Denmark
    1208. Murat Topbas, Karadeniz Technical University, Trabzon, Turkey
    1209. Roman Topór-Madry, Jagiellonian University Medical College, Kraków, Poland
    1210. Liv Elin Torheim, Oslo Metropolitan University, Oslo, Norway
    1211. María José Tormo, Health Service of Murcia, Murcia, Spain
    1212. Michael J Tornaritis, Research and Education Institute of Child Health, Nicosia, Cyprus
    1213. Maties Torrent, Institut d'Investigacio Sanitaria Illes Balears, Menorca, Spain
    1214. Laura Torres-Collado, CIBER en Epidemiología y Salud Pública, Alicante, Spain
    1215. Stefania Toselli, University of Bologna, Bologna, Italy
    1216. Giota Touloumi, National and Kapodistrian University of Athens, Athens, Greece
    1217. Pierre Traissac, French National Research Institute for Sustainable Development, Montpellier, France
    1218. Thi Tuyet-Hanh Tran, Hanoi University of Public Health, Hanoi, Viet Nam
    1219. Dimitrios Trichopoulos, Harvard TH Chan School of Public Health, Boston, United States
    1220. Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece
    1221. Oanh TH Trinh, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
    1222. Atul Trivedi, Government Medical College, Bhavnagar, India
    1223. Lechaba Tshepo, Sefako Makgatho Health Science University, Ga-Rankuwa, South Africa
    1224. Maria Tsigga, International Hellenic University, Thessaloniki, Greece
    1225. Shoichiro Tsugane, National Cancer Center, Tokyo, Japan
    1226. Azaliia M Tuliakova, Ufa Eye Research Institute, Ufa, Russian Federation
    1227. Marshall K Tulloch-Reid, The University of the West Indies, Kingston, Jamaica
    1228. Fikru Tullu, Addis Ababa University, Addis Ababa, Ethiopia
    1229. Tomi-Pekka Tuomainen, University of Eastern Finland, Kuopio, Finland
    1230. Jaakko Tuomilehto, Finnish Institute for Health and Welfare, Helsinki, Finland
    1231. Maria L Turley, Ministry of Health, Wellington, New Zealand
    1232. Gilad Twig, Tel-Aviv University, Tel-Aviv, Israel
    1233. Per Tynelius, Karolinska Institutet, Stockholm, Sweden
    1234. Themistoklis Tzotzas, Hellenic Medical Association for Obesity, Athens, Greece
    1235. Christophe Tzourio, University of Bordeaux, Bordeaux, France
    1236. Peter Ueda, Karolinska Institutet, Stockholm, Sweden
    1237. Eunice Ugel, Universidad Centro-Occidental Lisandro Alvarado, Barquisimeto, Venezuela
    1238. Flora AM Ukoli, Meharry Medical College, Nashville, United States
    1239. Hanno Ulmer, Medical University of Innsbruck, Innsbruck, Austria
    1240. Belgin Unal, Dokuz Eylul University, Izmir, Turkey
    1241. Zhamyila Usupova, Republican Center for Health Promotion, Bishkek, Kyrgyzstan
    1242. Hannu MT Uusitalo, University of Tampere Tays Eye Center, Tampere, Finland
    1243. Nalan Uysal, Sabiha Gokcen Ilkokulu, Ankara, Turkey
    1244. Justina Vaitkeviciute, Lithuanian University of Health Sciences, Kaunas, Lithuania
    1245. Gonzalo Valdivia, Pontificia Universidad Católica de Chile, Santiago, Chile
    1246. Susana Vale, Polytechnic Institute of Porto, Porto, Portugal
    1247. Damaskini Valvi, Icahn School of Medicine at Mount Sinai, New York City, United States
    1248. Rob M van Dam, National University of Singapore, Singapore, Singapore
    1249. Johan Van der Heyden, Sciensano, Brussels, Belgium
    1250. Yvonne T van der Schouw, Utrecht University, Utrecht, Netherlands
    1251. Koen Van Herck, Ghent University, Ghent, Belgium
    1252. Hoang Van Minh, Hanoi University of Public Health, Hanoi, Viet Nam
    1253. Natasja M Van Schoor, VU University Medical Center, Amsterdam, Netherlands
    1254. Irene GM van Valkengoed, University of Amsterdam, Amsterdam, Netherlands
    1255. Dirk Vanderschueren, Katholieke Universiteit Leuven, Leuven, Belgium
    1256. Diego Vanuzzo, Cardiovascular Prevention Centre Udine, Udine, Italy
    1257. Anette Varbo, Copenhagen University Hospital, Copenhagen, Denmark
    1258. Gregorio Varela-Moreiras, Universidad CEU San Pablo, Madrid, Spain
    1259. Patricia Varona-Pérez, National Institute of Hygiene, Epidemiology and Microbiology, Havana, Cuba
    1260. Senthil K Vasan, University of Southampton, Southampton, United Kingdom
    1261. Tomas Vega, Consejería de Sanidad Junta de Castilla y León, Valladolid, Spain
    1262. Toomas Veidebaum, National Institute for Health Development, Tallinn, Estonia
    1263. Gustavo Velasquez-Melendez, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
    1264. Biruta Velika, Centre for Disease Prevention and Control, Riga, Latvia
