ABC | Volume 113, Nº2, August 2019

Editorial Jardim Overweight, the cardiovascular risk of the century Arq Bras Cardiol. 2019; 113(2):185-187 Figure 1 – Nutritional status based on body mass index (n = 685). Firminópolis, Brazil (2002–2015). *Significant p = 0.05. Male (%) Female (%) 80 70 60 50 40 30 20 10 0 80 70 60 50 40 30 20 10 0 * * * * * 45.8 30.3 44.2 44.2 10.0 25.5 53.6 30.2 29.7 35.4 16.7 34.3 Weight Weight normal overweight obesity normal overweight obesity 1. Simão AF, Precoma DB, Andrade JP, Correa Filho H, Saraiva JFK, Oliveira GMM,Sociedade Brasileira de Cardiologia., et al. I Diretriz Brasileira de Prevenção Cardiovascular. Arq Bras Cardiol. 2013;101(6 Supl 2):1-63. 2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet 2014;384(9945):766–81. 3. NCD Risk Factor Collaboration (NCD-RisC). 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. 2016;387(10026):1377-96. 4. The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017; 377(1):13-27. 5. Flores-Ortiz R, MaltaDC, Velasquez-Melendez G (2019) Adult body weight trends in 27 urban populations of Brazil from 2006 to 2016: A population- based study. PLoS One.2019;14(3):e0213254. 6. Schmidt, MI, Duncan BB, Mill JG, Lotufo PA, Chor D, Barreto SM, et. al. Cohort Profile: Longitudinal Study of Adult Health (ELSA-Brasil). Int J Epidemiol., 2015,44(1):68-75. 7. Souza LG, Jardim TV, Rezende AC, Sousa ALL, Moreira HG, Perillo NB, et. al. Predictors of overweight/obesity in a Brazilian cohort after 13 years of follow-up. Nutr J.2018;17(1):10. 8. Crispim PA,  Peixoto MR,  Jardim PC. Risk factors associated with high blood pressure in two-to five-year-old children.. Arq Bras Cardiol. 2014, 102(1):39-46. 9. Monego ET , Jardim PC. Determinants of risk of cardiovascular diseases in schoolchildren. Arq Bras Cardiol. 2006;87(1):37-45. 10. Jardim TV, Gaziano TA, Nascente FM, Carneiro CS, Morais P, Roriz V, et al. Multiple cardiovascular risk factors in adolescents from a middle-income country: Prevalence and associated factors. PLoS One. 2018;13(7):e0200075. References older school children (7 to 14 years old), also in the Midwest region, found 16% of overweight children and 4.9% of obese children, revealing the same trend since childhood. 9 Finally, wrapping up the cycle, in the evaluation of school adolescents (12 to 17 years old), two population-based studies, one representing a city and another representing the whole country – the studies CORADO and ERICA – found overweight percentages of 23.3% and 17.1%, respectively. 10,11 There is no other way of looking at it: it is an epidemic, it ravages the world, it grows rapidly and is not effectively tackled. The scientific community has not realized the seriousness of this issue, it still works from a “treatment” perspective and is very shy when it comes to primary prevention, as it was clearly outlined in recent documents from the European Society of Hypertension and the European Association for the Study of obesity. 12,13 We already have strong indications that incentives or even restrictive measures with taxation of certain products that may be considered harmful are cost-effective and may potentially lead us to a safer spot. 14,15 It is really a time for taking action, for us to stop being doctors of illness and acting from the perspective of real healthcare professionals. We should all make more of an effort. And that includes each individual from society and especially from the government. Tackling overweight should be a government policy in pursuit of an effective action nationwide, otherwise we will move towards an even darker future in terms of cardiovascular disease. 186