Portrait of Dr James Bentham

Dr James Bentham

Lecturer in Statistics

About

James carried out his PhD research at the Department of Mathematics at Imperial College. It involved analysis of free text descriptions of incidents that had occurred in the NHS, using text mining and multivariate statistical methods. His first postdoctoral position was at King’s College, carrying out statistical analysis for a genome-wide association study of lupus. 

He then returned to Imperial, developing Bayesian hierarchical models for the NCD Risk Factor Collaboration. This has led to the publication of estimates of body-mass index, height, blood pressure and diabetes for countries around the world.

James came to Kent in 2017 and continues to develop more sophisticated Bayesian models, as well as returning to genetic analyses and text mining. 

Research interests

Developing Bayesian hierarchical models and applying them to data on risk factors for non-communicable diseases. James is also interested in applying multivariate statistical methods to genetic data, and in developing text mining methods.

Supervision

Please email me if you have any queries

Professional

Member of RSS East Kent Group. 

Publications

Article

  • Vandevijvere, S., Jaacks, L., Monteiro, C., Moubarac, J., Girling‐ButcherM., Lee, A., Pan, A., Bentham, J. and Swinburn, B. (2019). Global trends in ultraprocessed food and drink product sales and their association with adult body mass index trajectories. Obesity Reviews [Online]. Available at: https://doi.org/10.1111/obr.12860.
    This study evaluated global trends in ultraprocessed food and drink (UPFD) volume sales/capita and associations with adult body mass index (BMI) trajectories. Total food/drink volume sales/capita from Euromonitor for 80 countries (2002‐2016) were matched to mean adult BMI from the NCD Risk Factor Collaboration (2002‐2014). Products were classified as UPFD/non‐UPFD according to the NOVA classification system. Mixed models for repeated measures were used to analyse associations between UPFD volume sales/capita and adult BMI trajectories, controlling for confounding factors. The increase in UPF volume sales was highest for South and Southeast Asia (67.3%) and North Africa and the Middle East (57.6%), while for UPD, the increase was highest for South and Southeast Asia (120.0%) and Africa (70.7%). In 2016, baked goods were the biggest contributor to UPF volume sales (13.1%‐44.5%), while carbonated drinks were the biggest contributor to UPD volume sales (40.2%‐86.0%). For every standard deviation increase (51 kg/capita, 2002) in UPD volume sales, mean BMI increased by 0.195 kg/m2 for men (P < .001) and 0.072 kg/m2 for women (P = .003). For every standard deviation (40 kg/capita, 2002) increase in UPF volume sales, mean BMI increased by 0.316 kg/m2 for men (P < .001), while the association was not significant for women. Increases in UPFD volume sales/capita were positively associated with population‐level BMI trajectories.
  • Zhou, B., Bentham, J., Di Cesare, M., Bixby, H., Danaei, G., Hajifathalian, K., Taddei, C., Carrillo-Larco, R., Djalalinia, S., Khatibzadeh, S., Lugero, C., Peykari, N., Zhang, W., Bennett, J., Bilano, V., Stevens, G., Cowan, M., Riley, L., Chen, Z., Hambleton, I., Jackson, R., Kengne, A., Khang, Y., Laxmaiah, A., Liu, J., Malekzadeh, R., Neuhauser, H., Sori?, M., Starc, G., Sundström, J., Woodward, M., Ezzati, M., Abarca-GómezL., Abdeen, Z., Abu-Rmeileh, N., Acosta-Cazares, B., Adams, R., Aekplakorn, W., Afsana, K., Aguilar-Salinas, C., Agyemang, C., Ahmad, N., Ahmadvand, A., Ahrens, W., Ajlouni, K., Akhtaeva, N., Al-Raddadi, R., Ali, M., Ali, O., Alkerwi, A., Aly, E., Amarapurkar, D., Amouyel, P., Amuzu, A., Andersen, L., Anderssen, S., ÄngquistL., Anjana, R., Ansong, D., Aounallah-Skhiri, H., Araújo, J., Ariansen, I., Aris, T., Arlappa, N., Arveiler, D., Aryal, K., Aspelund, T., Assah, F., AssunçãoM., Avdicová, M., Azevedo, A., Azizi, F., Babu, B., Bahijri, S., Balakrishna, N., Bamoshmoosh, M., Banach, M., Bandosz, P., Banegas, J., Barbagallo, C., BarcelóA., Barkat, A., Barros, A., Barros, M., Bata, I., Batieha, A., Batyrbek, A., Baur, L., Beaglehole, R., Romdhane, H., Benet, M., Benson, L., Bernabe-Ortiz, A., Bernotiene, G., Bettiol, H., Bhagyalaxmi, A., Bharadwaj, S., Bhargava, S., Bi, Y., Bikbov, M., Bista, B., Bjerregaard, P., Bjertness, E., Bjertness, M., Björkelund, C., Blokstra, A., Bo, S., Bobak, M., Boeing, H., Boggia, J., Boissonnet, C., Bongard, V., Borchini, R., Bovet, P., Braeckman, L., Brajkovich, I., Branca, F., Breckenkamp, J., Brenner, H., Brewster, L., Bruno, G., Bueno-de-Mesquita, H., Bugge, A., Burns, C., Bursztyn, M., de