Prevalence of overweight and obesity in incarcerated individuals in developed and developing countries: a systematic review and meta-analysis

We systematically assessed evidence of overweight and obesity prevalence, and possible determinants, in people who experience incarceration globally. We searched Embase, Medline, and Cochrane databases. Overweight and obesity proportions were pooled into a meta-analysis and compared with national prevalences. 71 studies met the inclusion criteria; 38 were included in the meta-analysis. Studies in high8 income countries reported higher proportions of overweight and obesity (73.3%, 95% CI 73.1, 73.5) than upper-middle-income countries (66.1%, 95% CI 64.1, 67.7) and lower10 middle-income countries (52.8%, 95% CI 47.1, 58.1). The prevalence of overweight and obesity in female incarcerated individuals was higher than that in the general population (RD 11.7%, 95% CI 9.1, 14.3), especially in low and middle-income countries (RD 35.1%, 95% CI 29.4, 40.7). The prevalence of overweight and obesity in male incarcerated individuals was lower than that in the general population in all income categories (RD -10.8%, 95% CI - 13.2, -8.4). Incarcerated individuals in low and lower-middle income countries were less likely to achieve sufficient energy intake, fruit/vegetables, and sufficient physical activity, compared with high- and upper-middle-income countries. The prevalence of overweight and obesity in incarcerated populations differed between developed and developing countries. Future research should focus on female incarcerated individuals, especially in lower-middle-income countries