Trends in cardiometabolic risk factors according to body mass index in Peru between 2015 and 2023

Global evidence has shown rising trends in the prevalence of cardiometabolic risk factors. Whether the same trends are observed according to body mass index (BMI) cut-offs is unknown, though critical to focus on specific BMI populations.

We conducted a pooled analysis of national health surveys in Peru, grouped into three-year periods (2015-17 [n = 97,079], 2018-20 [n = 98,540], 2021-23 [n = 94,850]). BMI (kg/m²) was classified into four categories: normal weight (18-24.9), overweight (25-29.9), obesity I (30-34.9), and obesity II (≥35). For each period-BMI category, we computed the age-sex-standardized prevalence of cardiometabolic risk factors: raised blood pressure with and without self-reported antihypertensive treatment, self-reported diabetes with and without treatment, daily smoking, alcohol consumption in the last month, and fruits/vegetables consumption in the last week.

The proportion of people with raised blood pressure increased in the overweight and obesity groups, with the largest increase observed in the obesity II group (22 % relative increase). Diabetes prevalence rose substantially among normal weight (89 %) and overweight individuals (58 %). Smoking, alcohol, and fruit/vegetable consumption showed no major changes across BMI categories.

The prevalence of raised blood pressure has increased between 2015 and 17 and 2020-23, with greater increases observed in the overweight and obesity groups; conversely, the prevalence of self-reported diabetes has increased across BMI categories. These findings highlight the need for tailored interventions targeting both overweight/obese individuals and normal weight populations with diabetes risk.