Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey.

Southampton Women's Survey causal modeling child and adolescent health dietary interventions health inequalities obesity

Journal

Obesity science & practice
ISSN: 2055-2238
Titre abrégé: Obes Sci Pract
Pays: United States
ID NLM: 101675151

Informations de publication

Date de publication:
Oct 2021
Historique:
received: 01 02 2021
revised: 26 03 2021
accepted: 02 05 2021
entrez: 11 10 2021
pubmed: 12 10 2021
medline: 12 10 2021
Statut: epublish

Résumé

In the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques. Using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities of childhood obesity was investigated. Predicted probabilities of obesity (using UK90 cut-offs) at age 6-7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy-relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake). At age 6-7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged. Simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.

Sections du résumé

BACKGROUND BACKGROUND
In the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques.
OBJECTIVES OBJECTIVE
Using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities of childhood obesity was investigated.
METHODS METHODS
Predicted probabilities of obesity (using UK90 cut-offs) at age 6-7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy-relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake).
RESULTS RESULTS
At age 6-7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged.
CONCLUSIONS CONCLUSIONS
Simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.

Identifiants

pubmed: 34631133
doi: 10.1002/osp4.520
pii: OSP4520
pmc: PMC8488449
doi:

Types de publication

Journal Article

Langues

eng

Pagination

545-554

Subventions

Organisme : Medical Research Council
ID : MC_UU_12011/4
Pays : United Kingdom

Informations de copyright

© 2021 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

Déclaration de conflit d'intérêts

The authors have no competing interests to declare.

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Auteurs

Simon J Russell (SJ)

Obesity Policy Research Unit Population, Policy and Practice Great Ormond Street Institute of Child Health University College London London UK.

Steven Hope (S)

Obesity Policy Research Unit Population, Policy and Practice Great Ormond Street Institute of Child Health University College London London UK.

Helen Croker (H)

Obesity Policy Research Unit Population, Policy and Practice Great Ormond Street Institute of Child Health University College London London UK.

Sarah Crozier (S)

MRC Lifecourse Epidemiology Unit Medicine University of Southampton Southampton UK.
NIHR Applied Research Collaboration Wessex Southampton Science Park Innovation Centre Southampton UK.

Jessica Packer (J)

Obesity Policy Research Unit Population, Policy and Practice Great Ormond Street Institute of Child Health University College London London UK.

Hazel Inskip (H)

MRC Lifecourse Epidemiology Unit Medicine University of Southampton Southampton UK.
NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK.

Russell M Viner (RM)

Obesity Policy Research Unit Population, Policy and Practice Great Ormond Street Institute of Child Health University College London London UK.

Classifications MeSH