The George Institute for Global Health, University of New South Wales, Kensington, NSW, 2042, Australia.
The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia.
Int J Obes (Lond). 2019 Apr;43(4):782-789. doi: 10.1038/s41366-018-0210-2. Epub 2018 Oct 3.
BACKGROUND/OBJECTIVES: Adult obesity has been shown to substantially heighten the risk of adverse health outcomes but its impact on life expectancy (LE) has not been quantified in Australia. Our aim is to estimate reductions in LE and years of life lost (YLL) associated with overweight and obesity, relative to those at a healthy weight for Australian adults aged 20-69 years.
SUBJECTS/METHODS: We used a microsimulation model of obesity progression in Australia that integrates annual change in BMI based on age and sex, with Australian life-table data and published relative risk of all-cause mortality for different BMI categories. Remaining LE and YLL compared to healthy weight were estimated using 10-year cohorts, by sex. A nationally representative sample of 12,091 adults aged 20-69 from the 2014/15 Australian National Health Survey were used to represent the input population of 14.9 million.
Estimated remaining years of LE for healthy weight men and women aged 20-29 years was approximately 57.0 (95% CI 56.7-57.4) and 59.7 (95% CI 59.4-60.0) years, respectively. YLL associated with being overweight at baseline was approximately 3.3 years. For those obese and severely obese the loss in LE was predicted to be 5.6-7.6 years and 8.1-10.3 years for men and women aged 20-29 years, respectively. Across men and women, excess BMI in the adult population is responsible for approximately 36.3 million YLLs. Men stand to lose 27.7% more life years compared to women.
Overweight and obesity is associated with premature mortality at all ages, for both men and women. Adults aged 20-39 years with severe obesity will experience the largest YLL, relative to healthy weight. More needs to be done in Australia to establish a coherent, sustained, cost-effective strategy to prevent overweight and obesity, particularly for men in early adulthood.
背景/目的：成人肥胖已被证明会大大增加不良健康后果的风险，但尚未在澳大利亚量化其对预期寿命（LE）的影响。我们的目的是估计澳大利亚 20-69 岁成年人超重和肥胖相对于健康体重的 LE 减少和生命损失年（YLL）。
我们使用了澳大利亚肥胖进展的微观模拟模型，该模型将 BMI 的年度变化与年龄和性别结合在一起，结合了澳大利亚生命表数据和不同 BMI 类别全因死亡率的已发表相对风险。通过按性别对 10 年队列进行比较，估算与健康体重相比剩余的 LE 和 YLL。使用来自 2014/15 年澳大利亚国家健康调查的 12091 名 20-69 岁成年人的全国代表性样本来代表 1490 万输入人群。
估计健康体重的 20-29 岁男性和女性的剩余 LE 约为 57.0（95%CI 56.7-57.4）和 59.7（95%CI 59.4-60.0）年。基线超重的 YLL 约为 3.3 年。对于 20-29 岁的男性和女性肥胖和重度肥胖，LE 丧失预计分别为 5.6-7.6 年和 8.1-10.3 年。在男性和女性中，成年人的超重和肥胖导致大约 3630 万 YLL。与女性相比，男性损失的生命年数多 27.7%。
超重和肥胖与所有年龄段的过早死亡有关，无论男女。患有严重肥胖症的 20-39 岁成年人相对于健康体重，将经历最大的 YLL。澳大利亚需要采取更多措施，制定一致、持续、具有成本效益的策略来预防超重和肥胖，尤其是在年轻人中。
