The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia.
School of Public Health, Faculty of Medicine, The University of Sydney, Sydney 2042, Australia.
Nutrients. 2017 Sep 6;9(9):983. doi: 10.3390/nu9090983.
Interventions targeting portion size and energy density of food and beverage products have been identified as a promising approach for obesity prevention. This study modelled the potential cost-effectiveness of: a package size cap on single-serve sugar sweetened beverages (SSBs) >375 mL ( ), and product reformulation to reduce energy content of packaged SSBs ( ). The cost-effectiveness of each intervention was modelled for the 2010 Australia population using a multi-state life table Markov model with a lifetime time horizon. Long-term health outcomes were modelled from calculated changes in body mass index to their impact on Health-Adjusted Life Years (HALYs). Intervention costs were estimated from a limited societal perspective. Cost and health outcomes were discounted at 3%. Total intervention costs estimated in AUD 2010 were AUD 210 million. Both interventions resulted in reduced mean body weight ( : 0.12 kg; : 0.23 kg); and HALYs gained ( : 73,883; energy : 144,621). Cost offsets were estimated at AUD 750.8 million ( ) and AUD 1.4 billion ( ). Cost-effectiveness analyses showed that both interventions were "dominant", and likely to result in long term cost savings and health benefits. A package size cap and kJ reduction of SSBs are likely to offer excellent "value for money" as obesity prevention measures in Australia.
针对食品和饮料产品份量大小和能量密度的干预措施已被确定为预防肥胖的一种有前途的方法。本研究建立了以下两种方案的潜在成本效益模型:
对单份含糖饮料(SSB)的包装大小进行限制,容量大于 375 毫升( );
对包装 SSB 的能量含量进行产品配方改革( )。
使用具有终生时间范围的多状态生命表马尔可夫模型,对 2010 年澳大利亚人口的每种干预措施的成本效益进行建模。从计算得出的体重指数变化到对健康调整生命年(HALYs)的影响,对长期健康结果进行建模。干预成本从有限的社会角度进行估算。成本和健康结果以 3%贴现。按 2010 年澳元计算,总干预成本估计为 2.1 亿澳元。这两种干预措施都导致平均体重降低( :0.12 千克; :0.23 千克)和 HALYs 增加( :73883 人年;能量 :144621 人年)。成本抵消估计为 7.508 亿澳元( )和 14 亿澳元( )。成本效益分析表明,这两种干预措施都是“占优势的”,很可能会带来长期的成本节约和健康效益。作为澳大利亚预防肥胖的措施,包装尺寸限制和 SSB 的 kJ 减少很可能提供极好的“物有所值”。