Cardiometabolic & kidneyMeta-analysis
Metabolic traits in obesity and normal BMI in industrialised countries: a multi-country analysis of national population-based studies
- Pooled analysis of national population-based health surveys
- multi-country
- trend analysis
Authors' conclusion
In industrialised countries, blood pressure and non-HDL cholesterol in older adults with obesity are increasingly similar to those with normal BMI, with higher use of antihypertensive and lipid-lowering medicines a possible driver of this convergence.
Study context
- Population
- Adults aged 20–79 years from national populations of Japan, South Korea, Taiwan, Thailand, Finland, England and the USA, 1990–2024110 health surveys
- Participants
- 978,425 adults
- Comparison
- Obesity and overweight vs normal BMI
- Outcome
- Mean SBP, non-HDL cholesterol and HDL cholesterol, and proportion using antihypertensive and lipid-lowering medicines
Pooled result
As reported in the abstract
Change over time in difference vs normal BMI (pooled across countries, age groups, obesity and overweight BMI ranges) · 1990–2024
Obesity and overweight vs Normal BMIEstimate
females
change in difference in mean non-HDL cholesterol −0.05 mmol/L per decade(95% CI −0.07 to −0.03)
males
change in difference in mean non-HDL cholesterol −0.07 mmol/L per decade(CI −0.09 to −0.05)
Obesity and overweight vs Normal BMIEstimate
females
change in difference in SBP −0.7 mmHg per decade(95% CI −1.0 to −0.4)
males
change in difference in SBP −0.6 mmHg per decade(CI −0.9 to −0.4)
Obesity and overweight vs Normal BMIIncrease in difference in lipid-lowering medicine use, percentage points per decade (CI)
females
1.5(1.0–2.1)
males
1.6(1.0–2.2)
- Antihypertensive medicines, pooled increase in difference, females (percentage points per decade)
- 0.7 (0.3-1.0)
- Antihypertensive medicines, pooled increase in difference, males (percentage points per decade)
- 2.0 (1.3-2.8)
Further pooled results
Adults younger than 40 years (subgroup)
- Little change in the gap between obesity or overweight and normal BMI; rarely treated for high cholesterol or BP regardless of BMI
Original publication
Metabolic traits in obesity and normal BMI in industrialised countries: a multi-country analysis of national population-based studies. Lancet. Published 1 July 2026. doi:10.1016/s0140-6736(26)00758-0
Summarised from the published abstract; every number is checked against it