LeónA., Cacciottolo, J., Cai, H., Cameron, C., Can, G., CândidoA., Capuano, V., Cardoso, V., Carlsson, A., Carvalho, M., Casanueva, F., Casas, J., Caserta, C., Chamukuttan, S., Chan, A., Chan, Q., Chaturvedi, H., Chaturvedi, N., Chen, C., Chen, F., Chen, H., Chen, S., Chen, Z., Cheng, C., Dekkaki, I., Chetrit, A., Chiolero, A., Chiou, S., Chirita-Emandi, A., Chirlaque, M., Cho, B., Cho, Y., Christofaro, D., Chudek, J., Cifkova, R., Cinteza, E., Claessens, F., Clays, E., Concin, H., Cooper, C., Cooper, R., Coppinger, T., Costanzo, S., Cottel, D., Cowell, C., Craig, C., Crujeiras, A., Cruz, J., D’Arrigo, G., d’Orsi, E., Dallongeville, J., Damasceno, A., Danaei, G., Dankner, R., Dantoft, T., Dauchet, L., Davletov, K., De Backer, G., De Bacquer, D., de Gaetano, G., De Henauw, S., de Oliveira, P., De Smedt, D., Deepa, M., Dehghan, A., Delisle, H., Deschamps, V., Dhana, K., Di Castelnuovo, A., Dias-da-Costa, J., Diaz, A., Dickerson, T., Djalalinia, S., Do, H., Donfrancesco, C., Donoso, S., Döring, A., Dorobantu, M., Doua, K., Drygas, W., Dulskiene, V., DžakulaA., Dzerve, V., Dziankowska-Zaborszczyk, E., Eggertsen, R., Ekelund, U., El Ati, J., Elliott, P., Elosua, R., Erasmus, R., Erem, C., Eriksen, L., Eriksson, J., Escobedo-de la PeñaJ., Evans, A., Faeh, D., Fall, C., Farzadfar, F., Felix-Redondo, F., Ferguson, T., Fernandes, R., Fernández-BergésD., Ferrante, D., Ferrari, M., Ferreccio, C., Ferrieres, J., Finn, J., Fischer, K., Föger, B., Foo, L., Forslund, A., Forsner, M., Fouad, H., Francis, D., do Carmo Franco, M., Franco, O., Frontera, G., Fuchs, F., Fuchs, S., Fujita, Y., Furusawa, T., Gaciong, Z., Galvano, F., Garcia-de-la-Hera, M., Gareta, D., Garnett, S., Gaspoz, J., Gasull, M., Gates, L., Geleijnse, J., Ghasemian, A., Ghimire, A., Giampaoli, S., Gianfagna, F., Gill, T., Giovannelli, J., Goldsmith, R., Gonçalves, H., Gonzalez-Gross, M., González-Rivas, J., Gorbea, M., Gottrand, F., Graff-Iversen, S., Grafnetter, D., Grajda, A., Grammatikopoulou, M., Gregor, R., Grodzicki, T., GrøntvedA., Grosso, G., Gruden, G., Grujic, V., Gu, D., Guan, O., Gudmundsson, E., Gudnason, V., Guerrero, R., Guessous, I., Guimaraes, A., Gulliford, M., Gunnlaugsdottir, J., Gunter, M., Gupta, P., Gupta, R., Gureje, O., Gurzkowska, B., Gutierrez, L., Gutzwiller, F., Hadaegh, F., HalkjærJ., Hambleton, I., Hardy, R., Hari Kumar, R., Hata, J., Hayes, A., He, J., He, Y., Elisabeth, M., Henriques, A., Cadena, L., Herrala, S., Heshmat, R., Hihtaniemi, I., Ho, S., Ho, S., Hobbs, M., Hofman, A., Dinc, G., Horimoto, A., Hormiga, C., Horta, B., Houti, L., Howitt, C., Htay, T., Htet, A., Than Htike, M., Hu, Y., Huerta, J., Huisman, M., Husseini, A., Huybrechts, I., Hwalla, N., Iacoviello, L., Iannone, A., Ibrahim, M., Wong, N., Ikeda, N., Ikram, M., Irazola, V., Islam, M., al-Safi Ismail, A., Ivkovic, V., Iwasaki, M., Jackson, R., Jacobs, J., Jaddou, H., Jafar, T., Jamrozik, K., Janszky, I., Jasienska, G., Jelakovi?, A., Jelakovi?, B., Jennings, G., Jeong, S., Jiang, C., Joffres, M., Johansson, M., Jokelainen, J., Jonas, J., JørgensenT., Joshi, P., Jó?wiakJ., Juolevi, A., Jurak, G., JureÅ¡a, V., Kaaks, R., Kafatos, A., Kajantie, E., Kalter-Leibovici, O., Kamaruddin, N., Karki, K., Kasaeian, A., Katz, J., Kauhanen, J., Kaur, P., Kavousi, M., Kazakbaeva, G., Keil, U., Boker, L., Keinänen-KiukaanniemiS., Kelishadi, R., Kemper, H., Kengne, A., Kerimkulova, A., Kersting, M., Key, T., Khader, Y., Khalili, D., Khang, Y., Khateeb, M., Khaw, K., Kiechl-Kohlendorfer, U., Kiechl, S., Killewo, J., Kim, J., Kim, Y., Klumbiene, J., Knoflach, M., Kolle, E., Kolsteren, P., Korrovits, P., Koskinen, S., Kouda, K., Kowlessur, S., Koziel, S., Kriemler, S., Kristensen, P., Krokstad, S., Kromhout, D., Kruger, H., Kubinova, R., Kuciene, R., Kuh, D., Kujala, U., Kulaga, Z., Krishna Kumar, R., Kurjata, P., Kusuma, Y., Kuulasmaa, K., Kyobutungi, C., Laatikainen, T., Lachat, C., Lam, T., Landrove, O., Lanska, V., Lappas, G., Larijani, B., Laugsand, L., Laxmaiah, A., Le Nguyen Bao, K., Le, T., Leclercq, C., Lee, J., Lee, J., LehtimäkiT., León-MuñozL., Levitt, N., Li, Y., Lilly, C., Lim, W., Lima-Costa, M., Lin, H., Lin, X., Lind, L., Linneberg, A., Lissner, L., Litwin, M., Liu, J., Lorbeer, R., Lotufo, P., Lozano, J., Luksiene, D., Lundqvist, A., Lunet, N., Lytsy, P., Ma, G., Ma, J., Machado-Coelho, G., Machi, S., Maggi, S., Magliano, D., Magriplis, E., Majer, M., Makdisse, M., Malekzadeh, R., Malhotra, R., Mallikharjuna Rao, K., Malyutina, S., Manios, Y., Mann, J., Manzato, E., Margozzini, P., Marques-Vidal, P., Marques, L., Marrugat, J., Martorell, R., Mathiesen, E., Matijasevich, A., Matsha, T., Mbanya, J., Mc Donald Posso, A., McFarlane, S., McGarvey, S., McLachlan, S., McLean, R., McLean, S., McNulty, B., Mediene-Benchekor, S., Medzioniene, J., Meirhaeghe, A., Meisinger, C., Menezes, A., Menon, G., Meshram, I., Metspalu, A., Meyer, H., Mi, J., Mikkel, K., Miller, J., Minderico, C., Francisco, J., Miranda, J., Mirrakhimov, E., MiÅ¡igoj-Durakovic, M., Modesti, P., Mohamed, M., Mohammad, K., Mohammadifard, N., Mohan, V., Mohanna, S., Mohd