Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
Public Health. 2024 Jul;232:45-51. doi: 10.1016/j.puhe.2024.04.015. Epub 2024 May 11.
Overweight and obesity (OWOB) starts in childhood, influences adult cardiovascular risk, and is not equally distributed across ethnic groups. It is unclear which effects can be expected from reductions in OWOB across the life course on inequalities in cardio-metabolic diseases in a multi-ethnic population. This study aims to estimate the effects of three scenarios of changes in OWOB (the Normal-Weight-for-All scenario, the No-Ethnic-Difference-over-the-Life-Course scenario, the and No-Ethnic-Differences-in-Childhood scenario).
A simulation study.
We combine data from multiple data sources and use the Dynamic Modeling for Health Impact Assessment (DYNAMO-HIA) model to estimate the effects of three scenarios on the cumulative incidence of diabetes mellitus, ischaemic heart disease (IHD) and stroke between 18 and 70 years in the five largest ethnic groups in the Netherlands.
In the scenario where all individuals have normal weight, the cumulative incidence decreased in all ethnic minority groups for all diseases, with largest decreases among South-Asian Surinamese, where the reduction of diabetes incidence exceeded 50%. In the scenario where the prevalence of OWOB in each ethnic-minority group was reduced to the current level among the Dutch-origin population, ethnic inequalities in cardio-metabolic diseases were substantially reduced, particularly when lowered prevalence of OWOB persisted across the lifespan. Reductions were the largest for diabetes and for the Asian Surinamese population.
A substantial part of the well-known ethnic inequalities in incidence of diabetes, IHD, and stroke can be attributed to OWOB. Interventions aimed at reducing OWOB have clear potential to reduce the health inequalities in these outcomes, especially for diabetes, in particular when they have an impact across the lifespan.
超重和肥胖（OWOB）始于儿童时期，影响成人心血管风险，且在不同种族群体中的分布不均。目前尚不清楚在多民族人群中，通过终生降低 OWOB 可以预期对心血管代谢疾病不平等产生哪些影响。本研究旨在估计 OWOB 变化的三种情景（所有人群的正常体重情景、终生无种族差异情景、儿童期无种族差异情景）对心血管代谢疾病不平等的影响。
模拟研究。
我们结合了多个数据源的数据，并使用动态健康影响评估模型（DYNAMO-HIA）来估计这三种情景对荷兰五个最大种族群体 18 至 70 岁之间糖尿病、缺血性心脏病（IHD）和中风累积发病率的影响。
在所有个体均正常体重的情景下，所有少数族裔群体的所有疾病的累积发病率都有所下降，其中南亚苏里南人下降幅度最大，糖尿病发病率下降超过 50%。在 OWOB 患病率在每个少数族裔群体中都降低到荷兰裔人群当前水平的情景下，心血管代谢疾病的种族不平等大大减少，特别是当 OWOB 的低流行率贯穿整个生命周期时。减少幅度最大的是糖尿病和亚洲苏里南人。
众所周知的糖尿病、IHD 和中风发病率的种族不平等很大程度上归因于 OWOB。旨在降低 OWOB 的干预措施具有明显的潜力，可以降低这些结果的健康不平等，特别是在糖尿病方面，特别是当它们对整个生命周期都有影响时。
