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肥胖结局建模:降低成年人肥胖风险的影响可能大于降低儿童肥胖患病率。

Modelling obesity outcomes: reducing obesity risk in adulthood may have greater impact than reducing obesity prevalence in childhood.

机构信息

Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

Obes Rev. 2013 Jul;14(7):523-31. doi: 10.1111/obr.12029. Epub 2013 Apr 18.

Abstract

A common policy response to the rise in obesity prevalence is to undertake interventions in childhood, but it is an open question whether this is more effective than reducing the risk of becoming obese during adulthood. In this paper, we model the effect on health outcomes of (i) reducing the prevalence of obesity when entering adulthood; (ii) reducing the risk of becoming obese throughout adult life; and (iii) combinations of both approaches. We found that, while all approaches reduce the prevalence of chronic diseases and improve life expectancy, a given percentage reduction in obesity prevalence achieved during childhood had a smaller effect than the same percentage reduction in the risk of becoming obese applied throughout adulthood. A small increase in the probability of becoming obese during adulthood offsets a substantial reduction in prevalence of overweight/obesity achieved during childhood, with the gains from a 50% reduction in child obesity prevalence offset by a 10% increase in the probability of becoming obese in adulthood. We conclude that both policy approaches can improve the health profile throughout the life course of a cohort, but they are not equivalent, and a large reduction in child obesity prevalence may be reversed by a small increase in the risk of becoming overweight or obese in adulthood.

摘要

一种常见的应对肥胖患病率上升的政策反应是在儿童期进行干预,但在成年期降低肥胖风险是否比在儿童期降低肥胖风险更有效,这仍是一个悬而未决的问题。在本文中,我们建立了模型来研究以下措施对健康结果的影响:(i)降低进入成年时肥胖的流行率;(ii)降低整个成年期肥胖的风险;以及(iii)两者的组合。我们发现,虽然所有方法都能降低慢性病的患病率并延长预期寿命,但在儿童期实现的肥胖患病率的给定百分比降低,其效果小于在整个成年期应用的肥胖风险降低的相同百分比。在成年期肥胖风险增加的微小概率可以抵消儿童期超重/肥胖患病率的大幅降低,儿童肥胖患病率降低 50%带来的收益可以被成年期肥胖风险增加 10%所抵消。我们的结论是,这两种政策方法都可以改善整个队列的生命过程中的健康状况,但它们并不等效,在儿童期大幅降低肥胖患病率可能会被成年期肥胖风险的微小增加所逆转。

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