School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Research and Training Centre for Community Development, Hanoi, Vietnam.
BMC Public Health. 2022 Apr 4;22(1):645. doi: 10.1186/s12889-022-13061-8.
There is limited evidence about lifetime burden of child malnutrition. This study aimed to estimate the lifetime impact of being underweight or overweight/obese during childhood in Vietnam.
We developed a life table model in combination with a Markov model for Vietnamese children aged 5-19 years and simulated until they reached 75 years of age or died using published data. The starting year was 2019 and the model estimated number of deaths, years of life lived and quality-adjusted life years (QALY) with an annual discount rate of 3%. We performed scenario, one-way, and probabilistic sensitivity analyses to assess the impact of uncertainties in input parameters.
The model estimated 9.68 million deaths (6.44 million men and 3.24 million women), 622 million years of life lived (317 million men and 305 million women), and 601 million QALYs (308 million men and 293 million women). Scenario analyses showed that the reduction in either underweight or overweight/obesity alone, and reduction in both underweight and overweight/obesity resulted in fewer deaths, more years of life lived and more QALYs gained. In the scenario where everyone was a healthy weight, the model estimated 577,267 fewer deaths (6.0% less), 2 million more years of life lived (0.3% more), and 3 million QALYs gained (0.6% more) over base-case results which represents current situation in Vietnam.
Our results suggest that addressing underweight and overweight/obesity will contribute to reducing deaths and increasing years of life lived and QALYs. Policies and interventions in alignment with Sustainable Development Goals to address underweight and overweight/obesity are necessary to achieve health for all.
关于儿童期营养不良的终身负担,证据有限。本研究旨在估计越南儿童期体重过轻或超重/肥胖对其一生的影响。
我们为 5-19 岁的越南儿童开发了一个生命表模型,结合马尔可夫模型进行模拟,直至他们达到 75 岁或死亡,使用已发表的数据。起始年份为 2019 年,该模型估计死亡人数、生命年数和质量调整生命年(QALY),贴现率为每年 3%。我们进行了情景、单向和概率敏感性分析,以评估输入参数不确定性的影响。
该模型估计有 968 万人死亡(644 万男性和 324 万女性)、6.22 亿生命年数(3.17 亿男性和 3.05 亿女性)和 6.01 亿 QALY(3.08 亿男性和 2.93 亿女性)。情景分析表明,单独减少体重过轻或超重/肥胖,以及同时减少体重过轻和超重/肥胖,都会导致死亡人数减少、生命年数增加和 QALY 增加。在每个人都处于健康体重的情况下,该模型估计会减少 577,267 人死亡(减少 6.0%)、增加 200 万年的生命年数(增加 0.3%)和增加 300 万 QALY(增加 0.6%),这代表了越南目前的情况。
我们的结果表明,解决体重过轻和超重/肥胖问题将有助于减少死亡人数、增加生命年数和提高 QALY。为实现全民健康,有必要制定符合可持续发展目标的政策和干预措施,以解决体重过轻和超重/肥胖问题。