Yusoff, M., MøllehaveL., MøllerN., Molnár, D., Momenan, A., Mondo, C., Monyeki, K., Moon, J., Moreira, L., Morejon, A., Moreno, L., Morgan, K., Moschonis, G., Mossakowska, M., Mostafa, A., Mota, J., Esmaeel Motlagh, M., Motta, J., Msyamboza, K., Mu, T., Muiesan, M., Müller-NurasyidM., Murphy, N., Mursu, J., Musil, V., Nabipour, I., Nagel, G., Naidu, B., Nakamura, H., NámeÅ¡ná, J., Nang, E., Nangia, V., Narake, S., Nauck, M., Navarrete-MuñozE., Ndiaye, N., Neal, W., Nenko, I., Neovius, M., Nervi, F., Neuhauser, H., Nguyen, C., Nguyen, N., Nguyen, Q., Nguyen, Q., Nieto-MartínezR., Niiranen, T., Ning, G., Ninomiya, T., Nishtar, S., Noale, M., Noboa, O., Noorbala, A., Norat, T., Noto, D., Al Nsour, M., O’Reilly, D., Oda, E., Oehlers, G., Oh, K., Ohara, K., Olinto, M., Oliveira, I., Omar, M., Onat, A., Ong, S., Ono, L., Ordunez, P., Ornelas, R., Osmond, C., Ostojic, S., Ostovar, A., Otero, J., Overvad, K., Owusu-Dabo, E., Paccaud, F., Padez, C., Pahomova, E., Pajak, A., Palli, D., Palmieri, L., Pan, W., Panda-Jonas, S., Panza, F., Papandreou, D., Park, S., Parnell, W., Parsaeian, M., Patel, N., Pecin, I., Pednekar, M., Peer, N., Peeters, P., Peixoto, S., Peltonen, M., Pereira, A., Peters, A., Petersmann, A., Petkeviciene, J., Peykari, N., Pham, S., Pigeot, I., Pikhart, H., Pilav, A., Pilotto, L., Pitakaka, F., Piwonska, A., Plans-RubióP., PolaÅ¡ek, O., Porta, M., Portegies, M., Pourshams, A., Poustchi, H., Pradeepa, R., Prashant, M., Price, J., Puder, J., Puiu, M., Punab, M., Qasrawi, R., Qorbani, M., Bao, T., Radic, I., Radisauskas, R., Rahman, M., Raitakari, O., Raj, M., Ramachandra Rao, S., Ramachandran, A., Ramos, E., Rampal, L., Rampal, S., Rangel Reina, D., Redon, J., Reganit, P., Ribeiro, R., Riboli, E., Rigo, F., Rinke de Wit, T., Ritti-Dias, R., Robinson, S., Robitaille, C., Rodríguez-ArtalejoF., del Cristo Rodriguez-Perez, M., Rodríguez-VillamizarL., Rojas-Martinez, R., Romaguera, D., Ronkainen, K., Rosengren, A., Roy, J., Rubinstein, A., Sandra Ruiz-Betancourt, B., Rutkowski, M., Sabanayagam, C., Sachdev, H., Saidi, O., Sakarya, S., Salanave, B., Salazar Martinez, E., SalmerónD., Salomaa, V., Salonen, J., Salvetti, M., Sánchez-Abanto, J., Sans, S., Santos, D., Santos, I., Nunes dos Santos, R., Santos, R., Saramies, J., Sardinha, L., Sarganas, G., Sarrafzadegan, N., Saum, K., Savva, S., Scazufca, M., Schargrodsky, H., Schipf, S., Schmidt, C., Schöttker, B., Schultsz, C., Schutte, A., Sein, A., Sen, A., Senbanjo, I., Sepanlou, S., Sharma, S., Shaw, J., Shibuya, K., Shin, D., Shin, Y., Si-Ramlee, K., Siantar, R., Sibai, A., Santos Silva, D., Simon, M., Simons, J., Simons, L., Sjöström, M., Skovbjerg, S., Slowikowska-Hilczer, J., Slusarczyk, P., Smeeth, L., Smith, M., Snijder, M., So, H., Sobngwi, E., Söderberg, S., Solfrizzi, V., Sonestedt, E., Song, Y., SørensenT., Soric, M., JéromeC., Soumare, A., Staessen, J., Starc, G., Stathopoulou, M., Stavreski, B., Steene-Johannessen, J., Stehle, P., Stein, A., Stergiou, G., Stessman, J., Stieber, J., Stöckl, D., Stocks, T., Stokwiszewski, J., Stronks, K., Strufaldi, M., Sun, C., Sundström, J., Sung, Y., Suriyawongpaisal, P., Sy, R., Shyong Tai, E., Tammesoo, M., Tamosiunas, A., Tan, E., Tang, X., Tanser, F., Tao, Y., Tarawneh, M., Tarqui-Mamani, C., Tautu, O., Taylor, A., Theobald, H., Theodoridis, X., Thijs, L., Thuesen, B., Tjonneland, A., Tolonen, H., Tolstrup, J., Topbas, M., Topór-MadryR., Tormo, M., Torrent, M., Traissac, P., Trichopoulos, D., Trichopoulou, A., Trinh, O., Trivedi, A., Tshepo, L., Tulloch-Reid, M., Tullu, F., Tuomainen, T., Tuomilehto, J., Turley, M., Tynelius, P., Tzourio, C., Ueda, P., Ugel, E., Ulmer, H., Uusitalo, H., Valdivia, G., Valvi, D., van der Schouw, Y., Van Herck, K., Van Minh, H., van Rossem, L., Van Schoor, N., van Valkengoed, I., Vanderschueren, D., Vanuzzo, D., Vatten, L., Vega, T., Velasquez-Melendez, G., Veronesi, G., Monique Verschuren, W., Verstraeten, R., Victora, C., Viet, L., Viikari-Juntura, E., Vineis, P., Vioque, J., Virtanen, J., Visvikis-Siest, S., Viswanathan, B., Vlasoff, T., Vollenweider, P., Voutilainen, S., Wade, A., Wagner, A., Walton, J., Wan Bebakar, W., Wan Mohamud, W., Wanderley, R., Wang, M., Wang, Q., Wang, Y., Wang, Y., Wannamethee, S., Wareham, N., Wedderkopp, N., Weerasekera, D., Whincup, P., Widhalm, K., Widyahening, I., Wiecek, A., Wijga, A., Wilks, R., Willeit, J., Willeit, P., Williams, E., Wilsgaard, T., Wojtyniak, B., Wong-McClure, R., Wong, J., Wong, T., Woo, J., Woodward, M., Giwercman Wu, A., Wu, F., Wu, S., Xu, H., Yan, W., Yang, X., Ye, X., Yiallouros, P., Yoshihara, A., Younger-Coleman, N., Yusoff, A., Zainuddin, A., Zambon, S., Zampelas, A., Zdrojewski, T., Zeng, Y., Zhao, D., Zhao, W., Zheng, W., Zheng, Y., Zhu, D., Zhussupov, B., Zimmermann, E. and Cisneros, J. (2018). Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants. International Journal of Epidemiology [Online]. Available at: https://doi.org/10.1093/ije/dyy016.
    Background
    Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure.

