A record number of one in five children around the world are overweight or obese, a major study has found.
In the “most comprehensive study to date,” researchers in China analyzed more than 2,000 studies involving nearly 46 million children and teens from more than 150 countries or regions between 2000 and 2023.
Puerto Rico topped the list, with 28 percent of children qualifying as obese. The U.S. territory was closely followed by the South Pacific islands of French Polynesia (22 percent), the Bahamas (21.3 percent), Kuwait (20.5 percent) and Samoa (19.3 percent).
The US, meanwhile, came in at 18.6 percent, putting it at number seven on the list. In Britain, 7.6 percent of children were obese, putting this 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 shows 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 east coast of Australia, only 0.4 percent of children are obese. This was closely followed by the South Asian country Bhutan (0.5 percent) and Senegal (0.8 percent).
In terms of regions, Polynesia – which includes countries such as French Polynesia, Tonga, Somoa and New Zealand – topped the list, with almost 20 percent of children qualifying as obese.
The data confirms previous findings suggesting that Polynesian countries have a higher obesity rate, although other reports on overweight children ranked the US significantly lower.
The researchers blame higher obesity rates on diets filled with ultra-processed foods, especially in the US and areas like Puerto Rico.
“European countries and the US often embrace a dietary preference of processed foods, which are typically high in unhealthy fats, added sugars and refined carbohydrates,” the team wrote.
“In contrast, diets rich in whole grains and vegetables, which are generally considered healthier options, have historically been prioritized in Southeast Asian countries.”
In Japan, for example, only four percent of children qualify as obese.
A sedentary lifestyle, skipping breakfast and not getting enough exercise were also theories behind higher numbers.
Skipping breakfast has been shown to lead to less fullness throughout the day, which can lead to 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 includes countries such as French Polynesia, Tonga, Somoa and New Zealand – topped the list, with almost 20 percent of children qualifying as obese
The findings come after a report warned that deaths from obesity-related diseases such as heart disease and stroke have risen by 50 percent over the past two decades.
In the study, the average age of participants was 10 years, and there were almost as many boys as girls.
Of all 46 million participants, approximately 4.5 million 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 countries stood at 3.6 percent.
They also noted that race played a role, with Hispanic children most likely to be obese and Asian children the least likely.
As for the countries at the lower end of the spectrum, many of them are low-income countries with less food availability.
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 that different countries had limited data and different criteria for defining obesity.
The research was published on Monday in JAMA Pediatrics.