    1265. Giovanni Veronesi, University of Insubria, Varese, Italy
    1266. WM Monique Verschuren, National Institute for Public Health and the Environment, Bilthoven, Netherlands
    1267. Cesar G Victora, Federal University of Pelotas, Pelotas, Brazil
    1268. Giovanni Viegi, National Research Council, Pisa, Italy
    1269. Lucie Viet, National Institute for Public Health and the Environment, Bilthoven, Netherlands
    1270. Salvador Villalpando, National Institute of Public Health, Cuernavaca, Mexico
    1271. Paolo Vineis, Imperial College London, London, United Kingdom
    1272. Jesus Vioque, University Miguel Hernandez, Alicante, Spain
    1273. Jyrki K Virtanen, University of Eastern Finland, Kuopio, Finland
    1274. Marjolein Visser, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
    1275. Sophie Visvikis-Siest, Institut National de la Santé et de la Recherche Médicale, Nancy, France
    1276. Bharathi Viswanathan, Ministry of Health, Victoria, Seychelles
    1277. Mihaela Vladulescu, Sunflower Nursery School, Craiova, Romania
    1278. Tiina Vlasoff, North Karelia Center for Public Health, Joensuu, Finland
    1279. Dorja Vocanec, University of Zagreb School of Medicine, Zagreb, Croatia
    1280. Peter Vollenweider, Lausanne University Hospital, Lausanne, Switzerland
    1281. Henry Völzke, University Medicine Greifswald, Greifswald, Germany
    1282. Ari Voutilainen, University of Eastern Finland, Kuopio, Finland
    1283. Sari Voutilainen, University of Eastern Finland, Kuopio, Finland
    1284. Martine Vrijheid, Barcelona Institute for Global Health CIBERESP, Barcelona, Spain
    1285. Tanja GM Vrijkotte, University Medical Centers, Groningen, Netherlands
    1286. Alisha N Wade, University of the Witwatersrand, Johannesburg, South Africa
    1287. Aline Wagner, University of Strasbourg, Strasbourg, France
    1288. Thomas Waldhör, Medical University of Vienna, Vienna, Austria
    1289. Janette Walton, Cork Institute of Technology, Cork, Ireland
    1290. Elvis OA Wambiya, African Population and Health Research Center, Nairobi, Kenya
    1291. Wan Mohamad Wan Bebakar, Universiti Sains Malaysia, Kelantan, Malaysia
    1292. Wan Nazaimoon Wan Mohamud, Institute for Medical Research, Kuala Lumpur, Malaysia
    1293. Rildo de Souza Wanderley Júnior, University of Pernambuco, Recife, Brazil
    1294. Ming-Dong Wang, Public Health Agency of Canada, Ottawa, Canada
    1295. Ningli Wang, Capital Medical University Beijing Tongren Hospital, Beijing, China
    1296. Qian Wang, Xinjiang Medical University, Urumqi, China
    1297. Xiangjun Wang, Shanghai Educational Development Co. Ltd., Shanghai, China
    1298. Ya Xing Wang, Capital Medical University, Beijing, China
    1299. Ying-Wei Wang, Ministry of Health and Welfare, Taipei, Taiwan
    1300. S Goya Wannamethee, University College London, London, United Kingdom
    1301. Nicholas Wareham, University of Cambridge, Cambridge, United Kingdom
    1302. Adelheid Weber, Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Vienna, Austria
    1303. Niels Wedderkopp, University of Southern Denmark, Odense, Denmark
    1304. Deepa Weerasekera, Ministry of Health, Auckland, New Zealand
    1305. Daniel Weghuber, Paracelsus Medical University, Salzburg, Austria
    1306. Wenbin Wei, Capital Medical University, Beijing, China
    1307. Aneta Weres, University of Rzeszów, Rzeszów, Poland
    1308. Bo Werner, Örebro University, Örebro, Sweden
    1309. Peter H Whincup, St George's, University of London, London, United Kingdom
    1310. Kurt Widhalm, Medical University of Vienna, Vienna, Austria
    1311. Indah S Widyahening, Universitas Indonesia, Jakarta, Indonesia
    1312. Andrzej Wiecek, Medical University of Silesia, Katowice, Poland
    1313. Rainford J Wilks, The University of the West Indies, Kingston, Jamaica
    1314. Johann Willeit, Medical University of Innsbruck, Innsbruck, Austria
    1315. Peter Willeit, Medical University of Innsbruck, Innsbruck, Austria
    1316. Julianne Williams, World Health Organization Regional Office for Europe, Moscow, Russian Federation
    1317. Tom Wilsgaard, UiT The Arctic University of Norway, Tromsø, Norway
    1318. Bogdan Wojtyniak, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
    1319. Roy A Wong-McClure, Caja Costarricense de Seguro Social, San José, Costa Rica
    1320. Andrew Wong, University College London, London, United Kingdom
    1321. Jyh Eiin Wong, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    1322. Tien Yin Wong, Duke-NUS Medical School, Singapore, Singapore