    Methods
    We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29?years to 70–79?years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure.

    Results
    In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association.

    Conclusions
    Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.
  • Ezzati, M., Di Cesare, M. and Bentham, J. (2018). Determining the worldwide prevalence of obesity – Authors’ reply. The Lancet [Online] 391:1774. Available at: https://doi.org/10.1016/S0140-6736(18)30781-5.
  • Pearson-Stuttard, J., Zhou, B., Kontis, V., Bentham, J., Gunter, M. and Ezzati, M. (2018). Worldwide burden of cancer attributable to diabetes and high body-mass index : a comparative risk assessment. Lancet Diabetes and Endocrinology [Online] 6:e6-e15. Available at: https://doi.org/10.1016/S2213-8587(18)30150-5.
    Background
    Diabetes and high body-mass index (BMI) are associated with increased risk of several cancers, and are increasing in prevalence in most countries. We estimated the cancer incidence attributable to diabetes and high BMI as individual risk factors and in combination, by country and sex.

    Methods
    We estimated population attributable fractions for 12 cancers by age and sex for 175 countries in 2012. We defined high BMI as a BMI greater than or equal to 25 kg/m2. We used comprehensive prevalence estimates of diabetes and BMI categories in 2002, assuming a 10-year lag between exposure to diabetes or high BMI and incidence of cancer, combined with relative risks from published estimates, to quantify contribution of diabetes and high BMI to site-specific cancers, individually and combined as independent risk factors and in a conservative scenario in which we assumed full overlap of risk of diabetes and high BMI. We then used GLOBOCAN cancer incidence data to estimate the number of cancer cases attributable to the two risk factors. We also estimated the number of cancer cases in 2012 that were attributable to increases in the prevalence of diabetes and high BMI from 1980 to 2002. All analyses were done at individual country level and grouped by region for reporting.

    Findings
    We estimated that 5·7% of all incident cancers in 2012 were attributable to the combined effects of diabetes and high BMI as independent risk factors, corresponding to 804?100 new cases. 187?600 (24·5%) of 766?000 cases of liver cancer and 121?700 (38·4%) of 317?000 cases of endometrial cancer were attributable to these risk factors. In the conservative scenario, about 4·5% (629?000 new cases) of all incident cancers assessed were attributable to diabetes and high BMI combined. Individually, high BMI (544?300 cases) was responsible for almost twice as many cancer cases as diabetes (293?300 cases). 25·8% of diabetes-related cancers (equating to 75?600 new cases) and 31·9% of high BMI-related cancers (174?040 new cases) were attributable to increases in the prevalence of these risk factors from 1980 to 2002.

    Interpretation
    A substantial number of cancer cases are attributable to diabetes and high BMI. As the prevalence of these cancer risk factors increases, clinical and public health efforts should focus on identifying optimal preventive and screening measures for whole populations and individual patients.
  • Ueda, P., Woodward, M., Lu, Y., Hajifathalian, K., Al-Wotayan, R., Aguilar-Salinas, C., Ahmadvand, A., Azizi, F., Bentham, J., Cifkova, R., Cesare, M., Eriksen, L., Farzadfar, F., Ferguson, T., Ikeda, N., Khalili, D., Khang, Y., Lanska, V., Leon-Munoz, L., Magliano, D., Margozzini, P., Msyamboza, K., Mutungi, G., Oh, K., Oum, S., Rodriguez-Artalejo, F., Rojas-Martinez, R., Valdivia, G., Wilks, R., Shaw, J., Stevens, G., Tolstrup, J., Zhou, B., Salomon, J., Ezzati, M. and Danaei, G. (2017). Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries: a pooled analysis of prospective cohorts and health surveys. Lancet Diabetes and Endocrinology [Online] 5:196-213. Available at: http://dx.doi.org/10.1016/S2213-8587(17)30015-3.
  • Kengne, A., Bentham, J., Zhou, B., Peer, N., Matsha, T., Bixby, H., Cesare, M., Hajifathalian, K., Lu, Y., Taddei, C., Bovet, P., Kyobutungi, C., Agyemang, C., Aounallah-Skhiri, H., Assah, F., Barkat, A., Romdhane, H., Chan, Q., Chaturvedi, N., Damasceno, A., Delisle, H., Delpeuch, F., Doua, K., Egbagbe, E., Ati, J., Elliott, P., Engle-Stone, R., Erasmus, R., Fouad, H., Gareta, D., Gureje, O., Hendriks, M., Houti, L., Ibrahim, M., Kemper, H., Killewo, J., Kowlessur, S., Kruger, H., Laamiri, F., Laid, Y., Levitt, N., Lunet, N., Magliano, D., Maire, B., Prevel-Martin, Y., Mediene-Benchekor, S., Mohamed, M., Mondo, C., Monyeki, K., Mostafa, A., Nankap, M., Owusu-Dabo, E., Rinke de Wit, T., Saidi, O., Schultsz, C., Scutte, A., Senbanjo, I., Shaw, J., Smeeth, L., Sobngwi, E., Jerome, C., Stronks, K., Tanser, F., Tchibindat, F., Traissac, P., Tshepo, L., Tullu, F., Ukoli, F., Viswanathan, B., Wade, A., Danaei, G., Stevens, G., Riley, L., Ezzati, M. and Mbanya, J. (2017). Trends in obesity and diabetes across regions in Africa from 1980 to 2014: an analysis of pooled population-based studies. International Journal of Epidemiology [Online] 46:1421-1432. Available at: https://doi.org/10.1093/ije/dyx078.
    Background
    The 2016 Dar Es Salaam Call to Action on Diabetes and Other non-communicable diseases (NCDs) advocates national multi-sectoral NCD strategies and action plans based on available data and information from countries of sub-Saharan Africa and beyond. We estimated trends from 1980 to 2014 in age-standardized mean body mass index (BMI) and diabetes prevalence in these countries, in order to assess the co-progression and assist policy formulation.
    Methods
    We pooled data from African and worldwide population-based studies which measured height, weight and biomarkers to assess diabetes status in adults aged???18 years. A Bayesian hierarchical model was used to estimate trends by sex for 200 countries and territories including 53 countries across five African regions (central, eastern, northern, southern and western), in mean BMI and diabetes prevalence (defined as either fasting plasma glucose of ? 7.0?mmol/l, history of diabetes diagnosis, or use of insulin or oral glucose control agents).
    Results
