Trends in the prevalence of underweight in women across generations in Japan
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LETTER TO THE EDITOR
Trends in the prevalence of underweight in women across generations in Japan Hikaru Otsuka1 · Hiroki Tabata2 · Yuki Someya1,2 · Yoshifumi Tamura1,2,3,4 Received: 16 October 2020 / Accepted: 21 October 2020 © The Japanese Society Bone and Mineral Research 2020
Keywords Underweight women · Body mass index · Sarcopenia · Osteoporosis We have read with great interest the article by Kanazawa et al. [1]. They summarized clinical practice guide on fracture risk in lifestyle disease including type 2 diabetes (T2DM). Accordingly, we are strongly concerned that the number of underweight women with type 2 diabetes, highrisk phenotype of fractures, could greatly increase in the future in Japan. Underweight (BMI 18.5 kg/m2 or less) women are not only at risk of fractures [2], but also they are at risk of developing T2DM [3], the latter is not well recognized in clinical setting. Underweight women have approximately double the risk for T2DM compared to normal weight [3]. According to the NCD Risk Factor Collaboration database, in 2016, the prevalence of underweight in women was 9.3% in Japan, the highest in developed countries. In particular, the rate of young underweight women significantly increased from 12.7 to 19.8% between 1982 and 2018 (National Nutrition Survey, Japan (NNS-J)); it was much higher than that in young women in other developed countries in East Asia (Korea; 12.1%) (KNHANES, 2018) and North America (U.S.; 3.8%) (NHANES, 2018). Since BMI at young is correlated with BMI at middle age [4], the generation of women with a higher prevalence of * Yoshifumi Tamura ys‑[email protected] 1
Juntendo University Graduate School of Medicine, 2‑1‑1 Hongo, Bunkyo‑ku, Tokyo 113‑8421, Japan
2
Sportology Center, Juntendo University Graduate School of Medicine, 2‑1‑1 Hongo, Bunkyo‑ku, Tokyo 113‑8421, Japan
3
Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2‑1‑1 Hongo, Bunkyo‑ku, Tokyo 113‑8421, Japan
4
Faculty of International Liberal Arts, Juntendo University, 2‑1‑1 Hongo, Bunkyo‑ku, Tokyo 113‑8421, Japan
underweight at a younger age may have a higher prevalence of underweight at an older age. If so, the younger generation of women with a higher prevalence of underweight may have multiple risk factors for fractures such as underweight at both young age and older age [5] and type 2 diabetes later in life. Thus, evaluating the prevalence pattern of underweight in Japanese women over the life course would be beneficial in estimating future negative health outcomes caused by underweight. We investigated the trends in the prevalence of underweight in women across generations in Japan. Using the data available in the NNS-J database (1975–2018), we evaluated the trends in the prevalence of underweight among Japanese women between their 20 and 60 s in each generation per decade. As shown in Fig. 1, the prevalence of underweight in women in their 20 s was increased in the three generations born after 1959 (e.g., 1959–1968, 1969–1978, and 1979–1988) compared with
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