    1323. Jean Woo, The Chinese University of Hong Kong, Hong Kong, China
    1324. Mark Woodward, University of New South Wales, Sydney, Australia
    1325. Frederick C Wu, University of Manchester, Manchester, United Kingdom
    1326. Jianfeng Wu, Shandong University of Traditional Chinese Medicine, Jinan, China
    1327. Li Juan Wu, Capital Medical University, Beijing, China
    1328. Shouling Wu, Kailuan General Hospital, Tangshan, China
    1329. Haiquan Xu, Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs, Beijing, China
    1330. Liang Xu, Beijing Institute of Ophthalmology, Beijing, China
    1331. Nor Azwany Yaacob, Universiti Sains Malaysia, Kelantan, Malaysia
    1332. Uruwan Yamborisut, Mahidol University, Nakhon Pathom, Thailand
    1333. Weili Yan, Children's Hospital of Fudan University, Shanghai, China
    1334. Ling Yang, University of Oxford, Oxford, United Kingdom
    1335. Xiaoguang Yang, Chinese Center for Disease Control and Prevention, Beijing, China
    1336. Yang Yang, Shanghai Educational Development Co. Ltd, Shanghai, China
    1337. Nazan Yardim, Ministry of Health, Ankara, Turkey
    1338. Mehdi Yaseri, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
    1339. Tabara Yasuharu, Kyoto University, Kyoto, Japan
    1340. Xingwang Ye, University of Chinese Academy of Sciences, Shanghai, China
    1341. Panayiotis K Yiallouros, University of Cyprus, Nicosia, Cyprus
    1342. Moein Yoosefi, Non-Communicable Diseases Research Center, Tehran, Islamic Republic of Iran
    1343. Akihiro Yoshihara, Niigata University, Niigata, Japan
    1344. Qi Sheng You, Capital Medical University, Beijing, China
    1345. San-Lin You, Fu Jen Catholic University, Taipei, Taiwan
    1346. Novie O Younger-Coleman, The University of the West Indies, Kingston, Jamaica
    1347. Safiah Md Yusof, International Medical University, Shah Alam, Malaysia
    1348. Ahmad Faudzi Yusoff, Ministry of Health, Kuala Lumpur, Malaysia
    1349. Luciana Zaccagni, University of Ferrara, Ferrara, Italy
    1350. Vassilis Zafiropulos, Hellenic Mediterranean University, Heraklion, Greece
    1351. Ahmad A Zainuddin, Ministry of Health, Kuala Lumpur, Malaysia
    1352. Seyed Rasoul Zakavi, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
    1353. Farhad Zamani, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
    1354. Sabina Zambon, University of Padua, Padua, Italy
    1355. Antonis Zampelas, Agricultural University of Athens, Athens, Greece
    1356. Hana Zamrazilová, Institute of Endocrinology, Prague, Czech Republic
    1357. Maria Elisa Zapata, Centro de Estudios sobre Nutrición Infantil, Buenos Aires, Argentina
    1358. Abdul Hamid Zargar, Center for Diabetes and Endocrine Care, Srinagar, India
    1359. Ko Ko Zaw, University of Public Health, Yangon, Myanmar
    1360. Tomasz Zdrojewski, Medical University of Gdansk, Gdansk, Poland
    1361. Kristyna Zejglicova, National Institute of Public Health, Prague, Czech Republic
    1362. Tajana Zeljkovic Vrkic, University Hospital Center Zagreb, Zagreb, Croatia
    1363. Yi Zeng, Peking University, Beijing, China
    1364. Luxia Zhang, Peking University First Hospital, Beijing, China
    1365. Zhen-Yu Zhang, University of Leuven, Leuven, Belgium
    1366. Dong Zhao, Capital Medical University Beijing An Zhen Hospital, Beijing, China
    1367. Ming-Hui Zhao, Peking University First Hospital, Beijing, China
    1368. Wenhua Zhao, Chinese Center for Disease Control and Prevention, Beijing, China
    1369. Shiqi Zhen, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
    1370. Wei Zheng, Vanderbilt University, Nashville, United States
    1371. Yingfeng Zheng, Sun Yat-sen University, Guangzhou, China
    1372. Bekbolat Zholdin, West Kazakhstan Medical University, Aktobe, Kazakhstan
    1373. Maigeng Zhou, Chinese Center for Disease Control and Prevention, Beijing, China
    1374. Dan Zhu, Inner Mongolia Medical University, Hohhot, China
    1375. Marie Zins, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
    1376. Emanuel Zitt, Agency for Preventive and Social Medicine, Bregenz, Austria
    1377. Yanina Zocalo, Universidad de la República, Montevideo, Uruguay
    1378. Julio Zuñiga Cisneros, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
    1379. Monika Zuziak, Przedszkole No. 81, Warsaw, Poland
    1380. Majid Ezzati, Imperial College London, London, United Kingdom
    1381. Sarah Filippi, Imperial College London, London, United Kingdom