    African data came from 245 population-based surveys (1.2 million participants) for BMI and 76 surveys (182?000 participants) for diabetes prevalence estimates. Countries with the highest number of data sources for BMI were South Africa (n?=?17), Nigeria (n?=?15) and Egypt (n?=?13); and for diabetes estimates, Tanzania (n?=?8), Tunisia (n?=?7), and Cameroon, Egypt and South Africa (all n?=?6). The age-standardized mean BMI increased from 21.0?kg/m2 (95% credible interval: 20.3–21.7) to 23.0?kg/m2 (22.7–23.3) in men, and from 21.9?kg/m2 (21.3–22.5) to 24.9?kg/m2 (24.6–25.1) in women. The age-standardized prevalence of diabetes increased from 3.4% (1.5–6.3) to 8.5% (6.5–10.8) in men, and from 4.1% (2.0–7.5) to 8.9% (6.9–11.2) in women. Estimates in northern and southern regions were mostly higher than the global average; those in central, eastern and western regions were lower than global averages. A positive association (correlation coefficient ? 0.9) was observed between mean BMI and diabetes prevalence in both sexes in 1980 and 2014.
    Conclusions
    These estimates, based on limited data sources, confirm the rapidly increasing burden of diabetes in Africa. This rise is being driven, at least in part, by increasing adiposity, with regional variations in observed trends. African countries’ efforts to prevent and control diabetes and obesity should integrate the setting up of reliable monitoring systems, consistent with the World Health Organization’s Global Monitoring System Framework.
  • Bentham, J. and NCD Risk Factor Collaboration (NCD-RisC), (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet [Online] 390:16-22. Available at: http://doi.org/10.1016/s0140-6736(17)32129-3.
    Background
    Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health
    consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI)
    and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to
    compare trends with those of adults.
    Methods
    We pooled 2416 population-based studies with measurements of height and weight on 128·9 million
    participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to
    estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories
    for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for
    children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below
    the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to
    2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).
    Findings
    Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change
    (–0·01 kg/m² per decade; 95% credible interval –0·42 to 0·39, posterior probability [PP] of the observed decrease being
    a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m² per decade (0·69–1·35, PP>0·9999) in central
    Latin America and an increase of 0·95 kg/m² per decade (0·64–1·25, PP>0·9999) in Polynesia and Micronesia. The
    range for boys was from a non-significant increase of 0·09 kg/m² per decade (–0·33 to 0·49, PP=0·6926) in eastern
    Europe to an increase of 0·77 kg/m² per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean
    BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions
    for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in
    BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised
    prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9%
    (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased
    from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4%
    (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6)
    among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook
    Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of
    obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the
    Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately
    or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese.
    Interpretation
    The rising trends in children’s and adolescents’ BMI have plateaued in many high-income countries,
    albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.
  • Pearson-Stuttard, J., Zhou, B., Kontis, V., Bentham, J., Gunter, M. and Ezzati, M. (2017). The global burden of cancer attributable to diabetes and high body mass index: a comparative risk assessment. The Lancet Diabetes & Endocrinology [Online] 6:95-104. Available at: https://doi.org/10.1016/S2213-8587(17)30366-2.
    Background
    Diabetes and high body-mass index (BMI) are associated with increased risk of several cancers, and are
    increasing in prevalence in most countries. We estimated the cancer incidence attributable to diabetes and high BMI
    as individual risk factors and in combination, by country and sex.
    Methods
    We estimated population attributable fractions for 12 cancers by age and sex for 175 countries in 2012. We
    defined high BMI as a BMI greater than or equal to 25 kg/m². We used comprehensive prevalence estimates of
    diabetes and BMI categories in 2002, assuming a 10-year lag between exposure to diabetes or high BMI and incidence
    of cancer, combined with relative risks from published estimates, to quantify contribution of diabetes and high BMI
    to site-specific cancers, individually and combined as independent risk factors and in a conservative scenario in which
    we assumed full overlap of risk of diabetes and high BMI. We then used GLOBOCAN cancer incidence data to
    estimate the number of cancer cases attributable to the two risk factors. We also estimated the number of cancer cases
    in 2012 that were attributable to increases in the prevalence of diabetes and high BMI from 1980 to 2002. All analyses
    were done at individual country level and grouped by region for reporting.
    Findings
    We estimated that 5·6% of all incident cancers in 2012 were attributable to the combined effects of diabetes
    and high BMI as independent risk factors, corresponding to 792600 new cases. 187600 (24·5%) of 766000 cases of
    liver cancer and 121700 (38·4%) of 317000 cases of endometrial cancer were attributable to these risk factors. In the
    conservative scenario, about 4·5% (626 900 new cases) of all incident cancers assessed were attributable to diabetes
    and high BMI combined. Individually, high BMI (544300 cases) was responsible for twice as many cancer cases as
    diabetes (280 100 cases). 26·1% of diabetes-related cancers (equating to 77000 new cases) and 31·9% of high BMIrelated
    cancers (174 040 new cases) were attributable to increases in the prevalence of these risk factors from
    1980 to 2002.
    Interpretation
    A substantial number of cancer cases are attributable to diabetes and high BMI. As the prevalence of
    these cancer risk factors increases, clinical and public health efforts should focus on identifying optimal preventive
    and screening measures for whole populations and individual patients.
  • Bentham, J. and NCD Risk Factor Collaboration (NCD-RisC), (2016). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet [Online] 387:1513-1530. Available at: https://doi.org/10.1016/S0140-6736(16)00618-8.
    Background
    One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.

