Differences in magnitude and rates of change in BMI distributions by socioeconomic and geographic factors in Mexico, Colombia, and Peru, 2005–2010

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Previous studies about obesity and its associated factors in low- and middle-income countries have been based mostly on women of reproductive age. Furthermore, disproportionally changing BMI distributions have been a challenge for its appropriate modeling. In this context, we assessed the magnitude and rate of change in BMI distribution by socioeconomic and geographic factors in both sexes in Latin American countries, modeling the shape of BMI distributions.


We used data from national surveys conducted in Mexico, Colombia, and Peru at two time points between 2005 and 2013 (N = 57,414, 13,5403, and 30,811, respectively). We estimated shapes of BMI distributions for 2005 and 2010, and assessed their changes, using the generalized additive model for location, scale, and shape (GAMLSS), in which BMI was assumed to follow a Box-Cox Power Exponential (BCPE) distribution.


In all the three countries, higher education was negatively associated with BMI in women but somewhat positive in men; and household wealth was positively associated in men but not in women. Lower household wealth was associated with higher rates of change in BMI distributions in women.


Education and household wealth were associated with BMI distributions and their change over time. Observed sex differences in these associations have implications for designing relevant policies and programs to approach target populations effectively. The BCPE-GAMLSS method can provide a useful visual assessment of time-varying measures.

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We would like to thank Dr. Teresa Shamah-Levy and her colleagues at National Institute of Public Health, Mexico, and Dr. Jaime Miranda and Dr. Rodrigo Carrillo-Larco at Universidad Peruana Cayetano Heredia, for providing us information about survey methods used in conducting national health and nutritional surveys. We also thank Mr. Mark Miller at Joint High Performance Computing Exchange (JHPCE) Cluster, Johns Hopkins Bloomberg School of Public Health, for facilitating and troubleshooting the use of the cluster computer system.


This research received any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

GY formulated the research question, designed the study, carried out data analysis, and prepared the first draft. JCJS and CCS provided intellectual guidance and inputs in formulating the research question, designing the study, interpreting results, and writing the manuscript. LHM supervised the entire procedure and provided intellectual inputs at each step of this study.

Correspondence to Goro Yamada.

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This study was reviewed by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board and considered as secondary analyses of existing, de-identified and de-linked databases.

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