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A record one in five children around the world are overweight or obese, a major review suggests.
In the 'most comprehensive study to date,' researchers in China analyzed more than 2,000 studies involving nearly 46million children and teens from over 150 countries or regions between 2000 and 2023.
Puerto Rico topped the list, with 28 percent of children qualifying as obese. The US territory was closely followed by South Pacific island French Polynesia (22 percent), the Bahamas (21.3 percent), Kuwait (20.5 percent), and Samoa (19.3 percent).
The US, meanwhile, came in with 18.6 percent, making it number seven on the list. In the UK, 7.6 percent of children were obese, putting it in the bottom half of countries.
The data only looked at children who were obese rather than obese or overweight.
A report from researchers in China found that one in five children worldwide are now considered obese
The highest rates of childhood obesity were found in Puerto Rico, French Polynesia, the Bahamas, Kuwait, and Samoa
However, in Vanuatu, a small island off the eastern coast of Australia, just 0.4 percent of kids are obese.It was followed closely by south Asian country Bhutan (0.5 percent), Senegal (0.8 percent).
In terms of regions, Polynesia - which encompasses countries like French Polynesia, Tonga, Somoa, and New Zealand - topped the list, with nearly 20 percent of children qualifying as obese.
The data confirms earlier findings suggesting that Polynesian countries have higher obesity ratings, though other reports looking at overweight children ranked the US significantly lower.
The researchers blamed higher obesity rates on diets filled with ultra-processed food, particularly in the US and territories like Puerto Rico.
'European countries and the US often embrace a diet preference of processed food, which are typically abundant in unhealthy fats, added sugars, and refined carbohydrates,' the team wrote.
'In contrast, diets rich in whole grains and vegetables, which are generally regarded as healthier options, have historically been prioritized in Southeast Asian countries.'
In Japan, for example, just four percent of children qualify as obese.
Sedentary lifestyles, skipping breakfast, and not getting enough exercise were also theories behind higher rates.
Skipping breakfast has been shown to lead to less fullness throughout the day, which can cause overeating.
However, the team also noted that mothers who were obese or smoked during pregnancy were more likely to have overweight children.
In terms of regions, Polynesia - which encompasses countries like French Polynesia, Tonga, Somoa, and New Zealand - topped the list, with nearly 20 percent of children qualifying as obese
The findings come after a report warned that deaths from obesity-related diseases like heart conditions and stroke have risen by 50 percent in the last 20 years.
In the study, the average participant age was 10, and there were nearly equal numbers of boys and girls.
Of all 46million participants, about 4.5million were diagnosed with obesity, or 8.3 percent.
The team found that high-income countries had an average obesity rate of 9.3 percent, while low-income nations came in at 3.6 percent.
They also noted that race played a role, with Hispanic children most likely to be obese and Asian children least likely.
As for countries on the lower end of the spectrum, many of these are low-income nations with less food available.
In many of the countries, such as those in Africa, children are more likely to be active, such as working in agriculture or walking to school and other places.
Limitations of the study included several countries having limited data and differing criteria for defining obesity.
The study was published Monday in JAMA Pediatrics.