    Methods
    We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.

    Findings
    We used data from 751 studies including 4?372?000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.

    Interpretation
    Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries.
  • Morris, D., Sheng, Y., Zhang, Y., Wang, Y., Zhu, Z., Tombleson, P., Chen, L., Graham, D., Bentham, J., Roberts, A., Chen, R., Zuo, X., Wang, T., Wen, L., Yang, C., Liu, L., Yang, L., Li, F., Huang, Y., Yin, X., Yang, S., Ronnblom, L., Furnrohr, B., Voll, R., Schett, G., Costedoat-Chalumeau, N., Gaffney, P., Lau, Y., Zhang, X., Yang, W., Cui, Y. and Vyse, T. (2016). Genome-wide association meta-analysis in Chinese and European individuals identifies ten new loci associated with systemic lupus erythematosus. Nature Genetics [Online] 48:940-946. Available at: http://dx.doi.org/10.1038/ng.3603.
    Systemic lupus erythematosus (SLE; OMIM 152700) is a genetically complex autoimmune disease. Genome-wide association studies (GWASs) have identified more than 50 loci as robustly associated with the disease in single ancestries, but genome-wide transancestral studies have not been conducted. We combined three GWAS data sets from Chinese (1,659 cases and 3,398 controls) and European (4,036 cases and 6,959 controls) populations. A meta-analysis of these studies showed that over half of the published SLE genetic associations are present in both populations. A replication study in Chinese (3,043 cases and 5,074 controls) and European (2,643 cases and 9,032 controls) subjects found ten previously unreported SLE loci. Our study provides further evidence that the majority of genetic risk polymorphisms for SLE are contained within the same regions across both populations. Furthermore, a comparison of risk allele frequencies and genetic risk scores suggested that the increased prevalence of SLE in non-Europeans (including Asians) has a genetic basis.
  • Zhou, B., Bentham, J., Di Cesare, M., Bixby, H., Danaei, G., Cowan, M., Paciorek, C., Singh, G., Hajifathalian, K., Bennett, J., Taddei, C., Bilano, V., Carrillo-Larco, R., Djalalinia, S., Khatibzadeh, S., Lugero, C., Peykari, N., Zhang, W., Lu, Y., Stevens, G., Riley, L., Bovet, P., Elliott, P., Gu, D., Ikeda, N., Jackson, R., Joffres, M., Kengne, A., Laatikainen, T., Lam, T., Laxmaiah, A., Liu, J., Miranda, J., Mondo, C., Neuhauser, H., Sundström, J., Smeeth, L., Soric, M., Woodward, M., Ezzati, M., Abarca-GómezL., Abdeen, Z., Rahim, H., Abu-Rmeileh, N., Acosta-Cazares, B., Adams, R., Aekplakorn, W., Afsana, K., Aguilar-Salinas, C., Agyemang, C., Ahmadvand, A., Ahrens, W., Al Raddadi, R., Al Woyatan, R., Ali, M., Alkerwi, A., Aly, E., Amouyel, P., Amuzu, A., Andersen, L., Anderssen, S., ÄngquistL., Anjana, R., Ansong, D., Aounallah-Skhiri, H., Araújo, J., Ariansen, I., Aris, T., Arlappa, N., Aryal, K., Arveiler, D., Assah, F., AssunçãoM., Avdicová, M., Azevedo, A., Azizi, F., Babu, B., Bahijri, S., Balakrishna, N., Bandosz, P., Banegas, J., Barbagallo, C., BarcelóA., Barkat, A., Barros, A., Barros, M., Bata, I., Batieha, A., Baur, L., Beaglehole, R., Romdhane, H., Benet, M., Benson, L., Bernabe-Ortiz, A., Bernotiene, G., Bettiol, H., Bhagyalaxmi, A., Bharadwaj, S., Bhargava, S., Bi, Y., Bikbov, M., Bjerregaard, P., Bjertness, E., Björkelund, C., Blokstra, A., Bo, S., Bobak, M., Boeing, H., Boggia, J., Boissonnet, C., Bongard, V., Braeckman, L., Brajkovich, I., Branca, F., Breckenkamp, J., Brenner, H., Brewster, L., Bruno, G., Bueno-de-Mesquita, H., Bugge, A., Burns, C., Bursztyn, M., de LeónA., Cacciottolo, J., Cameron, C., Can, G., CândidoA., Capuano, V., Cardoso, V., Carlsson, A., Carvalho, M., Casanueva, F., Casas, J., Caserta, C., Chamukuttan, S., Chan, A., Chan, Q., Chaturvedi, H., Chaturvedi, N., Chen, C., Chen, F., Chen, H., Chen, S., Chen, Z., Cheng, C., Dekkaki, I., Chetrit, A., Chiolero, A., Chiou, S., Chirita-Emandi, A., Cho, B., Cho, Y., Chudek, J., Cifkova, R., Claessens, F., Clays, E., Concin, H., Cooper, C., Cooper, R., Coppinger, T., Costanzo, S., Cottel, D., Cowell, C., Craig, C., Crujeiras, A., Cruz, J., D’Arrigo, G., d’Orsi, E., Dallongeville, J., Damasceno, A., Dankner, R., Dantoft, T., Dauchet, L., De Backer, G., De Bacquer, D., de Gaetano, G., De Henauw, S., De Smedt, D., Deepa, M., Dehghan, A., Delisle, H., Deschamps, V., Dhana, K., Di Castelnuovo, A., Dias-da-Costa, J., Diaz, A., Dickerson, T., Do, H., Dobson, A., Donfrancesco, C., Donoso, S., Döring, A., Doua, K., Drygas, W., Dulskiene, V., DžakulaA., Dzerve, V., Dziankowska-Zaborszczyk, E., Eggertsen, R., Ekelund, U., El Ati, J., Ellert, U., Elliott, P., Elosua, R., Erasmus, R., Erem, C., Eriksen, L., de la PeñaJ., Evans, A., Faeh, D., Fall, C., Farzadfar, F., Felix-Redondo, F., Ferguson, T., Fernández-BergésD., Ferrante, D., Ferrari, M., Ferreccio, C., Ferrieres, J., Finn, J., Fischer, K., Föger, B., Foo, L., Forslund, A., Forsner, M., Fortmann, S., Fouad, H., Francis, D., Franco, M., Franco, O., Frontera, G., Fuchs, F., Fuchs, S., Fujita, Y., Furusawa, T., Gaciong, Z., Gareta, D., Garnett, S., Gaspoz, J., Gasull, M., Gates, L., Gavrila, D., Geleijnse, J., Ghasemian, A., Ghimire, A., Giampaoli, S., Gianfagna, F., Giovannelli, J., Goldsmith, R., Gonçalves, H., Gross, M., Rivas, J., Gottrand, F., Graff-Iversen, S., Grafnetter, D., Grajda, A., Gregor, R., Grodzicki, T., GrøntvedA., Gruden, G., Grujic, V., Gu, D., Guan, O., Gudnason, V., Guerrero, R., Guessous, I., Guimaraes, A., Gulliford, M., Gunnlaugsdottir, J., Gunter, M., Gupta, P., Gureje, O., Gurzkowska, B., Gutierrez, L., Gutzwiller, F., Hadaegh, F., HalkjærJ., Hambleton, I., Hardy, R., Harikumar, R., Hata, J., Hayes, A., He, J., Hendriks, M., Henriques, A., Cadena, L., Herrala, S., Heshmat, R., Hihtaniemi, I., Ho, S., Ho, S., Hobbs, M., Hofman, A., Dinc, G., Hormiga, C., Horta, B., Houti, L., Howitt, C., Htay, T., Htet, A., Hu, Y., Huerta, J., Husseini, A., Huybrechts, I., Hwalla, N., Iacoviello, L., Iannone, A., Ibrahim, M., Ikram, M., Irazola, V., Islam, M., Ivkovic, V., Iwasaki, M., Jackson, R., Jacobs, J., Jafar, T., Jamrozik, K., Janszky, I., Jasienska, G., Jelakovic, B., Jiang, C., Joffres, M., Johansson, M., Jonas, J., JørgensenT., Joshi, P., Juolevi, A., Jurak, G., JureÅ¡a, V., Kaaks, R., Kafatos, A., Kalter-