The potential impact fraction of population weight reduction scenarios on non-communicable diseases in Belgium: application of the g-computation approach.

Health impact assessment Health policy Non-communicable diseases Overweight Potential impact fractions g-computation

Journal

BMC medical research methodology
ISSN: 1471-2288
Titre abrégé: BMC Med Res Methodol
Pays: England
ID NLM: 100968545

Informations de publication

Date de publication:
14 Apr 2024
Historique:
received: 20 07 2023
accepted: 04 04 2024
medline: 15 4 2024
pubmed: 15 4 2024
entrez: 14 4 2024
Statut: epublish

Résumé

Overweight is a major risk factor for non-communicable diseases (NCDs) in Europe, affecting almost 60% of all adults. Tackling obesity is therefore a key long-term health challenge and is vital to reduce premature mortality from NCDs. Methodological challenges remain however, to provide actionable evidence on the potential health benefits of population weight reduction interventions. This study aims to use a g-computation approach to assess the impact of hypothetical weight reduction scenarios on NCDs in Belgium in a multi-exposure context. Belgian health interview survey data (2008/2013/2018, n = 27 536) were linked to environmental data at the residential address. A g-computation approach was used to evaluate the potential impact fraction (PIF) of population weight reduction scenarios on four NCDs: diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) disease. Four scenarios were considered: 1) a distribution shift where, for each individual with overweight, a counterfactual weight was drawn from the distribution of individuals with a "normal" BMI 2) a one-unit reduction of the BMI of individuals with overweight, 3) a modification of the BMI of individuals with overweight based on a weight loss of 10%, 4) a reduction of the waist circumference (WC) to half of the height among all people with a WC:height ratio greater than 0.5. Regression models were adjusted for socio-demographic, lifestyle, and environmental factors. The first scenario resulted in preventing a proportion of cases ranging from 32.3% for diabetes to 6% for MSK diseases. The second scenario prevented a proportion of cases ranging from 4.5% for diabetes to 0.8% for MSK diseases. The third scenario prevented a proportion of cases, ranging from 13.6% for diabetes to 2.4% for MSK diseases and the fourth scenario prevented a proportion of cases ranging from 36.4% for diabetes to 7.1% for MSK diseases. Implementing weight reduction scenarios among individuals with excess weight could lead to a substantial and statistically significant decrease in the prevalence of diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) diseases in Belgium. The g-computation approach to assess PIF of interventions represents a straightforward approach for drawing causal inferences from observational data while providing useful information for policy makers.

Sections du résumé

BACKGROUND BACKGROUND
Overweight is a major risk factor for non-communicable diseases (NCDs) in Europe, affecting almost 60% of all adults. Tackling obesity is therefore a key long-term health challenge and is vital to reduce premature mortality from NCDs. Methodological challenges remain however, to provide actionable evidence on the potential health benefits of population weight reduction interventions. This study aims to use a g-computation approach to assess the impact of hypothetical weight reduction scenarios on NCDs in Belgium in a multi-exposure context.
METHODS METHODS
Belgian health interview survey data (2008/2013/2018, n = 27 536) were linked to environmental data at the residential address. A g-computation approach was used to evaluate the potential impact fraction (PIF) of population weight reduction scenarios on four NCDs: diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) disease. Four scenarios were considered: 1) a distribution shift where, for each individual with overweight, a counterfactual weight was drawn from the distribution of individuals with a "normal" BMI 2) a one-unit reduction of the BMI of individuals with overweight, 3) a modification of the BMI of individuals with overweight based on a weight loss of 10%, 4) a reduction of the waist circumference (WC) to half of the height among all people with a WC:height ratio greater than 0.5. Regression models were adjusted for socio-demographic, lifestyle, and environmental factors.
RESULTS RESULTS
The first scenario resulted in preventing a proportion of cases ranging from 32.3% for diabetes to 6% for MSK diseases. The second scenario prevented a proportion of cases ranging from 4.5% for diabetes to 0.8% for MSK diseases. The third scenario prevented a proportion of cases, ranging from 13.6% for diabetes to 2.4% for MSK diseases and the fourth scenario prevented a proportion of cases ranging from 36.4% for diabetes to 7.1% for MSK diseases.
CONCLUSION CONCLUSIONS
Implementing weight reduction scenarios among individuals with excess weight could lead to a substantial and statistically significant decrease in the prevalence of diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) diseases in Belgium. The g-computation approach to assess PIF of interventions represents a straightforward approach for drawing causal inferences from observational data while providing useful information for policy makers.

Identifiants

pubmed: 38616261
doi: 10.1186/s12874-024-02212-7
pii: 10.1186/s12874-024-02212-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

87

Informations de copyright

© 2024. The Author(s).

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Auteurs

Ingrid Pelgrims (I)

Department of Chemical and Physical Health Risks, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium. Ingrid.pelgrims@sciensano.be.
Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium. Ingrid.pelgrims@sciensano.be.
Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium. Ingrid.pelgrims@sciensano.be.

Brecht Devleesschauwer (B)

Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
Department of Translational Physiology, Infectiology and Public Health, Ghent University, Salisburylaan 133, Hoogbouw, B-9820, Merelbeke, Belgium.

Stefanie Vandevijvere (S)

Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.

Eva M De Clercq (EM)

Department of Chemical and Physical Health Risks, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.

Johan Van der Heyden (J)

Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.

Stijn Vansteelandt (S)

Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium.

Classifications MeSH