Funding

Wellcome Trust

  • Majid Ezzati

Medical Research Council

  • Maria LC Iurilli

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Acknowledgements

We thank WHO country and regional offices and World Heart Federation for support in data identification and access. The NCD-RisC database was funded by the Wellcome Trust. Maria LC Iurilli was supported by a Medical Research Council studentship. Sylvain Sebert received funding by the European Commission with grant agreements 633595 and 874739, respectively, for the DynaHEALTH and LongITools projects. The following contributors have deceased: Konrad Jamrozik, Altan Onat, Robespierre Ribeiro, Michael Sjöström, Agustinus Soemantri, Jutta Stieber, and Dimitrios Trichopoulos. The list of authors shows their last affiliation.

Senior Editor

  1. Eduardo Franco, McGill University, Canada

Reviewing Editor

  1. Christine M Friedenreich, University of Calgary, Canada

Reviewer

  1. Simon Capewell

Version history

  1. Received: June 17, 2020
  2. Accepted: January 7, 2021
  3. Version of Record published: March 9, 2021 (version 1)
  4. Version of Record updated: January 7, 2022 (version 2)

Copyright

© 2021, NCD Risk Factor Collaboration (NCD-RisC)

This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.

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  1. NCD Risk Factor Collaboration (NCD-RisC)
(2021)
Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight
eLife 10:e60060.
https://doi.org/10.7554/eLife.60060

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Further reading

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    2. Epidemiology and Global Health

    Status and physiological significance of circulating adiponectin in the very old and centenarians: an observational study

    Takashi Sasaki, Yoshinori Nishimoto ... Yasumichi Arai
    Research Article

    Background: High levels of circulating adiponectin are associated with increased insulin sensitivity, low prevalence of diabetes, and low body mass index (BMI); however, high levels of circulating adiponectin are also associated with increased mortality in the 60-70 age group. In this study, we aimed to clarify factors associated with circulating high-molecular-weight (cHMW) adiponectin levels and their association with mortality in the very old (85-89 years old) and centenarians.

    Methods: The study included 812 (women: 84.4%) for centenarians and 1,498 (women: 51.7%) for the very old. The genomic DNA sequence data were obtained by whole genome sequencing or DNA microarray-imputation methods. LASSO and multivariate regression analyses were used to evaluate cHMW adiponectin characteristics and associated factors. All-cause mortality was analyzed in three quantile groups of cHMW adiponectin levels using Cox regression.

    Results: The cHMW adiponectin levels were increased significantly beyond 100 years of age, were negatively associated with diabetes prevalence, and were associated with SNVs in CDH13 (p = 2.21 × 10-22) and ADIPOQ (p = 5.72 × 10-7). Multivariate regression analysis revealed that genetic variants, BMI, and high-density lipoprotein cholesterol (HDLC) were the main factors associated with cHMW adiponectin levels in the very old, whereas the BMI showed no association in centenarians. The hazard ratios for all-cause mortality in the intermediate and high cHMW adiponectin groups in very old men were significantly higher rather than those for all-cause mortality in the low level cHMW adiponectin group, even after adjustment with BMI. In contrast, the hazard ratios for all-cause mortality were significantly higher for high cHMW adiponectin groups in very old women, but were not significant after adjustment with BMI.