Leibovici, O., Kamaruddin, N., Kasaeian, A., Katz, J., Kauhanen, J., Kaur, P., Kavousi, M., Kazakbaeva, G., Keil, U., Boker, L., Keinänen-KiukaanniemiS., Kelishadi, R., Kemper, H., Kengne, A., Kersting, M., Key, T., Khader, Y., Khalili, D., Khang, Y., Khaw, K., Kiechl, S., Killewo, J., Kim, J., Klumbiene, J., Kolle, E., Kolsteren, P., Korrovits, P., Koskinen, S., Kouda, K., Koziel, S., Kristensen, P., Krokstad, S., Kromhout, D., Kruger, H., Kubinova, R., Kuciene, R., Kuh, D., Kujala, U., Kula, K., Kulaga, Z., Kumar, R., Kurjata, P., Kusuma, Y., Kuulasmaa, K., Kyobutungi, C., Laatikainen, T., Lachat, C., Lam, T., Landrove, O., Lanska, V., Lappas, G., Larijani, B., Laugsand, L., Laxmaiah, A., Bao, K., Le, T., Leclercq, C., Lee, J., Lee, J., LehtimäkiT., Lekhraj, R., León-MuñozL., Levitt, N., Li, Y., Lilly, C., Lim, W., Lima-Costa, M., Lin, H., Lin, X., Linneberg, A., Lissner, L., Litwin, M., Lorbeer, R., Lotufo, P., Lozano, J., Luksiene, D., Lundqvist, A., Lunet, N., Lytsy, P., Ma, G., Ma, J., Machado-Coelho, G., Machi, S., Maggi, S., Magliano, D., Majer, M., Makdisse, M., Malekzadeh, R., Malhotra, R., Rao, K., Malyutina, S., Manios, Y., Mann, J., Manzato, E., Margozzini, P., Marques-Vidal, P., Marrugat, J., Martorell, R., Mathiesen, E., Matijasevich, A., Matsha, T., Mbanya, J., Posso, A., McFarlane, S., McGarvey, S., McLachlan, S., McLean, R., McNulty, B., Khir, A., Mediene-Benchekor, S., Medzioniene, J., Meirhaeghe, A., Meisinger, C., Menezes, A., Menon, G., Meshram, I., Metspalu, A., Mi, J., Mikkel, K., Miller, J., Miquel, J., MiÅ¡igoj-Durakovic, M., Mohamed, M., Mohammad, K., Mohammadifard, N., Mohan, V., Yusoff, M., MøllerN., Molnár, D., Momenan, A., Mondo, C., Monyeki, K., Moreira, L., Morejon, A., Moreno, L., Morgan, K., Moschonis, G., Mossakowska, M., Mostafa, A., Mota, J., Motlagh, M., Motta, J., Muiesan, M., Müller-NurasyidM., Murphy, N., Mursu, J., Musil, V., Nagel, G., Naidu, B., Nakamura, H., NámeÅ¡ná, J., Nang, E., Nangia, V., Narake, S., Navarrete-MuñozE., Ndiaye, N., Neal, W., Nenko, I., Nervi, F., Nguyen, N., Nguyen, Q., Nieto-MartínezR., Niiranen, T., Ning, G., Ninomiya, T., Nishtar, S., Noale, M., Noboa, O., Noorbala, A., Noorbala, T., Noto, D., Al Nsour, M., O’Reilly, D., Oh, K., Olinto, M., Oliveira, I., Omar, M., Onat, A., Ordunez, P., Osmond, C., Ostojic, S., Otero, J., Overvad, K., Owusu-Dabo, E., Paccaud, F., Padez, C., Pahomova, E., Pajak, A., Palli, D., Palmieri, L., Panda-Jonas, S., Panza, F., Papandreou, D., Parnell, W., Parsaeian, M., Pecin, I., Pednekar, M., Peer, N., Peeters, P., Peixoto, S., Pelletier, C., Peltonen, M., Pereira, A., PérezR., Peters, A., Petkeviciene, J., Pham, S., Pigeot, I., Pikhart, H., Pilav, A., Pilotto, L., Pitakaka, F., Plans-RubióP., Polakowska, M., PolaÅ¡ek, O., Porta, M., Portegies, M., Pourshams, A., Pradeepa, R., Prashant, M., Price, J., Puiu, M., Punab, M., Qasrawi, R., Qorbani, M., Radic, I., Radisauskas, R., Rahman, M., Raitakari, O., Raj, M., Rao, S., Ramachandran, A., Ramos, E., Rampal, S., Reina, D., Rasmussen, F., Redon, J., Reganit, P., Ribeiro, R., Riboli, E., Rigo, F., de Wit, T., Ritti-Dias, R., Robinson, S., Robitaille, C., Rodríguez-ArtalejoF., Rodriguez-Perez del Cristo, M., Rodríguez-VillamizarL., Rojas-Martinez, R., Rosengren, A., Rubinstein, A., Rui, O., Ruiz-Betancourt, B., Horimoto, A., Rutkowski, M., Sabanayagam, C., Sachdev, H., Saidi, O., Sakarya, S., Salanave, B., Salazar Martinez, E., SalmerónD., Salomaa, V., Salonen, J., Salvetti, M., Sánchez-Abanto, J., Sans, S., Santos, D., Santos, I., dos Santos, R., Santos, R., Saramies, J., Sardinha, L., Margolis, G., Sarrafzadegan, N., Saum, K., Savva, S., Scazufca, M., Schargrodsky, H., Schneider, I., Schultsz, C., Schutte, A., Sen, A., Senbanjo, I., Sepanlou, S., Sharma, S., Shaw, J., Shibuya, K., Shin, D., Shin, Y., Siantar, R., Sibai, A., Silva, D., Simon, M., Simons, J., Simons, L., Sjöström, M., Skovbjerg, S., Slowikowska-Hilczer, J., Slusarczyk, P., Smeeth, L., Smith, M., Snijder, M., So, H., Sobngwi, E., Söderberg, S., Solfrizzi, V., Sonestedt, E., Song, Y., SørensenT., JéromeC., Soumare, A., Staessen, J., Starc, G., Stathopoulou, M., Stavreski, B., Steene-Johannessen, J., Stehle, P., Stein, A., Stergiou, G., Stessman, J., Stieber, J., Stöckl, D., Stocks, T., Stokwiszewski, J., Stronks, K., Strufaldi, M., Sun, C., Sundström, J., Sung, Y., Suriyawongpaisal, P., Sy, R., Tai, E., Tammesoo, M., Tamosiunas, A., Tang, L., Tang, X., Tanser, F., Tao, Y., Tarawneh, M., Tarqui-Mamani, C., Taylor, A., Theobald, H., Thijs, L., Thuesen, B., Tjonneland, A., Tolonen, H., Tolstrup, J., Topbas, M., Topór-MadryR., Tormo, M., Torrent, M., Traissac, P., Trichopoulos, D., Trichopoulou, A., Trinh, O., Trivedi, A., Tshepo, L., Tulloch-Reid, M., Tuomainen, T., Tuomilehto, J., Turley, M., Tynelius, P., Tzourio, C., Ueda, P., Ugel, E., Ulmer, H., Uusitalo, H., Valdivia, G., Valvi, D., van der Schouw, Y., Van Herck, K., van Rossem, L., van Valkengoed, I., Vanderschueren, D., Vanuzzo, D., Vatten, L., Vega, T., Velasquez-Melendez, G., Veronesi, G., Verschuren, W., Verstraeten, R., Victora, C., Viet, L., Viikari-Juntura, E., Vineis, P., Vioque, J., Virtanen, J., Visvikis-Siest, S., Viswanathan, B., Vollenweider, P., Voutilainen, S., Vrdoljak, A., Vrijheid, M., Wade, A., Wagner, A., Walton, J., Mohamud, W., Wang, M., Wang, Q., Wang, Y., Wannamethee, S., Wareham, N., Wederkopp, N., Weerasekera, D., Whincup, P., Widhalm, K., Widyahening, I., Wiecek, A., Wijga, A., Wilks, R., Willeit, J., Willeit, P., Williams, E., Wilsgaard, T., Wojtyniak, B., Wong, T., Wong-McClure, R., Woo, J., Woodward, M., Wu, A., Wu, F., Wu, S., Xu, H., Yan, W., Yang, X., Ye, X., Yiallouros, P., Yoshihara, A., Younger-Coleman, N., Yusoff, A., Yusoff, M., Zambon, S., Zdrojewski, T., Zeng, Y., Zhao, D., Zhao, W., Zheng, Y., Zhu, D., Zimmermann, E. and Zuñiga CisnerosJ. (2016). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet [Online] 389:37-55. Available at: https://doi.org/10.1016/S0140-6736(16)31919-5.
  • Bentham, J. and NCD Risk Factor Collaboration (NCD-RisC), (2016). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet [Online] 387:1377-1396. Available at: http://dx.doi.org/10.1016/S0140-6736(16)30054-X.
    Background
    Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.

    Methods
    We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ?40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.

    Findings
    We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ?35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women.

    Interpretation
    If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.
  • Bentham, J. (2016). A century of trends in adult human height. eLife [Online]. Available at: https://doi.org/10.7554/eLife.13410.001.
    Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
  • Bentham, J. and NCD Risk Factor Collaboration (NCD-RisC), (2015). Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants. Lancet Diabetes and Endocrinology [Online] 3:624-637. Available at: https://doi.org/10.1016/S2213-8587(15)00129-1.
  • Bentham, J., Morris, D., Cunninghame Graham, D., Pinder, C., Tombleson, P., Behrens, T., MartínJ., Fairfax, B., Knight, J., Chen, L., Replogle, J., SyvänenA., Rönnblom, L., Graham, R., Wither, J., Rioux, J., Alarcón-RiquelmeM. and Vyse, T. (2015). Genetic association analyses implicate aberrant regulation of innate and adaptive immunity genes in the pathogenesis of systemic lupus erythematosus. Nature Genetics [Online] 47:1457-1464. Available at: https://doi.org/10.1038/ng.3434.
    Systemic lupus erythematosus (SLE) is a genetically complex autoimmune disease characterized by loss of immune tolerance to nuclear and cell surface antigens. Previous genome-wide association studies (GWAS) had modest sample sizes, reducing their scope and reliability. Our study comprised 7,219 cases and 15,991 controls of European ancestry, constituting a new GWAS, a meta-analysis with a published GWAS and a replication study. We have mapped 43 susceptibility loci, including ten new associations. Assisted by dense genome coverage, imputation provided evidence for missense variants underpinning associations in eight genes. Other likely causal genes were established by examining associated alleles for cis-acting eQTL effects in a range of ex vivo immune cells. We found an over-representation (n = 16) of transcription factors among SLE susceptibility genes. This finding supports the view that aberrantly regulated gene expression networks in multiple cell types in both the innate and adaptive immune response contribute to the risk of developing SLE.
  • Bentham, J. and Vyse, T. (2013). The development of genome-wide association studies and their application to complex diseases, including lupus. Lupus [Online] 22:1205-1213. Available at: https://doi.org/10.1177/0961203313492870.
    In this review, we explain the motivation for carrying out genome-wide association studies (GWAS), contrasting the achievements of linkage-based experiments for Mendelian traits with the difficulties found when applying that type of experiment to complex diseases. We explain the technical and organizational developments that were required to make GWAS feasible, as well as some of the theoretical concerns that were raised during the design of these studies.

    We describe the impressive achievements of GWAS in lupus, and compare them with the experiences in three other genetically complex disorders: rheumatoid arthritis, type 1 diabetes and coronary heart disease. GWAS have been successful in identifying many new susceptibility loci for these four diseases, and have provided the motivation for novel immunological work.

    We conclude by describing preliminary steps that have been taken towards translating the results of GWAS into improvements in patient care, explaining some of the difficulties involved, as well as successes that have already been achieved.
  • Bentham, J. and Hand, D. (2011). Data mining from a patient safety database: the lessons learned. Data Mining and Knowledge Discovery [Online] 24:195-217. Available at: https://doi.org/10.1007/s10618-011-0225-y.
    The issue of patient safety is an extremely important one; each year in the UK, hundreds of thousands of people suffer due to some sort of incident that occurs whilst they are in National Health Service care. The National Patient Safety Agency (NPSA) works to try to reduce the scale of the problem. One of its major projects is to collect a very large dataset, the Reporting and Learning System (RLS), which describes several million of these incidents. The RLS is used as the basis for research by the NPSA. However, the NPSA has identified a gap in their work between high-level quantitative analysis and detailed, manual analysis of small samples. This paper describes the lessons learned from a knowledge discovery process that attempted to fill this gap. The RLS contains a free text description of each incident. A high dimensional model of the text is calculated, using the vector space model with term weighting applied. Dimensionality reduction techniques are used to produce the final models of the text. These models are examined using an anomaly detection tool to find groups of incidents that should be coherent in meaning, and that might be of interest to the NPSA. A three stage process is developed for assessing the results. The first stage uses a quantitative measure based on the use of planted groups of known interest, the second stage involves manual filtering by a non-expert, and the third stage is assessment by clinical experts.

Forthcoming

  • Bentham, J. (2019). Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature [Online] 569:260-264. Available at: http://dx.doi.org/10.1038/s41586-019-1171-x.
    Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
  • Benhtam, J. (2019). National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: an analysis of trends in Asian and Western countries. International Journal of Epidemiology.
    Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have
    opposite associations with coronary heart disease (CHD), multi-country reports of lipid trends
    only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL
    cholesterol and total-to-HDL cholesterol ratio in Asian and Western countries.
    Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian
    and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol,
    and mean total-to-HDL cholesterol ratio by country, sex and age group.
    Results: Since ~1980, mean TC increased in Asian countries. In Japan and South Korea, TC
    rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in
    Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western
    countries, except in Polish men. The decline was largest in Finland and Norway, ~0.4 mmol/L
    per decade. The decline in TC in most Western countries was the net effect of an increase in
    HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase
    largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan,
    South Korea and most Western countries, by as much as ~0.7 per decade in Swiss men
    (equivalent to ~26% decline in CHD risk per decade). The ratio increased in China.
    Conclusions: HDL cholesterol has risen and total-to-HDL cholesterol ratio has declined in
    many Western countries, Japan and South Korea, with only weak correlation to changes in TC
    or non-HDL cholesterol.
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