    Conclusions: cHMW adiponectin levels increased with age until centenarians, and the contribution of known major factors associated with cHMW adiponectin levels, including BMI and HDLC, varies with age, suggesting that its physiological significance also varies with age in the oldest old.

    Funding: This study was supported by grants from the Ministry of Health, Welfare, and Labour for the Scientific Research Projects for Longevity; a Grant-in-Aid for Scientific Research (No 21590775, 24590898, 15KT0009, 18H03055, 20K20409, 20K07792, 23H03337) from the Japan Society for the Promotion of Science; Keio University Global Research Institute (KGRI), Kanagawa Institute of Industrial Science and Technology (KISTEC), Japan Science and Technology Agency (JST) Research Complex Program 'Tonomachi Research Complex' Wellbeing Research Campus: Creating new values through technological and social innovation (JP15667051), the Program for an Integrated Database of Clinical and Genomic Information from the Japan Agency for Medical Research and Development (No. 16kk0205009h001, 17jm0210051h0001, 19dk0207045h0001); the medical-welfare-food-agriculture collaborative consortium project from the Japan Ministry of Agriculture, Forestry, and Fisheries; and the Biobank Japan Program from the Ministry of Education, Culture, Sports, and Technology.

    1. Epidemiology and Global Health

    Prediction of diabetic kidney disease risk using machine learning models: A population-based cohort study of Asian adults

    Charumathi Sabanayagam, Feng He ... Ching Yu Cheng
    Research Article Updated

    Background:

    Machine learning (ML) techniques improve disease prediction by identifying the most relevant features in multidimensional data. We compared the accuracy of ML algorithms for predicting incident diabetic kidney disease (DKD).

    Methods:

    We utilized longitudinal data from 1365 Chinese, Malay, and Indian participants aged 40–80 y with diabetes but free of DKD who participated in the baseline and 6-year follow-up visit of the Singapore Epidemiology of Eye Diseases Study (2004–2017). Incident DKD (11.9%) was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 with at least 25% decrease in eGFR at follow-up from baseline. A total of 339 features, including participant characteristics, retinal imaging, and genetic and blood metabolites, were used as predictors. Performances of several ML models were compared to each other and to logistic regression (LR) model based on established features of DKD (age, sex, ethnicity, duration of diabetes, systolic blood pressure, HbA1c, and body mass index) using area under the receiver operating characteristic curve (AUC).

    Results:

    ML model Elastic Net (EN) had the best AUC (95% CI) of 0.851 (0.847–0.856), which was 7.0% relatively higher than by LR 0.795 (0.790–0.801). Sensitivity and specificity of EN were 88.2 and 65.9% vs. 73.0 and 72.8% by LR. The top 15 predictors included age, ethnicity, antidiabetic medication, hypertension, diabetic retinopathy, systolic blood pressure, HbA1c, eGFR, and metabolites related to lipids, lipoproteins, fatty acids, and ketone bodies.

    Conclusions:

    Our results showed that ML, together with feature selection, improves prediction accuracy of DKD risk in an asymptomatic stable population and identifies novel risk factors, including metabolites.

    Funding:

    This study was supported by the National Medical Research Council, NMRC/OFLCG/001/2017 and NMRC/HCSAINV/MOH-001019-00. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

    1. Epidemiology and Global Health

    The importance of patient-partnered research in addressing long COVID: Takeaways for biomedical research study design from the RECOVER Initiative’s Mechanistic Pathways taskforce

    C Kim, Benjamin Chen ... RECOVER Mechanistic Pathways Task Force
    Review Article

    The NIH-funded RECOVER study is collecting clinical data on patients who experience a SARS-CoV-2 infection. As patient representatives of the RECOVER Initiative’s Mechanistic Pathways task force, we offer our perspectives on patient motivations for partnering with researchers to obtain results from mechanistic studies. We emphasize the challenges of balancing urgency with scientific rigor. We recognize the importance of such partnerships in addressing post-acute sequelae of SARS-CoV-2 infection (PASC), which includes ‘long COVID,’ through contrasting objective and subjective narratives. Long COVID’s prevalence served as a call to action for patients like us to become actively involved in efforts to understand our condition. Patient-centered and patient-partnered research informs the balance between urgency and robust mechanistic research. Results from collaborating on protocol design, diverse patient inclusion, and awareness of community concerns establish a new precedent in biomedical research study design. With a public health matter as pressing as the long-term complications that can emerge after SARS-CoV-2 infection, considerate and equitable stakeholder involvement is essential to guiding seminal research. Discussions in the RECOVER Mechanistic Pathways task force gave rise to this commentary as well as other review articles on the current scientific understanding of PASC mechanisms.